Smoking behavior change and risk of cardiovascular disease incidence and mortality in patients with type 2 diabetes mellitus

• Published in: Cardiovascular diabetology 2023-07, Vol.22 (1), p.193-193, Article 193
• Main Authors: Jeong, Su-Min, Yoo, Jung Eun, Park, Junhee, Jung, Wonyoung, Lee, Kyu Na, Han, Kyungdo, Lee, Cheol Min, Nam, Ki-Woong, Lee, Seung-Pyo, Shin, Dong Wook
• Format: Article
• Language: English
• Subjects: Alcohol; Antidiabetics; Body mass index; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular System; Cerebral infarction; Cigarette smoking; Cigarettes; Codes; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetic neuropathy; Drug addiction; Health behavior; Humans; Incidence; Ischemia; Ischemic Stroke; Medical aid; Medical screening; Mortality; Myocardial infarction; Myocardial Infarction - diagnosis; Myocardial Infarction - epidemiology; Population; Questionnaires; Smoking - adverse effects; Smoking - epidemiology; Smoking cessation; Smoking reduction; Stroke
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-023-01930-4

We aimed to examine the association between smoking behavior change and risk of cardiovascular disease (CVD) incidence and mortality in patients with type 2 diabetes mellitus (T2DM). This study used nationwide data from the Korean National Health Insurance System and included 349,137 T2DM patients who smoked. Smoking behavior changes were defined with five groups: quitters, reducers I (≥ 50% reduction), reducers II (20-50% reduction), sustainers (± 20%), and increasers (≥ 20% increase) from the number of cigarettes/day at the baseline. During a median follow-up of 5.1 years, 6,514 cases of myocardial infarction (MI) (1.9%), 7,837 cases of ischemic stroke (IS) (2.2%), and 14,932 deaths (4.3%) were identified. Quitters had a significantly decreased risk of MI (adjusted hazard ratio [aHR] 0.80, 95% CI 0.75-0.86) and IS (aHR 0.80, 95% CI 0.75-0.85) compared to sustainers, whereas reducers did not have a significant association with the risk of MI (aHR 1.03, 95% CI 0.94-1.13) and IS (aHR 1.00, 95% CI 0.92-1.08) in reducer I. Quitters also had a lower all-cause and CVD mortality than sustainers. Smoking cessation was associated with decreased CVD incidence, and all-cause and CVD mortality among T2DM patients. However, smoking reduction was not associated with decreased risks for these.