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Do early onset and pack-years of smoking increase risk of type II diabetes?

 Sun Jung Kim  ;  Sun Ha Jee  ;  Jung Mo Nam  ;  Woo Hyun Cho  ;  Jae-Hyun Kim  ;  Eun-Cheol Park 
 BMC PUBLIC HEALTH, Vol.14(1) : 178, 2014 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/epidemiology* ; Diabetes Mellitus, Type 2/etiology ; Female ; Health Status Indicators ; Humans ; Incidence ; Life Style* ; Male ; Middle Aged ; Nutrition Surveys ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Risk Factors ; Smoking/adverse effects* ; United States/epidemiology
Early onset of smoking ; Pack-years of smoking ; Risk of type 2 diabetes
BACKGROUND: Type II diabetes is not only major public health problem but also heavy fiscal burden to each nation's health care system around the world. This study aimed to investigate the effect of early onset and pack-years of smoking on type II diabetes risk.
METHODS: We used the most recent cross-sectional National Health and Nutrition Examination Survey set of South Korea (2010) and the United States (2009-2010). Participants who were diagnosed with diabetes after age 20 were included (South Korea: n = 7273, 44% male; U.S.: n = 3271, 52% male). Cox proportional models, stratified by sex and country, were used to estimate hazard ratios.
RESULTS: 7.1% of South Korean men, 5.5% of South Korean women, 15.5% of U.S. men, and 12.4% of U.S. women had type II diabetes; 40% of South Korean men, 34% of U.S. men, and 21% of U.S. women began smoking before age 20 (57%, 49%, 36% of those who had type II diabetes, respectively). Type II diabetic participants were older and married; have a higher BMI, low income, and less education; lack moderate physical activity, smoked more and earlier compared to those without type II diabetes. Differences in risk factors including life-style behaviors and SES were found in both diabetic and non-diabetic populations. Men who began smoking before age 16 had a higher type II diabetes risk than who never smoked (South Korea: hazard ratio [HR] 2.46, 95% confidence interval [CI] 1.04-5.79; U.S.: HR 1.64, 95% CI 1.01-2.67), as did U.S. men who began smoking between 16 and 20 years (HR 1.58, 95% CI 1.05-2.37). Smoking pack-years were also associated with type II diabetes in U.S. men (HR 1.07, 95% CI 1.01-1.12). In women population, however, associations were not found.
CONCLUSIONS: Early onset of smoking increases type II diabetic risk among men in South Korea and the U.S., and type II diabetic risk increases with higher pack-years in U.S. men, however, no associations were found in women population. Underage tobacco policy and education programs are strongly needed in both countries.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Cho, Woo Hyun(조우현)
Jee, Sun Ha(지선하) ORCID logo https://orcid.org/0000-0001-9519-3068
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