TY - JOUR
T1 - Smoking and Long-Term Risk of Type 2 Diabetes
T2 - The EPIC-InterAct Study in European Populations
AU - Spijkerman, Annemieke M W
AU - van der A, Daphne L
AU - Nilsson, Peter M
AU - Ardanaz, Eva
AU - Gavrila, Diana
AU - Agudo, Antonio
AU - Arriola, Larraitz
AU - Balkau, Beverley
AU - Beulens, Joline W
AU - Boeing, Heiner
AU - de Lauzon-Guillain, Blandine
AU - Fagherazzi, Guy
AU - Feskens, Edith J M
AU - Franks, Paul W
AU - Grioni, Sara
AU - Huerta, José María
AU - Kaaks, Rudolf
AU - Key, Timothy J
AU - Overvad, Kim
AU - Palli, Domenico
AU - Panico, Salvatore
AU - Redondo, M Luisa
AU - Rolandsson, Olov
AU - Roswall, Nina
AU - Sacerdote, Carlotta
AU - Sánchez, María-José
AU - Schulze, Matthias B
AU - Slimani, Nadia
AU - Teucher, Birgit
AU - Tjonneland, Anne
AU - Tumino, Rosario
AU - van der Schouw, Yvonne T
AU - Langenberg, Claudia
AU - Sharp, Stephen J
AU - Forouhi, Nita G
AU - Riboli, Elio
AU - Wareham, Nicholas J
AU - The InterAct Consortium
N1 - © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
PY - 2014/10/21
Y1 - 2014/10/21
N2 - OBJECTIVE: The aims of this study were to investigate the association between smoking and incident type 2 diabetes, accounting for a large number of potential confounding factors, and to explore potential effect modifiers and intermediate factors.RESEARCH DESIGN AND METHODS: The European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct is a prospective case-cohort study within eight European countries, including 12,403 cases of incident type 2 diabetes and a random subcohort of 16,835 individuals. After exclusion of individuals with missing data, the analyses included 10,327 cases and 13,863 subcohort individuals. Smoking status was used (never, former, current), with never smokers as the reference. Country-specific Prentice-weighted Cox regression models and random-effects meta-analysis were used to estimate hazard ratios (HRs) for type 2 diabetes.RESULTS: In men, the HRs (95% CI) of type 2 diabetes were 1.40 (1.26, 1.55) for former smokers and 1.43 (1.27, 1.61) for current smokers, independent of age, education, center, physical activity, and alcohol, coffee, and meat consumption. In women, associations were weaker, with HRs (95% CI) of 1.18 (1.07, 1.30) and 1.13 (1.03, 1.25) for former and current smokers, respectively. There was some evidence of effect modification by BMI. The association tended to be slightly stronger in normal weight men compared with those with overall adiposity.CONCLUSIONS: Former and current smoking was associated with a higher risk of incident type 2 diabetes compared with never smoking in men and women, independent of educational level, physical activity, alcohol consumption, and diet. Smoking may be regarded as a modifiable risk factor for type 2 diabetes, and smoking cessation should be encouraged for diabetes prevention.
AB - OBJECTIVE: The aims of this study were to investigate the association between smoking and incident type 2 diabetes, accounting for a large number of potential confounding factors, and to explore potential effect modifiers and intermediate factors.RESEARCH DESIGN AND METHODS: The European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct is a prospective case-cohort study within eight European countries, including 12,403 cases of incident type 2 diabetes and a random subcohort of 16,835 individuals. After exclusion of individuals with missing data, the analyses included 10,327 cases and 13,863 subcohort individuals. Smoking status was used (never, former, current), with never smokers as the reference. Country-specific Prentice-weighted Cox regression models and random-effects meta-analysis were used to estimate hazard ratios (HRs) for type 2 diabetes.RESULTS: In men, the HRs (95% CI) of type 2 diabetes were 1.40 (1.26, 1.55) for former smokers and 1.43 (1.27, 1.61) for current smokers, independent of age, education, center, physical activity, and alcohol, coffee, and meat consumption. In women, associations were weaker, with HRs (95% CI) of 1.18 (1.07, 1.30) and 1.13 (1.03, 1.25) for former and current smokers, respectively. There was some evidence of effect modification by BMI. The association tended to be slightly stronger in normal weight men compared with those with overall adiposity.CONCLUSIONS: Former and current smoking was associated with a higher risk of incident type 2 diabetes compared with never smoking in men and women, independent of educational level, physical activity, alcohol consumption, and diet. Smoking may be regarded as a modifiable risk factor for type 2 diabetes, and smoking cessation should be encouraged for diabetes prevention.
U2 - 10.2337/dc14-1020
DO - 10.2337/dc14-1020
M3 - Journal article
C2 - 25336749
SN - 0149-5992
VL - 37
SP - 3164
EP - 3171
JO - Diabetes Care
JF - Diabetes Care
IS - 12
ER -