Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men

BMJ. 1995 Mar 4;310(6979):555-9. doi: 10.1136/bmj.310.6979.555.


Objective: To examine the association between smoking, alcohol consumption, and the incidence of non-insulin dependent diabetes mellitus in men of middle years and older.

Design: Cohort questionnaire study of men followed up for six years from 1986.

Setting: The health professionals' follow up study being conducted across the United States.

Subjects: 41,810 male health professionals aged 40-75 years and free of diabetes, cardiovascular disease, and cancer in 1986 and followed up for six years.

Main outcome measure: Incidence of non-insulin dependent diabetes mellitus diagnosed in the six years.

Results: During 230,769 person years of follow up 509 men were newly diagnosed with diabetes. After controlling for known risk factors men who smoked 25 or more cigarettes daily had a relative risk of diabetes of 1.94 (95% confidence interval 1.25 to 3.03) compared with non-smokers. Men who consumed higher amounts of alcohol had a reduced risk of diabetes (P for trend < 0.001). Compared with abstainers men who drank 30.0-49.9 g of alcohol daily had a relative risk of diabetes of 0.61 (95% confidence interval 0.44 to 0.91).

Conclusions: Cigarette smoking may be an independent, modifiable risk factor for non-insulin dependent diabetes mellitus. Moderate alcohol consumption among healthy people may be associated with increased insulin sensitivity and a reduced risk of diabetes.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / epidemiology
  • Body Mass Index
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / etiology*
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / epidemiology
  • Prospective Studies
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • United States / epidemiology