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Influence of smoking and snus on the prevalence and incidence of type 2 diabetes amongst men: the northern Sweden MONICA study

  1. M. Eliasson1,2,
  2. K. Asplund2,
  3. S. Nasic2,
  4. B. Rodu3

Article first published online: 15 JUL 2004

DOI: 10.1111/j.1365-2796.2004.01344.x

Issue

Journal of Internal Medicine

Journal of Internal Medicine

Volume 256, Issue 2, pages 101–110, August 2004

Additional Information

How to Cite

Eliasson, M., Asplund, K., Nasic, S. and Rodu, B. (2004), Influence of smoking and snus on the prevalence and incidence of type 2 diabetes amongst men: the northern Sweden MONICA study. Journal of Internal Medicine, 256: 101–110. doi: 10.1111/j.1365-2796.2004.01344.x

Author Information

  1. 1

    From the Department of Medicine, Sunderby Hospital, Luleå

  2. 2

    Department of Public Health and Clinical Medicine, Umeå University, Umeå; Sweden

  3. 3

    Department of Pathology, School of Medicine, University of Alabama at Birmingham, AL, USA

*Mats Eliasson, Department of Medicine, Sunderby Hospital, SE-971 80 Luleå, Sweden. (fax: +46 920 28 34 70; e-mail: mats.eliasson@nll.se).

Publication History

  1. Issue published online: 15 JUL 2004
  2. Article first published online: 15 JUL 2004

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Keywords:

  • cohort studies;
  • diabetes mellitus;
  • epidemiology;
  • incidence;
  • prevalence;
  • smokeless;
  • tobacco

Abstract.

Objective.  To explore the effect of smoking and smokeless tobacco, ‘snus’, on the risk of type 2 diabetes.

Design.  Population-based cross-sectional and prospective follow-up study in northern Sweden.

Subjects.  A total of 3384 men, aged 25–74 years, who participated in the MONICA study in 1986, 1990, 1994 or 1999, 1170 of whom had an oral glucose tolerance test. In 1999, 1757 men from previous cohorts returned for re-examination.

Main outcome measures.  We compared the prevalence of type 2 diabetes or pathological glucose tolerance (PGT) amongst tobacco users to that of nonusers at entry into the study and at follow-up, using odds ratios.

Results.  Compared with never users, the age-adjusted risk of prevalent clinically diagnosed diabetes for ever smokers was 1.88 (CI 1.17–3.0) and for smokers 1.74 (0.94–3.2). Corresponding odds ratios for snus users were 1.34 (0.65–2.7) and 1.18 (0.48–2.9). We found no increased risk of prevalent PGT in snus users or smokers. Former smokers and snus users had an insignificantly increased risk for PGT. Compared with nonusers, the age-adjusted risk of developing clinically diagnosed diabetes during follow-up was 4.63 (1.37–16) in consistent exclusive smokers, 3.20 (1.16–8.8) in ex-smokers and no cases in consistent snus users. The risk of PGT during follow-up was not increased in consistent tobacco users but evident, although not statistically significant, in those who quit snus during the follow-up period, 1.85 (0.60–5.7). Adjustment for physical activity and alcohol consumption did not change the major findings.

Conclusions.  The risk of diabetes for snus users was not significantly increased. Smoking was associated with prevalent and incident cases of diabetes. Ex-tobacco users tended towards more PGT.

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