Cigarette smoking and diabetes mellitus: evidence of a positive association from a large prospective cohort study
Abstract
OBJECTIVE: Only a few prospective studies have examined the relationship between the frequency of cigarette smoking and the incidence of diabetes mellitus. The purpose of this study was to determine whether greater frequency of cigarette smoking accelerated the development of diabetes mellitus, and whether quitting reversed the effect. METHODS: Data were collected in the Cancer Prevention Study I, a prospective cohort study conducted from 1959 through 1972 by the American Cancer Society where volunteers recruited more than one million acquaintances in 25 US states. From these over one million original participants, 275,190 men and 434,637 women aged > or = 30 years were selected for the primary analysis using predetermined criteria. RESULTS: As smoking increased, the rate of diabetes increased for both men and women. Among those who smoked > or = 2 packs per day at baseline, men had a 45% higher diabetes rate than men who had never smoked; the comparable increase for women was 74%. Quitting smoking reduced the rate of diabetes to that of non-smokers after 5 years in women and after 10 years in men. CONCLUSIONS: A dose-response relationship seems likely between smoking and incidence of diabetes. Smokers who quit may derive substantial benefit from doing so. Confirmation of these observations is needed through additional epidemiological and biological research.
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Changes in mental and physical health due to changes in health investments take time to materialise.
“Secondly, changes in mental and physical health due to changes in health investments take time to materialise (see Kim et al., 2012;Will et al., 2001 for cigarette consumption; Mansikkamäki et al., 2015 for physical activity; and Forsman et al., 2011; Umberson and Montez, 2010 for social interactions).”
From The relationship between physical and mental health: A mediation analysis (2017) · cites this paper as Will et al., 2001
Recent cohort studies suggest that smoking may be an independent and modifiable risk factor for the development of type 2 diabetes.
“Recent cohort studies suggest that smoking also may be an independent and modifiable risk factor for the development of type 2 diabetes.”
In the ACS Cancer Prevention Study cohort, quitting smoking reduced the incidence of diabetes to that of nonsmokers after 5 years in women and after 10 years in men.
“In that same cohort, quitting smoking reduced the incidence of diabetes to that of nonsmokers after 5 years in women and after 10 years in men.”
Among participants in the ACS Cancer Prevention Study cohort, men and women who smoked ≥2 packs per day at baseline had a 45% and 74% higher diabetes incidence rate than never smokers.
“Among participants in the ACS Cancer Prevention Study cohort, men and women who smoked Ն2 packs per day at baseline had a 45% and 74% (respectively) higher diabetes mellitus incidence rate than that of men and women who had never smoked.”
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- Authors
- Will, J. C., Galuska, D. A., Ford, E. S., Mokdad, A., & Calle, E. E.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Will, Julie C
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-06
- Volume
- 30
- Issue
- 3
- Pages
- 540-546
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2103147983
- Cited by
- 376
- References
- 29
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 10 · 2023: 12 · 2022: 14 · 2021: 14 · 2020: 16 · 2019: 14 · 2018: 20 · 2017: 24 · 2016: 20 · 2015: 18 · 2014: 23 · 2013: 18 · 2012: 20
- FWCI
- 5.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- cigarette smoking, diabetes mellitus, smoking frequency, smoking cessation, diabetes incidence, dose-response relationship, sex differences
- MeSH terms
- Adult, Diabetes Mellitus, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Risk Factors, Sex Factors, Smoking, United States, Incidence, Proportional Hazards Models
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