GO TO CMA Home
GO TO Inside CMA
GO TO Advocacy and Communications
GO TO Member Services
GO TO Publications
GO TO Professional Development
GO TO Clinical Resources

GO TO What's New
GO TO Contact CMA
GO TO Web Site Search
GO TO Web Site Map


CMAJ
CMAJ Readers' ForumTribune des lecteurs du JAMC

Smoking likely causes some epidemic type 2 diabetes

Online posting: September 11, 2000

Re: Type 2 diabetes mellitus in Canada's First Nations: status of an epidemic in progress [Review], by T. Kue Young, Jeff Reading, Brenda Elias, John D. O'Neil, CMAJ 2000;163(5):561-6)
Major tobacco companies have long recognized that tobacco use causes hyperglycemia.1,2 Current or lifetime smoking or smokeless tobacco use very likely causes diabetes as well as many of the severe complications of diabetic tobacco users.3-5

A quarter or more of diabetes incidence among Canada's First Nations could be explained by diabetes relative risks (RR) as low as 1.5 in tobacco users ([1/4 = (RR-1) × prevalence] / [1 + (RR-1) × prevalence]) if prevalence is 64%6). Given the likely leading roles of tobacco use in causing type 2 diabetes and its complications, I hope that physicians, researchers, governments, and tobacco packages will soon better inform the public about tobacco's roles in diabetes.

I have no funding or conflicts of interest in relation to this study or this letter.

Bruce N. Leistikow, MD, MS
University of California
Davis, California
BNLeistikow@ucdavis.edu

Comments Send a letter to the editor
Envoyez une lettre à la rédaction

References
  1. Nicotine Review: British American Tobacco (BAT), 1983. http://outside.cdc.gov:8080/BASIS/ ncctld/web/mnimages/DDW?W=DETAILSID=26903 (accessed 8/29/00).
  2. Wakeham H. Presentation and report to the Philip Morris, Inc. Board of Directors: Minnesota and Minnesota Blue Cross vs Philip Morris, et al, Trial Exhibit 10299, 1969. http://www.mnbluecrosstobacco.com/toblit/trialnews/ docs/TE10299.pdf (accessed 2/24/98).
  3. Persson P, Carlsson S, Svanstrom L, Ostenson C, Efendic S, Grill V. Cigarette smoking, oral moist snuff use and glucose intolerance. J Intern Med 2000;248(2):103-110.
  4. Nakanishi N, Nakamura K, Matsuo Y, Suzuki K, Tatara K. Cigarette smoking and risk for impaired fasting glucose and type 2 diabetes in middle-aged Japanese men. Ann Intern Med 2000;133(3):183-91.
  5. Rimm EB, Manson JE, Stampfer MJ, Colditz GA, Willett WC, Rosner B, et al. Cigarette smoking and the risk of diabetes in women. Am J Public Health 1993;83(2):211-4.
  6. Young TK, Reading J, Elias B, O'Neil JD. Type 2 diabetes mellitus in Canada's First Nations: status of an epidemic in progress. CMAJ 2000;163(5):561-6.

© 2000 Canadian Medical Association or its licensors