title: Smoking, Smoking Cessation, and the Risk of Type 2 Diabetes among Japanese Adults: Japan Epidemiology Collaboration on Occupational Health Study.
abstract: OBJECTIVE
  To examine the association of smoking status, smoking intensity, and smoking cessation with the risk of type 2 diabetes (T2D) using a large database.
  
  
  METHODS
  The present study included 53,930 Japanese employees, aged 15 to 83 years, who received health check-up and did not have diabetes at baseline. Diabetes was defined as fasting plasma glucose ≥126 mg/dl, random plasma glucose ≥200 mg/dl, HbA1c ≥6.5% (≥48 mmol/mol), or receiving medication for diabetes. Cox proportional-hazards regression models were used to investigate the association between smoking and the risk of diabetes.
  
  
  RESULTS
  During 3.9 years of median follow-up, 2,441 (4.5%) individuals developed T2D. The multivariable-adjusted hazard ratios (95% CI) for diabetes were 1 (reference), 1.16 (1.04 to 1.30) and 1.34 (1.22 to 1.48) for never smokers, former smokers, and current smokers, respectively. Diabetes risk increased with increasing numbers of cigarette consumption among current smokers (P for trend <0.001). Although the relative risk of diabetes was greater among subjects with lower BMIs (< 23 kg/m2), attributable risk was greater in subjects with higher BMIs (≥ 23 kg/m2). Compared with individuals who had never smoked, former smokers who quit less than 5 years, 5 to 9 years, and 10 years or more exhibited hazards ratios for diabetes of 1.36 (1.14 to 1.62), 1.23 (1.01 to 1.51), and 1.02 (0.85 to 1.23), respectively.
  
  
  CONCLUSIONS
  Results suggest that cigarette smoking is associated with an increased risk of T2D, which may decrease to the level of a never smoker after 10 years of smoking cessation.
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Shamima
authors.initials: S
authors.lastname: Akter
authors.affiliation: Mitsui Chemicals, Inc., Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Okazaki
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan; Teikyo University Graduate School of Public Health, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kuwahara
authors.affiliation: Nippon Steel & Sumitomo Metal Corporation Kimitsu Works, Chiba, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: JFE Steel Corporation, Kanagawa, Japan.
authors.forename: Taizo
authors.initials: T
authors.lastname: Murakami
authors.affiliation: JFE Steel Corporation, Kanagawa, Japan.
authors.forename: Chii
authors.initials: C
authors.lastname: Shimizu
authors.affiliation: JFE Steel Corporation, Kanagawa, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Mitsubishi Plastics, Inc., Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tomita
authors.affiliation: All Japan Labour Welfare Foundation, Tokyo, Japan.
authors.forename: Satsue
authors.initials: S
authors.lastname: Nagahama
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Eguchi
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kochi
authors.affiliation: Azbil Corporation, Tokyo, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Imai
authors.affiliation: Azbil Corporation, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nishihara
authors.affiliation: Mitsubishi Fuso Truck and Bus Corporation, Kanagawa, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Sasaki
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Nakagawa
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Hitachi, Ltd., Ibaraki, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Honda
authors.affiliation: YAMAHA CORPORATION, Shizuoka, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Uehara
authors.affiliation: YAMAHA CORPORATION, Shizuoka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Safety and Health, Tokyo Gas Co., Ltd., Tokyo, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Hori
authors.affiliation: Genkiplaza Medical Center for Health Care, Tokyo, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Chihiro
authors.initials: C
authors.lastname: Nishiura
authors.affiliation: Department of Safety and Health, Tokyo Gas Co., Ltd., Tokyo, Japan.
authors.forename: Chiro
authors.initials: C
authors.lastname: Nishiura
authors.affiliation: Mizuho Bank, Ltd., Tokyo, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Totsuzaki
authors.affiliation: Fuji Electric Co., Ltd., Kanagawa, Japan.
authors.forename: Noritada
authors.initials: N
authors.lastname: Kato
authors.affiliation: Ricoh Co., Ltd., Kanagawa, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukasawa
authors.affiliation: Department of Epidemiology, Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen Province, Vietnam.
authors.forename: Ngoc M
authors.initials: NM
authors.lastname: Pham
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Kurotani
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nanri
authors.affiliation: Furukawa Electric Co., Ltd., Tokyo, Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Kabe
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
authors.affiliation: National Institute of Public Health, Saitama, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Sone
authors.affiliation: National Institute of Public Health, Saitama, Japan.
authors.forename: Seitaro
authors.initials: S
authors.lastname: Dohi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation / Q000379:methods; D055815:Young Adult