Smoking, Smoking Cessation, and the Risk of Type 2 Diabetes among Japanese Adults: Japan Epidemiology Collaboration on Occupational Health Study.

• Main Authors: Shamima Akter, Hiroko Okazaki, Keisuke Kuwahara, Toshiaki Miyamoto, Taizo Murakami, Chii Shimizu, Makiko Shimizu, Kentaro Tomita, Satsue Nagahama, Masafumi Eguchi, Takeshi Kochi, Teppei Imai, Akiko Nishihara, Naoko Sasaki, Tohru Nakagawa, Shuichiro Yamamoto, Toru Honda, Akihiko Uehara, Makoto Yamamoto, Ai Hori, Nobuaki Sakamoto, Chihiro Nishiura, Takafumi Totsuzaki, Noritada Kato, Kenji Fukasawa, Ngoc M Pham, Kayo Kurotani, Akiko Nanri, Isamu Kabe, Tetsuya Mizoue, Tomofumi Sone, Seitaro Dohi, Japan Epidemiology Collaboration on Occupational Health Study Group
• Format: Article
• Language: English
• Published: Public Library of Science (PLoS) 2015-01-01
• Series: PLoS ONE
• Online Access: http://europepmc.org/articles/PMC4511672?pdf=render

To examine the association of smoking status, smoking intensity, and smoking cessation with the risk of type 2 diabetes (T2D) using a large database.The present study included 53,930 Japanese employees, aged 15 to 83 years, who received health check-up and did not have diabetes at baseline. Diabetes was defined as fasting plasma glucose ≥126 mg/dl, random plasma glucose ≥200 mg/dl, HbA1c ≥6.5% (≥48 mmol/mol), or receiving medication for diabetes. Cox proportional-hazards regression models were used to investigate the association between smoking and the risk of diabetes.During 3.9 years of median follow-up, 2,441 (4.5%) individuals developed T2D. The multivariable-adjusted hazard ratios (95% CI) for diabetes were 1 (reference), 1.16 (1.04 to 1.30) and 1.34 (1.22 to 1.48) for never smokers, former smokers, and current smokers, respectively. Diabetes risk increased with increasing numbers of cigarette consumption among current smokers (P for trend <0.001). Although the relative risk of diabetes was greater among subjects with lower BMIs (< 23 kg/m2), attributable risk was greater in subjects with higher BMIs (≥ 23 kg/m2). Compared with individuals who had never smoked, former smokers who quit less than 5 years, 5 to 9 years, and 10 years or more exhibited hazards ratios for diabetes of 1.36 (1.14 to 1.62), 1.23 (1.01 to 1.51), and 1.02 (0.85 to 1.23), respectively.Results suggest that cigarette smoking is associated with an increased risk of T2D, which may decrease to the level of a never smoker after 10 years of smoking cessation.