4.13 Secondhand smoke and type 2 diabetes mellitus

Last updated: January 2017
Suggested citation: Campbell MA, Ford C, & Winstanley MH. Ch 4. The health effects of secondhand smoke. 4.13 Secondhand smoke and type 2 diabetes mellitus. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2017. Available from http://www.tobaccoinaustralia.org.au/chapter-4-secondhand/4-13-secondhand-smoke-and-diabetes

There is emerging evidence that secondhand smoke exposure increases the risk of developing type 2 diabetes mellitus.

Findings from a large prospective cohort study in the UK suggest that the risk of developing glucose intolerance (a pre-diabetic state) is increased in young adults who have long term exposure to secondhand smoke.1 Current smokers were most likely to develop glucose intolerance, followed by never smokers exposed to secondhand smoke, followed by unexposed never smokers.

In older populations, chronic exposure to secondhand smoke is associated with developing type 2 diabetes, and the risk increases with the degree of exposure.2-5 A meta-analysis of five high-quality observational studies found that when compared to never smokers with no secondhand smoke exposure, never smokers reporting secondhand smoke exposure had a 21% increased risk of type 2 diabetes mellitus.6 A separate study found an increased risk of diabetes mellitus among never smokers with secondhand smoke exposure of 51%.7 Further research is needed to confirm this association, and determine if it is causal.

As noted in Section 4.8, individuals with existing diabetes are at greater risk of developing coronary heart disease if exposed to secondhand smoke.8

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1. Houston T, Person S, Pletcher M, Liu K, Iribarren C, et al. Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: Cardia study. British Medical Journal, 2006; 332:1064-9. Available from: http://www.bmj.com/cgi/content/full/332/7549/1064

2. Ko K, Min H, Ahn Y, Park S, Kim C, et al. A prospective study investigating the association between environmental tobacco smoke exposure and the incidence of type 2 diabetes in never smokers. Annals of Epidemiology, 2010; 21(1):42–7. Available from: http://www.annalsofepidemiology.org/article/PIIS1047279710003601/fulltext

3. Kowall B, Rathmann W, Strassburger K, Heier M, Holle R, et al. Association of passive and active smoking with incident type 2 diabetes mellitus in the elderly population: The kora s4/f4 cohort study. European Journal of Epidemiology, 2010; 25(6):393–402. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20369275

4. Vardavas CI, Lionis C, Polychronopoulos E, Zeimbekis A, Bountziouka V, et al. The role of secondhand smoking on the prevalence of type 2 diabetes mellitus in elderly men and women living in mediterranean islands: The medis study. Diabetic Medicine, 2009; 27(2):242–3. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1464-5491.2009.02889.x/full

5. Leung C, Lam T, Ho K, Yew W, Tam C, et al. Passive smoking and tuberculosis. Archives of Internal Medicine, 2010; 170(3):287–92. Available from: http://archinte.ama-assn.org/cgi/content/full/170/3/287

6. Sun K, Liu D, Wang C, Ren M, Yang C, et al. Passive smoke exposure and risk of diabetes: A meta-analysis of prospective studies. Endocrine, 2014; 47(2):421–7. Available from: http://link.springer.com/article/10.1007%2Fs12020-014-0194-1

7. Eze IC, Schaffner E, Zemp E, von Eckardstein A, Turk A, et al. Environmental tobacco smoke exposure and diabetes in adult never-smokers. Environmental Health, 2014; 13:74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25253088

8. Office of Environmental Health Hazard Assessment and California Air Resources Board. Health effects of exposure to environmental tobacco smoke: Final report, approved at the Panel's June 24, 2005 meeting. Sacramento: California Environmental Protection Agency, 2005. Available from: http://www.oehha.ca.gov/air/environmental_tobacco/2005etsfinal.html