Australian patterns of tobacco smoking in 1986

A total of 9440 Australian men and women of over 15 years of age was interviewed at home in 1986 to determine the prevalence and consumption levels of tobacco products. Current smokers were defined as those who smoked any combination of cigarettes, cigars or pipes regularly. The percentage of current smokers among men was 32.9% and among women was 28.5%, and the peak prevalence of smoking was in the age-group 20-24 years for both men (40.5%) and women (40.8%). Among men, 27.7% were past smokers, and among women, 16.5% were past smokers. The proportion of past smokers among those who had ever smoked was higher in men (0.46) than among women (0.37), but in the younger age groups there was no relative excess among men. Male smokers consumed more cigarettes per day than did female smokers and men were exposed to a higher daily average amount of cigarette tar. Sociodemographic variables that were associated with smoking in both men and women included age and educational and occupational level. Asian-born persons had a significantly lower prevalence of smoking than did persons who were born in Australia.     

Increased risk of respiratory symptoms in young smokers of low tar cigarettes

The effect of cigarettes yielding less than 10 mg tar was investigated in a representative sample (n = 4729) of 16 and 18 year old Finns. The rate of response was 80%. Cough and phlegm were significantly increased in young people smoking low tar cigarettes. When more than nine cigarettes were smoked daily respiratory symptoms were 2.4-6.2 times more prevalent among those who smoked low tar cigarettes than among those who never smoked. No differences were found between the smokers of low tar and medium tar cigarettes (yielding tar 10-18 mg). These data disagree with the hypothesis that the new low tar brands of cigarettes are less likely to cause respiratory symptoms than the old medium tar brands.     

Smoking prevalence and associated risk factors in Canadian adults. Canadian Heart Health Surveys Research Group.

OBJECTIVE: To describe the prevalence and patterns of smoking among Canadian adults, the relation of smoking to other cardiovascular disease risk factors and the awareness of the causes of heart disease. DESIGN: Population-based cross-sectional surveys. SETTING: Nine Canadian provinces, from 1986 to 1990. PARTICIPANTS: A probability sample of 26,293 men and women aged 18 to 74 was selected from the health insurance registries in each province. Of these, 20,585 completed a questionnaire on smoking habits during a home interview. MAIN RESULTS: Approximately 29% of the Canadian population 18 years of age and over were regular cigarette smokers, and over 13% of regular smokers smoked more than 25 cigarettes per day. The proportion of women who had never smoked was higher (37%) than men (24%), except for young women aged 18 to 24. For all participants, there was a lower prevalence of high blood pressure and overweight among smokers than non-smokers. The prevalence of sedentary lifestyle, diabetes and elevated blood cholesterol was positively associated with smoking. The proportion of subjects who identified smoking as a cause of heart disease was higher among smokers, and over 90% believe that heart disease is preventable. CONCLUSION: Because smoking is positively associated with other cardiovascular risk factors, multifactorial and comprehensive approaches are needed in the implementation of cardiovascular disease prevention programs. Knowledge regarding the heart health hazards of smoking is high even among smokers. Motivational approaches that go beyond health risk messages are needed in cessation programs.     

Trends in pregnancy-related smoking rates in the United States, 1987-1996

CONTEXT: Rates of smoking are increasing among adolescents and young adults, but trends in smoking among pregnant women have not been studied. OBJECTIVE: To assess pregnancy-related variations in smoking behaviors and their determinants among women of childbearing age in the United States. DESIGN: Analysis of data collected between 1987-1996 from the Behavioral Risk Factor Surveillance System survey. SETTING AND SUBJECTS: A total of 187302 (178499 nonpregnant and 8803 pregnant) noninstitutionalized women aged 18 to 44 years from 33 states. MAIN OUTCOME MEASURES: Prevalence rates of smoking initiation and current smoking, median number of cigarettes smoked, and adjusted odds ratios for smoking stratified by pregnancy status; prevalence rate ratio for current smoking comparing pregnant with nonpregnant women. RESULTS: The overall percentage of women who had ever initiated smoking decreased significantly from 44.1% in 1987 to 38.2% in 1996. During that 10-year period, the prevalence of current smoking also decreased significantly among both pregnant women (16.3% to 11.8%) and nonpregnant women (26.7% to 23.6%). Overall, pregnant women were about half (54%) as likely as nonpregnant women to be current smokers during 1987-1996. Over time, the median number of cigarettes smoked per day by pregnant smokers remained at 10, whereas among nonpregnant smokers it decreased from 19 to 15 (P<.05 for trend). In the same period, among young women (aged 18-20 years), prevalence rates of smoking initiation and current smoking increased slightly. Sociodemographic subgroups of women at increased risk for current smoking were the same for pregnant and nonpregnant women (ie, those with a completed high school education or less, whites, and those who were unmarried). CONCLUSIONS: In this analysis, the decline in smoking over time among pregnant women was primarily due to the overall decline in smoking initiation rates among women of childbearing age, not to an increased rate of smoking cessation related to pregnancy. To foster effective perinatal tobacco control, efforts are needed to further reduce the number of young women who begin smoking. Clinicians should query all pregnant women and women of childbearing age about smoking and provide cessation and relapse interventions to each smoker.     

Reduced tar, nicotine, and carbon monoxide exposure while smoking ultralow- but not low-yield cigarettes

An unresolved public health issue is whether some modern cigarettes are less hazardous than others and whether patients who cannot stop smoking should be advised to switch to lower-yield cigarettes. We studied "tar" (estimated by urine mutagenicity), nicotine, and carbon monoxide exposure in habitual smokers switched from their usual brand to high- (15 mg of tar), low- (5 mg of tar), or ultralow-yield (1 mg of tar) cigarettes. There were no differences in exposure comparing high- or low-yield cigarettes, but tar and nicotine exposures were reduced by 49% and 56%, respectively, and carbon monoxide exposure by 36% while smoking ultralow-yield cigarettes. Similarly, in 248 subjects smoking their self-selected brand, nicotine intake, estimated by blood concentrations of its metabolite cotinine, was 40% lower in those who smoked ultralow but no different in those smoking higher yields of cigarettes. Our data indicate that ultralow-yield cigarettes do deliver substantial doses of tar, nicotine, and carbon monoxide, but that exposures are considerably less than for other cigarettes.     

社区综合干预对北京市郊区吸烟、慢性支气管炎和哮喘流行的影响

目的研究社区综合干预对北京市郊区人群吸烟、慢性支气管炎和哮喘流行情况的影响.方法1992年,将北京市房山区23个自然村整群随机分为13个干预村和10个对照村,对干预村进行以戒烟、改善居住环境为主的社区人群综合干预,对照村未施加干预.2000年4月,对干预区和对照区34 436名15岁以上人群进行吸烟、慢性支气管炎和哮喘流行情况普查.同期,对1 658名慢性阻塞性肺疾病(COPD)高危人群进行卫生知识水平、居住环境和吸烟状况的基线调查和复查.结果干预区男女高危人群卫生知识水平得分改善幅度和居住环境好转率显著大于对照区(P＜0.001).干预区全人群中男性吸烟率、现吸烟率下降幅度显著大于对照区(0.4% vs -0.8%,P＜0,001;2.4% vs 1.3%,P＜0.001),女性差异无显著性(P＞0.05).无论男女,干预区15～24岁人群1993～2000年累积新吸烟率显著低于对照区(男:18.9% vs 23.7%,P=0.005;女:0% vs 0.7%,P=0.005).干预区吸烟者日吸烟支数低于对照区[男:(14.8±7.0)支/d vs(17.2±8.2)支/d,P＜0.001;女:(12.8±6.9)支/d vs(13.4±7.2)支/d,P=0.088].由于人群老龄化,慢性支气管炎患病率呈上升趋势,干预村上升幅度低于对照村(男:0.9% vs 1.3%,P=0.012;女:0.1% vs 0.3%,P=0.003).控制年龄因素后,干预村慢性支气管炎1993～2000年累积发病率低于对照村(比值比:男性为0.80,95%CI:0.60～1.07;女性为0.76,95%CI:0.45～1.28).干预区男女哮喘患病率和累积发病率均与对照区差异无显著性(P＞0.05).结论社区综合干预可以有效提高人群COPD防治知识水平,改善居住环境,降低人群新发吸烟率和吸烟量,减少慢性支气管炎的发生,对哮喘无明显影响.     

Educational inequalities associated with health-related behaviours in the adult population of Singapore

INTRODUCTION: Socioeconomic differences in health-related behaviours have been widely studied in the Western populations, but are seldom considered in Asian populations. We examined the effect of education attainment on health-related behaviours (physical activity, cigarette smoking and alcohol consumption) among non-institutionalised Singaporeans aged 18-69 years. METHODS: We used data from the Singapore National Health Survey 2004. Information on physical activity, cigarette smoking, alcohol consumption and sociodemographic characteristics was collected from 4,084 adults. Age-adjusted prevalence of the three health-related behaviours by educational attainment was calculated by the direct method. Logistic regression models, adjusted for age, gender, ethnic group and employment status, were used to estimate the odds ratio and 95% confidence interval, in order to study the prevalence of health-related behaviours according to educational attainment. RESULTS: The prevalence of physical inactivity, daily smoking and regular alcohol consumption was found to be consistently highest among men and women with the least education. Prevalence of physical inactivity and smoking was inversely related to educational attainment for both genders. However, no clear gradient was found between education and alcohol consumption for men and women. CONCLUSION: Less-educated Singaporeans were more likely to smoke daily, drink alcohol regularly or not to exercise regularly. Health promotion policies or programmes aimed at encouraging healthy lifestyles in the Singapore population should take into account the educational inequalities in these health-related behaviours.     

Respiratory effects of non-tobacco cigarettes

Data from the Tucson epidemiological study of airways obstructive disease on smoking of non-tobacco cigarettes such as marijuana were analysed to determine the effect of such smoking on respiratory symptoms and pulmonary function. Among adults aged under 40, 14% had smoked non-tobacco cigarettes at some time and 9% were current users. The prevalence of respiratory symptoms was increased in smokers of non-tobacco cigarettes. After tobacco smoking had been controlled for men who smoked non-tobacco cigarettes showed significant decreases in expiratory flow rates at low lung volumes and in the ratio of the forced expiratory volume in one second to the vital capacity. This effect on pulmonary function in male non-tobacco cigarette smokers was greater than the effect of tobacco cigarette smoking. These data suggest that non-tobacco cigarette smoking may be an important risk factor in young adults with respiratory symptoms or evidence of airways obstruction.     

US college students' use of tobacco products: results of a national survey

CONTEXT: Adults aged 18 to 24 years, many of whom are in college, represent the youngest legal targets for tobacco industry marketing. Cigarette smoking has been described among college students, but little is known about non-cigarette tobacco use by college students or cigar use by adults of any age. OBJECTIVES: To assess the prevalence of all forms of tobacco use (cigarettes, cigars, pipes, and smokeless tobacco) among US college students and to identify student- and college-level factors associated with use of each product. DESIGN: The Harvard College Alcohol Survey, a self-administered survey conducted in 1999. SETTING: One hundred nineteen nationally representative US 4-year colleges. SUBJECTS: A total of 14,138 randomly selected students (60% response rate). MAIN OUTCOME MEASURES: Self-report of current (in the past 30 days), past-year, and lifetime use of cigarettes, cigars, pipes, smokeless tobacco, and all tobacco products. RESULTS: Nearly half (45.7%) of respondents had used a tobacco product in the past year and one third (32.9%) currently used tobacco. Cigarettes accounted for most of the tobacco use (28.5% current prevalence), but cigar use was also substantial (37.1% lifetime prevalence, 23.0% past-year prevalence, and 8.5% current prevalence) and combinations of the 2 were common. Total tobacco use was higher in men than in women (37. 9% vs 29.7%; P<.001), despite nearly identical current cigarette smoking rates between the sexes (28.5% for women vs 28.4% for men), because of greater use of cigars (current prevalence, 15.7% vs 3.9%; P<.001) and smokeless tobacco (current prevalence, 8.7% vs 0.4%; P<. 001) by men. Tobacco use was significantly higher among white students (P<.001), users of other substances (alcohol and marijuana) (P<.001), and students whose priorities were social rather than educational or athletic (P<.05). Among students who had used both cigars and cigarettes, only 8.9% smoked cigars at an earlier age than they had smoked cigarettes. CONCLUSION: Our study indicates that tobacco use is common among college students and is not limited to cigarettes. College appears to be a time when many students are trying a range of tobacco products and are in danger of developing lifelong nicotine dependence. National efforts to monitor and reduce tobacco use of all types should expand to focus on college students and other young adults. JAMA. 2000;284:699-705     

The effect of cigarette smoking on hemoglobin levels and anemia screening

The relationships among cigarette smoking, hemoglobin concentration, and carboxyhemoglobin concentration were examined using data from the Second National Health and Nutrition Examination Survey. Among women, smokers had a mean (+/- SE) hemoglobin level of 137 +/- 0.4 g/L, significantly higher than the mean hemoglobin level of 133 +/- 0.5 g/L for never-smokers. Among men, the mean hemoglobin levels for smokers and never-smokers were 156 +/- 0.4 and 152 +/- 0.5 g/L, respectively. No significant difference in mean hemoglobin was noted between ex-smokers and never-smokers. Mean hemoglobin levels and carboxyhemoglobin levels increased progressively with the number of cigarettes consumed per day. Cigarette smoking seems to cause a generalized upward shift of the hemoglobin distribution curve, which reduces the utility of hemoglobin level to detect anemia. Among women of comparable socioeconomic status, the prevalence of anemia was 4.8% +/- 0.6% among smokers, compared with 8.5% +/- 1.2% among never-smokers. This study suggests that minimum hemoglobin cutoff values should be adjusted for smokers to compensate for the masking effect of smoking on the detection of anemia.     

Carbon monoxide yield of cigarettes and its relation to cardiorespiratory disease

Estimates of the carbon monoxide yield of their cigarettes have been obtained for 4910 smokers (68% of all smokers) in the Whitehall study of men aged 40 to 64. In the 10 years after examination 635 men died. When men smoking cigarettes with high carbon monoxide yield were compared with those smoking cigarettes with a low yield, and after adjusting for age, employment grade, amount smoked, and tar yield, the risk of death was 32% lower for coronary heart disease, 49% higher for lung cancer, and 10% lower for total mortality; these differences were not statistically significant. Among men who said that they inhaled the risk of fatal coronary heart disease was 51% lower in the high carbon monoxide group (p less than 0.01), while the risk of lung cancer was 75% higher. These results provide no evidence that a smoker can reduce his risk of death by smoking a brand with a low carbon monoxide yield; he might even increase it. The complex interactions between characteristics of the smoker, smoking behaviour, constituents of tobacco smoke, and health are again demonstrated.     

Trends in cigarette smoking in the United States. Projections to the year 2000

Data from National Health Interview Surveys from 1974 through 1985 are used to project cigarette smoking prevalence to the year 2000. Smoking prevalence in the United States has declined at a linear rate since 1974. If this trend continues, in the year 2000, 22% of the adult population (40 million Americans) will be smokers. By the year 2000, the major inequalities in prevalence will occur among educational categories. At least 30% of those who have not proceeded beyond a high school education will be smokers, whereas less than 10% of college graduates will smoke. Among the other sociodemographic subgroups, smoking prevalence is expected to decrease by the year 2000 to 20% among men, to 23% among women, to 25% among blacks, and to 21% among whites. Between 1974 and 1985, approximately 1.3 million persons per year became former smokers, indicating considerable success in public health efforts to encourage people to stop smoking. However, in the early 1980s, approximately 1 million new young persons per year were recruited to the ranks of regular smokers. This is equivalent to about 3000 new smokers each day. Public health efforts need to focus more on preventing young people from starting to smoke, and such prevention efforts should particularly target less educated socioeconomic groups.     

General practitioners' detection of patients' smoking status

We examined the detection of smoking by 50 randomly-selected general practitioners. The practitioners said that they should detect smokers among their patients with a high degree of accuracy: a median of 100% of smokers under ideal conditions, and a median of 80% of smokers given the realities of practice. Practitioners actually identified 56.2% of their patients who were smokers--360 of 641 smokers among 2044 patients in the study. Some 65% of patients with a smoking-caused or smoking-exacerbated disease were detected, and this degree of detection was not related to age. For smokers of greater than 50 years of age and without any obvious smoking-related condition, the detection rates were similar to those of patients with smoking-related disease; however, in those patients who were less than 30 years of age, only 41% of smokers were detected--although the prevalence of smoking was higher in the younger than it was in the older patients. For all age-groups, the prevalence of smoking in men was about 15% higher than it was in women, but there was no significant difference between the detection rates in the sexes. In spite of their higher risks from smoking, the detection rates for pregnant women, or women who were taking oral contraceptive agents, were no higher than those for other women of less than 35 years of age. The doctors said that they had treated for smoking 78% of the detected smokers who had smoking-caused disease, compared with 35% of detected smokers with no smoking-related condition. They rated the value of such treatment higher in the former group than in those patients who had not yet developed smoking-related problems. Doctors appear to respond to the evidence of disease that is caused by smoking more than to the habit itself, which is a handicap in the prevention of smoking-related disease.     

Birth cohort analysis of prevalence of cigarette smoking among Hispanics in the United States

To investigate historical trends of cigarette smoking among Mexican-Americans, Cuban-Americans, and Puerto Rican-Americans, we conducted a birth cohort analysis of smoking prevalence by using smoking histories of 8286 adults and adolescents from the 1982-1983 Hispanic Health and Nutrition Examination Survey. We constructed smoking prevalence curves for men and women among successive ten-year birth cohorts. Birth cohort-specific prevalence rates were higher for men than for women. Rates, however, decreased among successive cohorts of men. Conversely, rates increased among successive cohorts of Cuban-American and Puerto Rican-American women. For example, peak rates among the 1911 through 1920 cohorts were 26% (Cuban-American women) and 25% (Puerto Rican-American women) compared with peak rates of 43% and 52%, respectively, among comparable groups from 1951 through 1960. These results demonstrate that despite a reduction of cigarette smoking among successive cohorts of Hispanic men, Hispanic women have made little progress or have actually increased their cigarette smoking.     

Patterns of tobacco smoking in Australia.

A large representative sample of Australians aged 14 years or more was interviewed about smoking. Forty-one per cent of the males and 29% of the females aged 16 years and over currently smoked cigarettes. Smoking rates for both sexes were highest in the 20 to 24 years age group. People in metropolitan areas smoked more than those in rural areas. There was a clear excess of smoking among British immigrants. Higher socioeconomic level was associated with lower smoking rates, with higher ex-smoking rates and with more frequent choice of low-tar brands. Low-tar cigarrettes were used more where health education had emphasized the importance of tar content. Choice of brands among young smokers appeared related to the advertising strategies employed by cigarette companies. The majority of ex-smokers over 60 years of age had given up more than five years previously. Although comparison with earlier surveys of smoking habits is difficult, the results suggested a decrease in cigarette smoking among males and a slight increase among females.     

西安市居民吸烟行为流行病学分析

目的　了解西安市居民的吸烟现状 .方法　随机抽取 10 0 0名 15～ 6 9岁居民进行入户调查 .结果　西安市居民吸烟率为 32 .2 % (男 6 4.2 % ,女 1.8% ) ,平均开始吸烟年龄为2 2 .5岁 ,日平均吸烟量为 12 .8支 ,且开始吸烟年龄越早 ,吸烟量越大 ,尝试、社交需要和解乏是主要的吸烟原因 ,吸烟者的戒烟率为 9.0 3% .分析发现 ,性别、职业、文化程度及家庭成员吸烟均与居民的吸烟行为有关 .结论　吸烟在西安市仍然是一个严重的公共卫生问题 ,控烟应从全社会抓起 ,以青少年作为宣传教育的重点 ,加强控烟力度     

Smoking in China: findings of the 1996 National Prevalence Survey.

CONTEXT: As the world's largest producer and consumer of tobacco products, China bears a large proportion of the global burden of smoking-related disease and may be experiencing a tobacco epidemic. OBJECTIVE: To develop an evidence-based approach supporting tobacco control initiatives in China. DESIGN AND SETTING: A population-based survey consisting of a 52-item questionnaire that included information on demographics, smoking history, smoking-related knowledge and attitudes, cessation, passive smoke exposure, and health status was administered in 145 disease surveillance points in the 30 provinces of China from March through July 1996. PARTICIPANTS: A nationally representative random sample of 128766 persons aged 15 to 69 years were asked to participate; 120298 (93.8%) provided data and were included in the final analysis. About two thirds of those sampled were from rural areas and one third were from urban areas. MAIN OUTCOME MEASURES: Current smoking patterns and attitudes; changes in smoking patterns and attitudes compared with results of a previous national survey conducted in 1984. RESULTS: A total of 41187 respondents smoked at least 1 cigarette per day, accounting for 34.1% of the total number of respondents, an increase of 3.4 percentage points since 1984. Current smoking continues to be prevalent among more men (63%) than women (3.8%). Age at smoking initiation declined by about 3 years for both men and women (from 28 to 25 years). Only a minority of smokers recognized that lung cancer (36%) and heart disease (4%) can be caused by smoking. Of the nonsmokers, 53.5% were exposed to environmental tobacco smoke at least 15 minutes per day on more than 1 day per week. Respondents were generally supportive of tobacco control measures. CONCLUSION: The high rates of smoking in men found in this study signal an urgent need for smoking prevention and cessation efforts; tobacco control initiatives are needed to maintain or decrease the currently low smoking prevalence in women.     

Distribution of cardiovascular disease risk factors by socioeconomic status among Canadian adults

BACKGROUND: This study was designed to describe the distribution of risk factors for cardiovascular disease by socioeconomic status in adult men and women across Canada using the Canadian Heart Health Surveys Database. METHODS: The data were derived from provincial cross-sectional surveys done between 1986 and 1992. Data were obtained through a home interview and a clinic visit using a probability sample of 29,855 men and women aged 18-74 years of whom 23,129 (77%) agreed to participate. The following risk factors for cardiovascular disease were considered: elevated total plasma cholesterol (greater than 5.2 mmol/L), regular current cigarette smoking (one or more daily), elevated diastolic or systolic blood pressure (140/90 mm Hg), overweight (body mass index and lack of leisure-time physical activity [less than once a week in the last month]). Education and income adequacy were used as measures of socioeconomic status and mother tongue as a measure of cultural affiliation. RESULTS: For most of the risk factors examined, the prevalence of the risk factors was inversely related to socioeconomic status, but the relationship was stronger and more consistent for education than for income. The inverse relationship between socioeconomic status and the prevalence of the risk factors was particularly strong for smoking and overweight, where a gradient was observed: 46% (standard error [SE] 1.4) of men and 42% (SE 4.3) of women who had not completed secondary school were regular smokers, but only 12% (SE 1.0) of men and 13% (SE 0.9) of women with a university degree were regular smokers. Thirty-nine percent (SE 1.4) of men and 19% (SE 3.8) of women who had not completed secondary school were overweight, compared with 26% (SE 2.6) of male and 19% of female university graduates. The prevalence of leisure-time physical inactivity and elevated cholesterol was highest in both men and women in the lowest socioeconomic category, particularly by level of education. INTERPRETATION: The differences in the prevalence of risk factors for cardiovascular disease between socioeconomic groups are still important in Canada and should be considered in planning programs to reduce the morbidity and mortality from cardiovascular disease.     

Smoking and diabetes in Chinese men

Smoking is a major cardiovascular risk factor and cause of death. Diabetes mellitus is also associated with an increased mortality and morbidity. Evidence concerning whether smoking increases the incidence of diabetes remains conflicting. Glycaemic status and smoking habits were analysed in 3718 Chinese subjects in order to assess the possible association between smoking and risk of diabetes in the Chinese population. The World Health Organisation 1998 criteria were used for the diagnosis of glucose intolerance. Smoking was defined as current cigarette smoking or ex-smoking without regard to daily consumption. The smoking habits of the studied subjects were correlated with glycaemic status. There were 3003 (80.8%) women and 715 (19.2%) men. The mean age (SD) was 38.4 (12.8) years (median 35.0, range 12-88 years). Of the 3718 subjects, 786 (21.1%) had diabetes, 708 (19.1%) had impaired glucose tolerance, and 2224 (59.8%) had normal results. Of the 3003 women, only 87 (2.9%) were smokers. The female smokers were younger, heavier, and had higher alcohol consumption than non-smokers. The prevalence of diabetes was similar between female smokers and non-smokers after adjustment for age, body mass index, family history of diabetes, and alcohol. Of the 715 men, 175 (24.5%) were smokers. The male smokers were younger, had lower blood pressure, and higher alcohol consumption. After adjustment for age, body mass index, family history of diabetes and alcohol, the male smokers had lower blood pressure, higher one hour plasma glucose, and more diabetes. Using logistic regression analysis (stepwise forward) with age, body mass index, alcohol, smoking, and family history of diabetes as independent variables to predict the risk of having diabetes, age and body mass index are independently associated with diabetes in both men and women. In addition, smoking is independently associated with the risk of diabetes in men, the odds ratio (95% confidence interval, CI) being 1.705 (1.106 to 2.630). Family history of diabetes is independently associated with the risk of diabetes in women, and the odds ratio (95% CI) is 1.643 (1.314, to 2.053). In conclusion, it was found that smoking is independently associated with diabetes after adjustment for age, body mass index, alcohol, and family history of diabetes in Hong Kong Chinese men, the odds ratio being 1.7. The prevalence of smoking in Hong Kong Chinese women is low and its association with diabetes is inconclusive.