The Risk of Cigarette Smoking

were diagnosed between 1950 and 1964. Vital status as of January 1, 1988 was ascertained for 98% of the 548 patients who participated in the baseline survey and were alive as of January 1, 1982. Fifty-four cases died during the 6-year follow-up (32 male, 22 female). Proportional hazards analysis revealed that heavy smoking was a significant independent predictor of all-cause mortality among females but not males. The excess mortality in female diabetics was explained primarily by a marked excess risk of coronary heart disease mortality in smokers. These data strongly suggest that cigarette smoking, especially among diabetic females, should be avoided in order to improve longevity. (Circulation 1990;82:37-43)

[1]  P. Hougaard,et al.  Epidemiological studies of diabetes mellitus in Denmark: 5. Mortality and causes of death among insulin-treated diabetic patients , 1984, Diabetologia.

[2]  G. Panzram,et al.  Prognosis of diabetes mellitus in a geographically defined population , 1981, Diabetologia.

[3]  L. Kuller,et al.  Marked decline of coronary heart disease mortality in 35-44-year-old white men in Allegheny County, Pennsylvania. , 1989, Circulation.

[4]  D L DeMets,et al.  Relation of ocular and systemic factors to survival in diabetes. , 1989, Archives of internal medicine.

[5]  W. Willett,et al.  Relative and absolute excess risks of coronary heart disease among women who smoke cigarettes. , 1987, The New England journal of medicine.

[6]  L. Rand,et al.  Magnitude and determinants of coronary artery disease in juvenile-onset, insulin-dependent diabetes mellitus. , 1987, The American journal of cardiology.

[7]  N. Tajima,et al.  Differential risk factors for death in insulin dependent diabetic patients by duration of disease , 1986 .

[8]  M. Shipley,et al.  Mortality and associated risk factors in diabetics. , 1985, Acta endocrinologica. Supplementum.

[9]  D. Wagener,et al.  The Pittsburgh Insulin-dependent Diabetes Mellitus (IDDM) Morbidity and Mortality Study: Case-Control Analyses of Risk Factors for Mortality , 1985, Diabetes Care.

[10]  E. Barrett-Connor,et al.  Interaction between cigarette smoking and diabetes mellitus in the prediction of death attributed to cardiovascular disease. , 1984, American journal of epidemiology.

[11]  L. Kuller,et al.  The Pittsburgh Insulin-dependent Diabetes Mellitus (IDDM) Morbidity and Mortality Study: Mortality Results , 1984, Diabetes.

[12]  F A Connell,et al.  Diabetes mortality in persons under 45 years of age. , 1983, American journal of public health.

[13]  L. Papoz,et al.  Long-term Study of Mortality and Vascular Complications in Juvenile-onset (Type I) Diabetes , 1981, Diabetes.

[14]  M. Meyer,et al.  Role of risk factors in complications of diabetes mellitus. , 1980, American journal of epidemiology.

[15]  R. Paffenbarger,et al.  Physical activity as an index of heart attack risk in college alumni. , 1978, American journal of epidemiology.