Association of cigarette smoking and tar and nicotine intake with development of type 2 diabetes mellitus in men and women from the general population: the MONICA/KORA Augsburg Cohort Study

Diabetologia. 2006 Aug;49(8):1770-6. doi: 10.1007/s00125-006-0298-0. Epub 2006 May 19.

Abstract

Aims/hypothesis: We examined sex-specific associations between cigarette smoking and incident type 2 diabetes mellitus in Germany.

Subjects, materials and methods: The study was based on 5,470 men and 5,422 women (aged 25-74 years) without diabetes who participated in one of the three population-based MONICA Augsburg surveys between 1984 and 1995. Incident cases of type 2 diabetes were assessed using follow-up questionnaires. Hazard ratios (HRs) were estimated from Cox proportional hazard models.

Results: Up to 31 December 2002 a total of 409 cases of incident type 2 diabetes among men and 263 among women were registered. The number of cigarettes and the nicotine and tar consumption per day were associated with a significantly increased risk of type 2 diabetes among men, but not among women; this could be due to the low power of the study in women. After multivariable adjustment, the HRs for type 2 diabetes compared with never-smokers were 1.48, 2.03 and 2.10 for men smoking 1 to 14, 15 to 19 and > or =20 cigarettes/day (p for trend <0.0001) and 1.25, 1.34 and 1.37 for women smoking 1 to 9, 10 to 19 and > or =20 cigarettes/day (p for trend 0.0985). Compared with never-smokers, the HRs for increasing tar intake in men (1-167, 168-259 and > or =260 mg/day) were 1.45, 2.32 and 2.07 (p for trend <0.0001); the respective HRs in women (1-89, 90-194 and > or =195 mg/day) were 1.18, 1.57 and 1.24 (p for trend 0.1159).

Conclusions/interpretation: Cigarette smoking is an important modifiable risk factor of type 2 diabetes particularly in men from the general population.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking
  • Cholesterol / blood
  • Coal Tar / adverse effects
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Dyslipidemias / epidemiology
  • Female
  • Germany / epidemiology
  • Humans
  • Hypertension / epidemiology
  • Male
  • Middle Aged
  • Nicotine / adverse effects*
  • Obesity / epidemiology
  • Physical Fitness
  • Smoking / adverse effects*

Substances

  • Nicotine
  • Coal Tar
  • Cholesterol