Smokeless tobacco (snus) is associated with an increased risk of type 2 diabetes : Results from five pooled cohorts
(2017) In Journal of Internal Medicine 281(4). p.398-406- Abstract
Background: Smoking and nicotine exposure increase insulin resistance and the risk of type 2 diabetes. Swedish smokeless tobacco (snus) is high in nicotine, and its use is prevalent in Scandinavian countries, but few studies have investigated snus use in relation to diabetes risk. Objective: To explore the association between snus use and risk of type 2 diabetes using pooled data from five cohorts. Methods: Analyses were based on prospective studies conducted between 1990 and 2013 including 54 531 never-smoking men and 2441 incident cases of type 2 diabetes identified through screening, self-reporting and hospital and prescription registries. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed and adjusted for age, body... (More)
Background: Smoking and nicotine exposure increase insulin resistance and the risk of type 2 diabetes. Swedish smokeless tobacco (snus) is high in nicotine, and its use is prevalent in Scandinavian countries, but few studies have investigated snus use in relation to diabetes risk. Objective: To explore the association between snus use and risk of type 2 diabetes using pooled data from five cohorts. Methods: Analyses were based on prospective studies conducted between 1990 and 2013 including 54 531 never-smoking men and 2441 incident cases of type 2 diabetes identified through screening, self-reporting and hospital and prescription registries. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed and adjusted for age, body mass index, educational level, alcohol consumption and physical activity. Results: Compared to never users, the HR of type 2 diabetes was 1.15 (95% CI: 1.00-1.32) in current users of snus. In individuals consuming 5-6 boxes per week, the HR was 1.42 (95% CI: 1.07-1.87); in those consuming ≥7 boxes per week, the HR was 1.68 (95% CI: 1.17-2.41). Each additional box of snus consumed per week yielded an HR of 1.08 (95% CI: 1.01-1.16). Conclusion: Our findings indicate that high consumption of snus is a risk factor for type 2 diabetes. The risk was similar to that in smokers, implying that smokers will not reduce their risk of type 2 diabetes by changing to snus use. The results also support the notion that nicotine increases the risk of type 2 diabetes.
(Less)
- author
- organization
- publishing date
- 2017-02-06
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Meta-analysis, Public health, Tobacco, Type 2 diabetes
- in
- Journal of Internal Medicine
- volume
- 281
- issue
- 4
- pages
- 398 - 406
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:28164394
- wos:000397490100006
- scopus:85012994961
- ISSN
- 0954-6820
- DOI
- 10.1111/joim.12592
- language
- English
- LU publication?
- yes
- id
- a608b41e-07d7-4a0c-81b9-8d02929aedf6
- date added to LUP
- 2017-03-02 09:20:42
- date last changed
- 2025-03-03 13:06:59
@article{a608b41e-07d7-4a0c-81b9-8d02929aedf6,
abstract = {{<p>Background: Smoking and nicotine exposure increase insulin resistance and the risk of type 2 diabetes. Swedish smokeless tobacco (snus) is high in nicotine, and its use is prevalent in Scandinavian countries, but few studies have investigated snus use in relation to diabetes risk. Objective: To explore the association between snus use and risk of type 2 diabetes using pooled data from five cohorts. Methods: Analyses were based on prospective studies conducted between 1990 and 2013 including 54 531 never-smoking men and 2441 incident cases of type 2 diabetes identified through screening, self-reporting and hospital and prescription registries. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed and adjusted for age, body mass index, educational level, alcohol consumption and physical activity. Results: Compared to never users, the HR of type 2 diabetes was 1.15 (95% CI: 1.00-1.32) in current users of snus. In individuals consuming 5-6 boxes per week, the HR was 1.42 (95% CI: 1.07-1.87); in those consuming ≥7 boxes per week, the HR was 1.68 (95% CI: 1.17-2.41). Each additional box of snus consumed per week yielded an HR of 1.08 (95% CI: 1.01-1.16). Conclusion: Our findings indicate that high consumption of snus is a risk factor for type 2 diabetes. The risk was similar to that in smokers, implying that smokers will not reduce their risk of type 2 diabetes by changing to snus use. The results also support the notion that nicotine increases the risk of type 2 diabetes.</p>}},
author = {{Carlsson, S. and Andersson, T. and Araghi, M. and Galanti, M. R. and Lager, A. and Lundberg, M. and Nilsson, Peter M and Norberg, M. and Pedersen, N. L. and Trolle Lagerros, Y. and Magnusson, C.}},
issn = {{0954-6820}},
keywords = {{Meta-analysis; Public health; Tobacco; Type 2 diabetes}},
language = {{eng}},
month = {{02}},
number = {{4}},
pages = {{398--406}},
publisher = {{Wiley-Blackwell}},
series = {{Journal of Internal Medicine}},
title = {{Smokeless tobacco (snus) is associated with an increased risk of type 2 diabetes : Results from five pooled cohorts}},
url = {{http://dx.doi.org/10.1111/joim.12592}},
doi = {{10.1111/joim.12592}},
volume = {{281}},
year = {{2017}},
}