Smoking and Long-Term Risk of Type 2 Diabetes: The EPIC-InterAct Study in European Populations
Year: 2014
Type: article
Study design: Observational Study
Abstract: 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.
Source: Diabetes Care
DOI: 10.2337/dc14-1020
Authors: Annemieke M.W. Spijkerman, Daphne L. van der A, Peter M. Nilsson, Eva Ardanaz, Diana Gavrila, Antonio Agudo, Larraitz Arriola, Beverley Balkau, Joline W. Beulens, Heiner Boeing, Blandine de Lauzon-Guillain, Guy Fagherazzi, Edith J.M. Feskens, Paul W. Franks, Sara Grioni, José María Huerta, Rudolf Kaaks, Timothy J. Key, Kim Overvad, Domenico Palli, Salvatore Panico, M. Luisa Redondo, Olov Rolandsson, Nina Roswall, Carlotta Sacerdote, María-José Sánchez, Matthias B. Schulze, Nadia Slimani, Birgit Teucher, Anne Tjonneland, Rosario Tumino, Yvonne T. van der Schouw, Claudia Langenberg, Stephen J. Sharp, Nita G. Forouhi, Elio Riboli, Nicholas J. Wareham
Institutions: National Institute for Public Health and the Environment, Lund University, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Institut Català d'Oncologia, Basque Government, Biogipuzkoa Health Research Institute, Inserm, Centre de recherche en Epidémiologie et Santé des Populations, University Medical Center Utrecht, German Institute of Human Nutrition, Wageningen University & Research, Umeå University, Fondazione IRCCS Istituto Nazionale dei Tumori, German Cancer Research Center, University of Oxford, Aarhus University, Aalborg University Hospital, Aalborg University, Istituto per lo Studio e la Prevenzione Oncologica, Federico II University Hospital, University of Naples Federico II, Gobierno del Principado de Asturias, Danish Cancer Society, Italian institute for Genomic Medicine, Andalusian School of Public Health, Centre international de recherche sur le cancer, University of Ragusa, International Flame Research Foundation, MRC Epidemiology Unit, Imperial College London
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2123797536