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Smokeless tobacco (snus) is associated with an increased risk of type 2 diabetes : Results from five pooled cohorts

Carlsson, S.; Andersson, T.; Araghi, M.; Galanti, M. R.; Lager, A.; Lundberg, M.; Nilsson, Peter M LU ; Norberg, M.; Pedersen, N. L. and Trolle Lagerros, Y., et al. (2017) In Journal of Internal Medicine1989-01-01+01:00 281(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.

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publication status
published
subject
keywords
Meta-analysis, Public health, Tobacco, Type 2 diabetes
in
Journal of Internal Medicine1989-01-01+01:00
volume
281
issue
4
pages
398 - 406
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • scopus:85012994961
  • wos:000397490100006
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
2018-01-21 04:19:57
@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},
  keyword      = {Meta-analysis,Public health,Tobacco,Type 2 diabetes},
  language     = {eng},
  month        = {02},
  number       = {4},
  pages        = {398--406},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Journal of Internal Medicine1989-01-01+01:00},
  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},
  volume       = {281},
  year         = {2017},
}