Abstract
Smoking cessation reduces the risk of cardiovascular disease (CVD), but also elevates fasting serum glucose (FSG) levels. The effect of post-cessation hyperglycemia on cardiovascular disease is unknown. The study population consisted of 127,066 men without type 2 diabetes from the Korean National Health Insurance System – Health Screening Cohort database. Change in smoking habits and FSG was determined by the difference in smoking status and FSG levels from the first (2002 and 2003) and second (2004 and 2005) health examinations. Continual smokers, quitters, ex-smokers, and never smokers were stratified according to FSG elevation. The study participants were followed-up for CVD and CVD-related death from 2006 to 2013. Compared to continual smokers, quitters had decreased risk of CVD among those without FSG elevation (hazard ratio, HR, 0.76, 95% confidence interval, CI, 0.66–0.86) and with FSG elevation (HR 0.83, 95% CI 0.72–0.96). Similarly, quitters had a tendency towards reduced risk of CVD-related death among those without FSG elevation (HR 0.74, 95% CI 0.51–1.09) and with FSG elevation (HR 0.68, 95% CI 0.46–1.03). Post-cessation hyperglycemia did not attenuate the beneficiary risk-reducing effects of quitting on CVD and CVD-related death.
Highlights
Smoking is considered one of the most important causes of preventable death worldwide[1]
In this large-scale cohort study of over 120,000 men without type 2 diabetes, we have shown that post-cessation hyperglycemia does not attenuate the beneficiary risk-reducing effects of smoking cessation on cardiovascular disease (CVD) and CVD-related death
This is the first study to investigate the effect of smoking habit change with and without fasting serum glucose (FSG) elevation on CVD and CVD-related death
Summary
Smoking is considered one of the most important causes of preventable death worldwide[1]. In the Unites States alone, smoking is estimated to account for approximately 480,000 deaths, or 20 percent of deaths annually[2] This is due to the fact that smoking causes a number of serious illnesses, including cardiovascular disease (CVD)[3]. Multiple studies have shown that smoking cessation temporarily increases the risk of type 2 diabetes, with quitters having a 14 to 54% increased risk of diabetes within the first two to three years[4,5,6,7,8,9]. Elevation of FSG is positively associated with the risk of cardiovascular disease and CVD-related death[13,14,15]. We aimed to determine the effect smoking cessation with and without FSG elevation on the risk of CVD and CVD-related death using the Korean National Health Insurance System – National Health Screening Cohort (NHIS-HealS) database
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