Self-reported smoking, urine cotinine, and risk of type 2 diabetes: Findings from the PREVEND prospective cohort study

Setor K. Kunutsor, John Tetteh, Richard S. Dey, Daan J. Touw, Robin P.F. Dullaart, Stephan J.L. Bakker

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Smoking is a major risk factor for type 2 diabetes (T2D), but the evidence has mostly relied on self-reports. We aimed to compare the associations of smoking exposure as assessed by self-reports and urine cotinine with T2D. Methods: Using the PREVEND prospective study, smoking status was assessed at baseline by self-reports and urine cotinine in 4708 participants (mean age, 53 years) without a history of diabetes. Participants were classified as never, former, light current and heavy current smokers according to self-reports and analogous cut-offs for urine cotinine. Hazard ratios (HRs) with 95% CIs were estimated for T2D. Results: During a median follow-up of 7.3 years, 259 participants developed T2D. Compared with self-reported never smokers, the multivariable adjusted HRs (95% CI) of T2D for former, light current, and heavy current smokers were 1.02 (0.75–1.4), 1.41 (0.89–2.22), and 1.30 (0.88–1.93), respectively. The corresponding adjusted HRs (95% CI) were 0.84 (0.43–1.67), 1.61 (1.12–2.31), and 1.58 (1.08–2.32), respectively, as assessed by urine cotinine. Urine cotinine-assessed but not self-reported smoking status improved T2D risk prediction beyond established risk factors. Conclusion: Urine cotinine assessed smoking status may be a stronger risk indicator and predictor of T2D compared to self-reported smoking status.

Original languageEnglish
Pages (from-to)414-421
Number of pages8
JournalPrimary Care Diabetes
Volume18
Issue number4
DOIs
Publication statusPublished - Aug 2024

Keywords

  • Cohort study
  • Cotinine
  • Risk factor
  • Smoking
  • Type 2 diabetes

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