The Endocrine Society

The Endocrine Society

Issue: August 2012
Perspective from Alvin C. Powers, MD
June 25, 2012
2 min read

NHANES: Secondhand smoke linked to obesity, diabetes

Issue: August 2012
Perspective from Alvin C. Powers, MD
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HOUSTON — Secondhand smoke has been found to cause numerous health risks, but new data from the NHANES survey has added diabetes and obesity to the list, based on evidence presented here.

“Studies have shown a positive association with cigarette smoking and the rate of type 2 diabetes. This is surprising, as smokers are leaner than nonsmokers, and obesity is positively associated with diabetes. The relationship between secondhand smoke and diabetes is less established,” Theodore C. Friedman, MD, PhD, chairman of the department of internal medicine at Charles R. Drew University of Medicine and Science in Los Angeles, said during a press conference.

Friedman and colleagues examined data from 6,391 adults who participated in the NHANES from 2001 to 2006. Smokers and nonsmokers were identified by the presence of cotinine, an alkaloid found in tobacco and a metabolite of nicotine.

When patients were asked, “Do you smoke cigarettes?” 25% answered “yes” and had serum cotinine >3 ng/mL. Secondhand smokers (34%) were identified when replying “no” to the question and had serum cotinine of >0.05 ng/mL. Additionally, nonsmokers (41%) were identified when they answered “no,” and had serum cotinine <0.05 ng/mL.

Researchers examined outcome variables including BMI, fasting blood glucose, HOMA and HbA1c.

After using a multivariate model with adjustments for age, sex, race, alcohol and physical activity, compared with nonsmokers, the secondhand smokers had higher HOMA (P=.048), HbA1c (P=.01), FBG (P=.02) and BMI (P=.02).

Current smokers had higher HbA1c (P=.01) and lower BMI (P=.01), compared with nonsmokers. When BMI was added to the adjusted model, researchers found that secondhand smokers and current smokers had higher HbA1c levels compared with nonsmokers (P=.02 and P=.001).

“Secondhand smoke is associated with both obesity and diabetes, but primary smoking is only associated with diabetes. More studies are needed to show the causal relationship between secondhand smoke and diabetes, and to understand the mechanisms involved with this association,” Friedman said.

He told Endocrine Today that 25 million people are at potential risk for developing diabetes within their lifetime due to exposure to secondhand smoke.

“We are researching animals on this, exposing them to cigarette smoke and looking at some of the mechanisms involved in diabetes,” he said.

“I think that legislation is crucial now. Certainly, over many years now, we’ve made much more progress in banning smoking in public places. But, we’ve got a long way to go.” – by Samantha Costa

For more information:

Kermah D. Abstract #SUN-192. Presented at: the Endocrine Society’s 94th Annual Meeting & Expo; June 23-26, 2012; Houston.

Disclosure: The researchers report no relevant financial disclosures.