Body mass decrease after initial gain following smoking cessation

BACKGROUND: Although smoking cessation is strongly associated with subsequent weight gain, it is not clear whether the initial gain in weight after smoking cessation remains over time. METHOD: Cross-sectional analyses were made, using data from periodic health examinations for workers, on the relationship between body mass index (BMI) and the length of smoking cessation. In addition, linear regression coefficients of BMI on the length of cessation were estimated according to alcohol intake and sport activity, to examine the modifying effect of these factors on the weight of former smokers. RESULTS: Means of BMI were 23.1 kg/m2, 23.3 kg/m2, 23.6 kg/m2 for light/medium smokers, heavy smokers and never smokers, respectively. Among former smokers who had smoked > or = 25 cigarettes a day, odds ratio (OR) of BMI >25 kg/m2 were 1.88 (95% confidence interval [CI] : 1.05-3.35), 1.32 (95% CI : 0.74-2.34), 0.66 (95% CI: 0.33-1.31) for those with 2-4 years, 5-7 years, and 8-10 years of smoking cessation, respectively. The corresponding OR among those who previously consumed <25 cigarettes a day were 1.06 (95% CI: 0.58-1.94), 1.00 (95% CI: 0.58-1.71), and 1.49 (95% CI: 0.95-2.32). CONCLUSIONS: The results suggest that although heavy smokers may experience large weight gain and weigh more than never smokers in the few years after smoking cessation, they thereafter lose weight to the never smoker level, while light and moderate smokers gain weight up to the never smoker level without any excess after smoking cessation.     

Underweight and overweight in relation to mortality among men aged 40-59 and 50-69 years: the Seven Countries Study

This study investigated the relation between body mass index (BMI) and the all-cause mortality rate among 7,985 European men. Starting around 1960, when all men were aged 40-59 years, mortality was followed for 15 years (1960-1975); starting around 1970, the survivors were followed for an additional 15 years (1970-1985). For the first and second follow-up periods, a BMI of 18.5-25 kg/m2 around 1960 and 1970, respectively, was considered the reference category. The authors found that the hazard ratios of mortality for a BMI of <18.5 kg/m2 was 2.1 (95% confidence interval (CI): 1.5, 2.8) for the first follow-up period and 1.7 (95% CI: 1.3, 2.2) for the second. A BMI of 25-30 kg/m2 was not related to increased mortality. Among never smokers, the hazard ratios for a BMI of >30 kg/m2 were 1.8 (95% CI: 1.2, 2.8) for the 1960-1975 follow-up period and 1.4 (95% CI: 1.0, 1.9) for the 1970-1985 follow-up period. A BMI of >30 kg/m2 was not related to increased mortality among current smokers. When mortality was followed for more than 15 years, the hazard ratio for a BMI of <18.5 kg/m2 declined and the hazard ratios for a BMI of >30 kg/m2 did not change. Underweight among those in all smoking categories and severe overweight in never smokers remained predictors of increased mortality when middle-aged men became older.     

The burden of mortality of obesity at middle and old age is small. A life table analysis of the US Health and Retirement Survey

The evidence of effect of overweight and obesity on mortality at middle and old age is conflicting. The increased relative risk of cardiovascular disease and diabetes for overweight and obese individuals compared to normal weight is well documented, but the absolute risk of cardiovascular death has decreased spectacularly since the 1980s. We estimate the burden of mortality of obesity among middle and old aged adults in the Health and Retirement Survey (HRS), a US prospective longitudinal study. We calculate univariate and multivariate age-specific probabilities and proportional hazard ratios of death in relation to self-reported body mass index (BMI), smoking and education. The life table translates age specific adjusted event rates in survival times, dependent on risk factor distributions (smoking, levels of education and self reported BMI). 95% confidence intervals are calculated by bootstrapping. The highest life expectancy at age 55 was found in overweight (BMI 25-29.9), highly educated non smokers: 30.7 (29.5-31.9) years (men) and 33.2 (32.1-34.3) (women), slightly higher than a BMI 23-24.9 in both sexes. Smoking decreased the population life expectancy with 3.5 (2.7-4.4) years (men) and 1.8 (1.0-2.5) years (women). Less than optimal education cost men and women respectively 2.8 (2.1-3.6) and 2.6 (1.6-3.6) years. Obesity and low normal weight decreased population life expectancy respectively by 0.8 (0.2-1.3) and 0.8 (0.0-1.5) years for men and women in a contemporary, US population. The burden of mortality of obesity is limited, compared to smoking and low education.     

Renal cell cancer and body size at different ages: an Italian multicenter case-control study

An increased risk of renal cell cancer (RCC) has been reported in overweight persons. The authors aimed to clarify which anthropometric measures are associated with risk of RCC and whether risk may vary according to selected variables. Between 1992 and 2004, they carried out an Italian multicenter case-control study including 767 (494 men, 273 women) incident cases of RCC and 1,534 hospital controls, frequency-matched to cases. To estimate odds ratios and 95% confidence intervals, they used conditional logistic regression matched on study center, sex, and age and adjusted for period of interview, years of education, smoking habits, and family history of kidney cancer. Using body-size measurements taken 1 year prior to diagnosis/interview, the authors found an odds ratio of 1.3 (95% confidence interval (CI): 1.0, 1.7) among obese persons (body mass index (BMI; weight (kg)/height (m)(2)) > or =30) versus normal-weight persons (BMI <25) and an odds ratio of 1.5 (95% CI: 1.1, 2.0) among persons in the highest tertile of waist-to-hip ratio. Direct associations emerged for BMI > or =30 (vs. <25) at ages 30 years (odds ratio = 1.5, 95% CI: 1.0, 2.3) and 50 years (odds ratio = 1.5, 95% CI: 1.1, 2.0). The direct association with waist-to-hip ratio was stronger among women than among men. RCC risks among overweight and obese persons were apparently higher in never smokers, persons with the clear-cell histologic type, and persons with a Fuhrman nuclear grade of G3-G4.     

上海市区中老年男性吸烟状况与肥胖关系的横断面研究

目的 评价上海市区中老年男性吸烟状况与肥胖的关系.方法 利用2002-2006年开展的上海市男性健康队列基线调查资料,分析61 491名40～74岁研究对象的吸烟情况与身体测量数据、体重变化等的关联.吸烟状况和体重变化数据采用问卷方式进行收集,身高、体重、腰围、臀围由调查员面访时对被访者进行测量而得.多元回归模型用于估计吸烟与肥胖间的关联强度,并调整可能的混杂因素.结果 调整年龄等可能的混杂因素后,吸烟组的体质指数(BMI)(23.4±3.1)和成人期体重增加值[(11.6±9.7)kg]均低于从未吸烟者组的BMI(24.0±2.9)和成人期体重增加值[(12.7±8.9)kg],两组平均BMI相差0.60(95%CI:-O.67～-0.54),体重增加相差1.46 kg(95%CI:-1.65～-1.27).吸烟组腰围臀围比(WHO)高于不吸烟组,平均差值达0.006 08(95%CI:0.005 08～0.007 09),差异均有统计学意义(P＜0.01).开始吸烟年龄越早,日吸烟支数越多,吸烟年数越长,总吸烟包年数越高,两组WHR的差值越大(趋势检验,P＜0.05).戒烟者的BMI、WHR和体重增加z值在戒烟的头几年均高于从未吸烟者,但随后可恢复至未吸烟者的水平.结论 吸烟与体重呈负相关,但可能加重中心性肥胖.戒烟虽伴暂时的体重上升,但随戒烟时间的延长,该效应消失.     

Development of overweight associated with childbearing depends on smoking habit: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

OBJECTIVE: To prospectively evaluate whether childbearing leads to development of overweight in women and to evaluate the role of other known risk factors. RESEARCH METHODS AND PROCEDURES: A prospective, multicenter observational study, the Coronary Artery Risk Development in Young Adults (CARDIA) Study from 1986 to 1996, examined subjects at baseline and in follow-up years 2, 5, 7, and 10. Included were 998 (328 black and 670 white) nulliparous women, age 18-30 years, who were not overweight at baseline. Relative odds for incident overweight (BMI > or = 25 kg/m2) associated with parity change (0, 1, or 2+) and risk factors were estimated using discrete-time survival models adjusted for baseline and time-dependent covariates. RESULTS: Parity change-association with development of overweight depended on smoking habit (interaction, p < 0.001). In multivariate adjusted models, 1 and 2+ births vs. 0, respectively, were associated with increased risk for development of overweight among never smokers [odds ratio (OR) = 2.66; 95% confidence interval (CI): 1.80, 3.93, and 2.10, 95% CI: 1.24, 3.56] and decreased risk among current smokers (OR = 0.41; 95% CI: 0.17, 0.96, and 0.36, 95% CI: 0.08, 1.65). Risk was increased for black vs. white race (OR = 3.49; 95% CI: 2.59, 4.69), frequent weight cycling (OR = 1.45; 95% CI: 1.03, 2.04), and high school education or less (OR = 2.21; 95% CI: 1.50, 3.26) and was decreased for highest physical activity quartile (OR = 0.62; 95% CI: 0.43, 0.90). DISCUSSION: Childbearing contributes to development of overweight in nonsmokers but not in smokers, where development of overweight is less likely in women who bear children. Race, education, and behaviors are important factors in development of overweight in young women.     

Nocturia and obesity: a population-based study in Finland

The authors' aim in this study was to analyze the association of nocturia with overweight and obesity. In 2003-2004, a questionnaire was mailed to 6,000 randomly selected Finns aged 18-79 years who were identified from the Finnish Population Register Centre. Information on nocturia was collected through questionnaires using the Danish Prostatic Symptom Score and the American Urological Association Symptom Index. Self-reported body weight and height were used to calculate body mass index (BMI; weight (kg)/height (m)2). Subjects were classified on the basis of BMI as nonoverweight (BMI<25), overweight (BMI 25-29.9 kgm2), or obese (BMI>or=30). Of the 6,000 subjects, 62.4% participated. Among men, the age-standardized prevalence of nocturia, defined as at least one void per night, was 33.4% (95% confidence interval (CI): 28.5, 38.3) in the nonoverweight, 35.8% (95% CI: 31.4, 40.1) in the overweight, and 48.2% (95% CI: 38.8, 57.6) in the obese. Among women, the corresponding figures were 37.2% (95% CI: 33.0, 41.5) in the nonoverweight, 48.3% (95% CI: 42.5, 54.2) in the overweight, and 53.6% (95% CI: 43.9, 63.2) in the obese. The associations remained similar when nocturia was defined as two or more voids per night. The age-standardized attributable fraction (population) of increased BMI for nocturia was 17.7% for men and 18.5% for women, corresponding to an 8.5% increase in the crude prevalence of nocturia in men and a 13.9% increase in women. The authors conclude that obesity is associated with increased nocturia, more strongly among women than among men.     

The association between amount of cigarettes smoked and overweight, central obesity among Chinese adults in Nanjing, China

OBJECTIVES: To examine the association between overweight, central obesity and cigarette smoking (total amount of cigarettes smoked [TACS] and status). DESIGN: Population-based cross-sectional study. Setting: Administrative villages and neighborhoods (n=45) randomly selected from three urban districts and two rural counties in Nanjing City, China. SUBJECTS AND METHODS: A representative sample (n=13,463) of permanent local male residents aged 35 years or older; 66.5% were urban residents. The response rate was 90.1%. Overweight (BMI>=24) and central obesity (waist circumference>=85 in men) were defined according to the new Chinese standard. The association between smoking (amount and status) and obesity was examined using logistic and linear regression analysis. RESULTS: The overall prevalence of overweight was 36.1% (29.7% with 24<=BMI<28 and 6.4% with BMI>=28). After adjusted for age, residence, education, occupation, family income, alcohol drinking, dietary intake, occupational and leisure-time physical activity, the prevalence was significantly lower among current smokers (33.0%) than in non-smokers (39.9%) and ex-smokers (39.2%), respectively (p<0.05). The amount of cigarette smoked was reversely associated with BMI (compared to non-smokers, ORs and 95%CIs for smokers with low-, medium- and high-TACS were 0.88 [0.79, 0.98], 0.77 [0.69, 0.86], and 0.77 [0.69, 0.86], respectively). The prevalence of central obesity was 35.9%. Compared to nonsmokers, only male ex-smokers were at increased risk of central obesity (OR=1.38, 95%CI=1.10, 1.74), while there was no significant association with current- smokers (OR=1.02 [0.92, 1.12]). The amount of cigarette smoked was not significantly associated with central obesity. CONCLUSIONS: Cigarette smoking was negatively associated with body weight indicated by BMI but not with central obesity indexed by waist circumference in Chinese men. Cessation of smoking may increase the risk of gaining overall body weight and developing central obesity. Cigarette smoking prevention and cessation should be a public health priority in China.     

Food habits, physical activity and body mass index in relation to smoking status in 40-42 year old Norwegian women and men

BACKGROUND: The aim of the study was to examine the associations between smoking habits, and dietary habits, physical activity and body mass index (BMI) in Norway in 1997-1999. METHODS: The study was cross-sectional. Data on smoking habits, consumption of selected foods and physical activity were collected by questionnaire while body height and weight were measured in 59,361 subjects 40-42 years in 11 Norwegian counties. RESULTS: In both genders, nearly twice as many never smokers than current smokers had fruit or vegetables at least twice a day; 25.5% versus 13.3% for women and 10.5% versus 4.6% for men. The proportion of non-smoking women with a high intake of fish and fruit/vegetables was considerably higher than that of non-smoking men. Mean BMI (95% confidence interval (CI)) was higher for never smokers than for current smokers; 25.2 (25.1-25.3) versus 24.7 (24.6-24.8) kg/m2 for women and 26.6 (26.5-26.7) versus 26.1 (26.0-26.2) kg/m2 for men. The prevalence of obesity (BMI > or =30 kg/m2) (mean and 95% CI) was 12.5% (11.9-13.1%) and 14.4% (13.7-15.1%) among never-smoking women and men, respectively, whereas in smokers, the prevalence of obesity was 10.3% (9.8-10.8%) in women and 12.3% (11.7-12.9%) in men. The prevalence of performing strenuous physical activity at least 1 h a week was approximately 10% lower among current smokers than among non-smokers for both men and women. CONCLUSION: We found that non-smokers had healthier eating habits and higher levels of physical activity than did smokers, whereas the prevalence of obesity was lower in smokers. On the other hand, there were considerable gender differences, and female smokers' eating habits were as healthy as non-smoking males' eating habits.     

Are Kuwaitis getting fatter?

The purpose of the study is to compare temporal changes in BMI, overweight (BMI > 25 Kg/m2) and obesity (BMI > 30 Kg/m2) of two independent cross-sectional samples of Kuwaitis studied in 1980-81 and 1993-94. The earlier sample of 2067 (896 men and 1171 women) and the latter sample of 3435 (1730 men and 1705 women) adult Kuwaitis (aged > or = 18 years), were drawn from primary health care (PHC) clinics and studied for nutritional assessment and for prevalence of obesity in 1980-81 and 1993-94, respectively. Weight was measured in kilograms and height in meters to obtain the body mass index (BMI), which is the weight in kilograms divided by the height in meters squared (Kg/m2). BMI > 25 and > 30 Kg/m2 were classified as overweight and obesity, respectively. The results of the study show that mean BMI (Kg/m2) increased significantly (p < 0.001) by 10.0 and 6.2% (2.5 and 1.7 Kg/m2) among men and women, respectively. Prevalence of overweight and obesity (BMI > 25 and > 30 Kg/m2) increased by 20.6 and 15.4% and by 13.7 and 8.4% among men and women, respectively. After controlling for sociodemographic differences between the two study periods, mean BMI was 2.0 and 1.6 Kg/m2 higher in 1993-94 than in 1980-81 among men and women, respectively. Prevalence of overweight and obesity (BMI > 25 and > 30 Kg/m2) also increased among both genders between the two periods (OR = 2.1 , 95% CI 1.7-2.7 and OR = 1.9, 95% CI 1.5-2.4, for men and OR = 2.2, 95% CI 1.6-3.0 and OR = 1.4, 95% CI 2.2 CI 1.0-1.9, for women). It can be concluded that the BMI, prevalence of overweight and obesity increased among Kuwaitis between 1980-81 and 1993-94, probably due to the effects of modernization, affluence, increased food consumption and the concomitant changes to sedentary lifestyles. The rate of temporal changes in BMI and obesity were higher, by comparison, in Kuwait than in selected other countries.     

Trends in overweight and obesity in Portugal: the National Health Surveys 1995-6 and 1998-9

OBJECTIVE: To assess overweight and obesity trends in the Portuguese population. RESEARCH METHODS AND PROCEDURES: National Health Surveys, conducted in 1995-6 (17,989 men; 20,249 women) and 1998-9 (17,923 men; 20,302 women), were used. RESULTS: In men, the prevalence of overweight and obesity increased from 39.9% (95% CI: 39.2 to 40.6) and 10.3% (95% CI: 9.9 to 10.7), respectively, in 1995-6, to 42.5% (95% CI: 41.8 to 43.2) and 11.5% (95% CI: 11.0 to 12.0), respectively, in 1998-9. In women, prevalence of obesity increased from 12.7% (95% CI: 12.2 to 13.2) in 1995-6 to 14.2% (95% CI: 13.7 to 14.6) in 1998-9, whereas the prevalence of overweight remained stable: 32.2% (95% CI: 31.6 to 32.9) in 1995-6 and 32.3% (95% CI: 31.6 to 32.9) in 1998-9. In men, prevalence of overweight and obesity were higher among former smokers and educational group of 6 to 12 years, and prevalence of obesity was higher in the Lisbon region. In women, prevalence of overweight and obesity were higher among never smokers, and prevalence of obesity was higher among educational group of -6 years. Prevalence of obesity was higher in the Alentejo region, and overweight was higher in the Center region. Finally, prevalence of obesity increased in both sexes for all strata studied (age, smoking status, educational level, and geographic region), whereas prevalence of overweight increased only in men. DISCUSSION: In Portugal, overweight and obesity levels are related to sociodemographic factors; the increase in obesity levels stresses the need for preventive measures.     

Body mass index in relation to adult asthma among 135,000 Norwegian men and women

The authors estimated the association between asthma and body mass index in a 1963-2002 study of 135,000 Norwegians aged 14-60 years who were followed on average for 21 years. Cox proportional hazards regression models were fitted to estimate the relative risk of asthma adjusting for smoking, education, and physical activity. Compared with persons with a body mass index (weight (kg)/height (m)(2)) of less than 25, overweight (body mass index: 25-29) men and women had relative risks of asthma of 1.27 (95% confidence interval (CI): 1.13, 1.43) and 1.30 (95% CI: 1.17, 1.45), respectively, while obese (body mass index: >/=30) men and women had relative risks of 1.78 (95% CI: 1.35, 2.34) and 1.99 (95% CI: 1.67, 2.37), respectively. Stratified analyses revealed a similar association between body mass index and asthma for never smokers, ever smokers, persons with less than or equal to 12 years of education, and persons with more than 12 years of education. Analyses including all the covariates gave results similar to those not adjusting for these factors. The risk of asthma increased steadily with body mass index, from a body mass index of 20 in men and of 22 in women. In men, the risk of asthma increased by 10% with each unit of increased body mass index between 25 and 30. The similar value for women was 7%. Overweight or obese persons reported asthma more often than did thinner persons after adjustment for smoking, education, and physical activity.     

Drinking patterns and body mass index in never smokers: National Health Interview Survey, 1997-2001

Alcohol could contribute to obesity. The authors examined the relation between drinking patterns and body mass index (BMI) (weight (kg)/height (m)(2)) by pooling cross-sectional data from the 1997-2001 National Health Interview Surveys. Weighted analyses included 45,896 adult never smokers who were current alcohol drinkers. Height and weight were self-reported. In adjusted analyses, alcohol quantity and frequency had opposite associations with BMI. As quantity increased from 1 drink/drinking day to > or =4 drinks/drinking day, BMI significantly increased; in men, it increased from 26.5 (95% confidence interval (CI): 26.3, 26.6) to 27.5 (95% CI: 27.4, 27.7), and in women, it increased from 25.1 (95% CI: 25.0, 25.2) to 25.9 (95% CI: 25.5, 26.3). As frequency increased from low quintiles of drinking days/year to high quintiles, BMI significantly decreased; in men, it decreased from 27.4 (95% CI: 27.2, 27.6) to 26.3 (95% CI: 26.2, 26.5), and in women, it decreased from 26.2 (95% CI: 26.0, 26.5) to 24.3 (95% CI: 24.2, 24.5). In stratified analyses of frequency trends within quantity categories, BMI declines were more pronounced in women than in men, but all linear trends were inverse and significant (p trend < 0.001). In all respondents combined, persons who consumed the smallest quantity the most frequently were leanest, and those who consumed the greatest quantity the least frequently were heaviest. Alcohol may contribute to excess body weight among certain drinkers.     

Weight concerns and smoking in a general population: the Inter99 study

OBJECTIVE: No previous studies have explored weight concerns in relation to smoking habits, or investigated how weight concerns affect smoking cessation in a general population. METHOD: Inter99 is a population-based lifestyle interventional study, conducted in 1999-2001 in Copenhagen, Denmark, comprising 30-60 year old men and women. All daily smokers (N=2408) were offered help to quit. The baseline investigation (N=6784) was used for analysing associations of smoking status with weight concerns (cross-sectional design). To analyse how weight concerns affected smoking cessation we included the 1387 daily smokers attending 1-year follow-up; 221 of these were verified quitters (longitudinal design). RESULTS: Daily smoking men and women had a significantly lower body mass index than never smokers (men: 3%, women 5%) but reported to be significantly less concerned of their weight (men: OR=0.64, 95%CI=0.4-0.9), women: 0.78(0.6-1.0)). Ex-smoking normal weight women were significantly more likely to be frequently concerned of their weight than never smoking normal weight women (OR=2.06, 95CI%=1.6-2.7). Fifty-two percent of the women and 32% of the men with a previous quit attempt reported that weight gain was a reason for relapse. Neither weight concerns nor eating patterns were predictive of point abstinence at 1-year follow-up. CONCLUSION: Smokers are believed to be very concerned of their weight but in this population-based study, daily smokers more frequently ate what they wanted, had a lower BMI and were significantly less concerned of their weight than never smokers. Weight concerns and eating patterns did not predict abstinence at 1-year follow-up. It seems that weight gain and weight concerns are independent factors.     

Tobacco smoking and risk of hip fracture in men and women

BACKGROUND: Previous findings suggest that tobacco smoking increases the risk of hip fracture in women. A similar adverse effect of smoking is suspected to be present in men, but bone mineral density studies have raised the concern that men may be more sensitive to the deleterious effect of smoking on bone than women. In this study we prospectively determined the influence of current, previous, and cumulative smoking history on risk of hip fracture in men and women and addressed the issue of possible gender difference in the susceptibility to tobacco smoking. METHODS: Pooled data from three population studies conducted in Copenhagen with detailed information on smoking habit. A total of 13,393 women and 17,379 men, initially examined between 1964 and 1992, were followed until 1997 for first admission due to hip fracture. The relative risks (RR) of hip fracture associated with smoking were estimated by means of multiplicative Poisson regression models. RESULTS: During follow-up, 722 hip fractures were identified in women, and 447 in men. After adjustment for potential confounders, including body mass index, female current smokers had an RR of hip fracture of 1.36 (95% CI: 1.12-1.65) and male smokers 1.59 (95% CI: 1.04-2.43) relative to never smokers. In both sexes, the RR of hip fracture gradually increased by current and accumulated tobacco consumption. The RR were consistently higher in men than in women, but the test for interaction between sex and tobacco smoking was insignificant. After 5 years, male ex-smokers had an adjusted RR of 0.73 (95% CI: 0.55-0.98) relative to current smokers, while no significant decrease in risk was observed in female ex-smokers (RR = 0.91; 95% CI: 0.72-1.17)). Approximately 19% of all hip fractures in the present study population were attributable to tobacco smoking. CONCLUSION: Tobacco smoking is an independent risk factor for hip fracture in men and women, and there appears to be no gender differences in smoking related risk. Smoking cessation reduces the risk of hip fracture in men after 5 years, while the deleterious effect of smoking seems to be more long-lasting in female ex-smokers.     

Cigarette smoking and risk of type 2 diabetes mellitus among middle-aged and elderly Japanese men and women

For examination of sex- and age-specific relations between smoking and risk of type 2 diabetes mellitus, 39,528 nondiabetic men and 88,613 nondiabetic women aged 40-79 years who underwent health checkups in Ibaraki-ken, Japan, in 1993 were followed through 2002. Risk ratios for diabetes according to smoking habits were calculated using a Cox proportional hazards model. Compared with never smokers, the risk ratio for diabetes among current smokers, after adjustment for age, systolic blood pressure, antihypertensive mediation use, alcohol intake, parental history of diabetes, body mass index, fasting status, blood glucose concentration, total and high density lipoprotein cholesterol levels, and log-transformed triglyceride level, was 1.27 (95% confidence interval (CI): 1.16, 1.38) in men and 1.39 (95% CI: 1.20, 1.61) in women. The excess risk was more pronounced among men with a parental history of diabetes than among men without one. The excess risk among current smokers was observed in both age subgroups (40-59 and 60-79 years). Respective multivariate risk ratios for the age subgroups were 1.37 (95% CI: 1.18, 1.60) and 1.20 (95% CI: 1.08, 1.34) in men and 1.45 (95% CI: 1.18, 1.79) and 1.34 (95% CI: 1.09, 1.66) in women. Smoking was independently associated with increased risk of type 2 diabetes among both middle-aged and elderly men and women.     

Weight gain and risk of impaired fasting glucose after smoking cessation

Background

Observation of early changes in fasting plasma glucose level induced by post-smoking cessation weight gain is useful in predicting the risks of diabetes mellitus (DM) and impaired fasting glucose (IFG). We investigated the effect of post-smoking cessation weight gain on early changes in the risk of a high fasting plasma glucose (IFG) level (≥100 mg/dL).

Methods

In 946 subjects who underwent repeated health examinations after smoking cessation, changes in body mass index (BMI) and the odds ratio (OR) for IFG risk (adjusted for sex, age, BMI, fasting plasma glucose at year 1, and alcohol consumption) were calculated every year for 3 years after smoking cessation.

Results

After smoking cessation, the rate of BMI increase significantly increased in quitters: 2.36% at year 2 (never smokers: 0.22%, current smokers: 0.39%) and 0.46% at year 3 (never smokers: 0.14%, current smokers: 0.32%). However, it decreased by 0.15% at year 4 (never smokers: 0.12%, current smokers: 0.26%). The ORs for quitters did not significantly increase at any time during the follow-up period. However, among quitters who had smoked at least 20 cigarettes per day, it was significantly higher (OR 1.51, 95% confidence interval 1.1–2.01 at year 1 and 1.71, 1.23–2.38 at year 2).

Conclusions

The time course of the risk of IFG after smoking cessation was similar to that for the rate of BMI increase. In contrast to the findings of previous reports, the increase in IFG risk after smoking cessation was brief and disappeared in the absence of a significant increase in BMI.Key words: smoking cessation, fasting, glucose tolerance, weight gain     

Women and tobacco in the European Union

Over the last decades, the prevalence of smoking in the European Union has followed different trends by sex. While the prevalence has declined for men, it has increased or is stable for women. In some countries where these changes took place earlier, the prevalence of smoking is now higher among women than among men. This document provides quantitative data for these trends in the European Union, with special reference to the situation in Spain. In 1995 there were 60 million men and 42 million women smokers in the European Union. Up to 48% of female smokers used light cigarettes, that is 20 million women. There are documents from the tobacco industry showing that the goal of the promotion of light cigarettes is to reassure their clients and to keep as smokers those concerned about their health who are considering the possibility of quitting. There is evidence confirming that this policy is successful, and that the misconceptions of smokers about light cigarettes deter them from quitting. There is evidence on the role of smoking in weight control. Women are more concerned than men about their weight, and for young women body image is very relevant. Young girls often have the perception that they are overweight. Although fear of being overweight is more common than actual overweight, the evidence suggests that being afraid of gaining weight plays a role in keeping women as smokers, and that young girls begin smoking taking into consideration weight issues. The advice on how to maintain weight should be included in any smoking cessation program for women. Any preventive action for teen age smokers should include weight control issues.     

Associations of maternal prenatal smoking with child adiposity and blood pressure

OBJECTIVE: To examine the extent to which maternal prenatal smoking is associated with adiposity, central adiposity, and blood pressure in 3-year-old children. RESEARCH METHODS AND PROCEDURES: We studied 746 mother-child pairs in Project Viva, a prospective cohort study, and categorized mothers as never, early pregnancy, or former smokers. Main outcome measures were overweight (BMI for age and sex > 85th percentile), BMI z-score, sum of subscapular (SS) and triceps (TR) skinfolds, SS:TR skinfold ratio, and systolic blood pressure (SBP). RESULTS: One hundred sixty-one (22%) mothers quit smoking before pregnancy, 71 (10%) smoked in early pregnancy, and 514 (69%) never smoked. At age 3 years, 204 (27%) children were overweight. On multivariable analysis, compared with children of never smokers, children of early pregnancy smokers had an elevated risk for overweight [odds ratio (OR), 2.2; 95% confidence interval (CI), 1.2, 3.9] and higher BMI z-score (0.30 units; 95% CI, 0.05, 0.55), SS + TR (2.0 mm; 95% CI, 0.9, 3.0), and SBP (2.4 mm Hg; 95% CI, -0.1, 4.9). Children of former smokers were not more overweight (BMI z-score, 0.02 units; 95% CI, -0.15, 0.19) but had higher SBP (1.5 mm Hg; 95% CI, -0.1, 3.2). We saw no relationship of smoking with central adiposity (SS:TR). DISCUSSION: Former and early pregnancy smokers had children with somewhat higher SBP, but only early pregnancy smokers had children who were more overweight. Mechanisms linking smoking with child adiposity and blood pressure may differ. A long-term impact of maternal smoking on offspring cardiovascular risk provides further reason to reduce smoking in women.     

Smoking and risk of incident psoriasis among women and men in the United States: a combined analysis

The authors evaluated the association between smoking and the incidence of psoriasis among 185,836 participants from a cohort of older women (the Nurses' Health Study, 1996-2008), a cohort of younger women (the Nurses' Health Study II, 1991-2005), and a cohort of men (Health Professionals' Follow-up Study, 1986-2006). Information on smoking was collected biennially during follow-up. The authors identified a total of 2,410 participants with incident psoriasis. Compared with never smokers, past smokers had a relative risk of incident psoriasis of 1.39 (95% confidence interval (CI): 1.27, 1.52) and current smokers had a relative risk of 1.94 (95% CI: 1.64, 2.28). For current smokers who smoked 1-14 cigarettes/day, the relative risk was 1.81 (95% CI: 1.38, 2.36); for those who smoked 15-24 cigarettes/day, the relative risk was 2.04 (95% CI: 1.68, 2.47); and for those who smoked 25 or more cigarettes/day, the relative risk was 2.29 (95% CI: 1.74, 3.01). There was a trend toward an increased risk of psoriasis with increasing pack-years or duration of smoking (P(trend) < 0.0001). The risk was highest among smokers who had 65 or more pack-years of smoking (relative risk = 2.72, 95% CI: 2.05, 3.60) and among those with a smoking duration of 30 or more years (relative risk = 1.99, 95% CI: 1.75, 2.25). The authors observed a graded reduction of risk with an increase in time since smoking cessation (P(trend) <0.0001). In this study, smoking was found to be an independent risk factor for psoriasis in both women and men. Psoriasis risk was particularly augmented for heavy smokers and persons with longer durations of smoking.