Abstract P383: Smoking Cessation and Weight Change in Relation to Cardiovascular Disease Incidence and Mortality Among Patients With Diabetes Mellitus

Introduction: Some studies suggested that smoking cessation could result in short-term weight gain, deterioration in glycemic control, and worsening of some diabetic symptoms. It is unclear whether weight gain following smoking cessation might mitigate the health benefits among adults with diabetes. Hypothesis: Smoking cessation is associated with a lower risk of cardiovascular disease (CVD) incidence and mortality among individuals with diabetes, and weight gain following smoking cessation does not modify the association. Methods: This prospective analysis included 9,780 men and women with type 2 diabetes from the Nurses’ Health Study (1984-2014) and Health Professionals Follow-Up Study (1988-2014). Information on newly diagnosed diseases, medical history, dietary and lifestyle factors, including smoking status and weight change, was updated every two years through validated questionnaires. Results: During 154,825 person-years of follow-up, there were 2,590 incident CVD cases and 3,326 deaths among participants with diabetes. Compared with those who continued to smoke, quitters had a lower risk of CVD incidence, regardless of weight change after quitting. The multivariate-adjusted hazard ratios (95% confidence intervals) for CVD were 0.66 (0.54-0.81) among recent quitters (≤6 years since smoking cessation) without weight gain, 0.69 (0.47-0.99) among recent quitters with weight gain of 0.1 to 5.0 kg, 0.57 (0.37-0.87) among recent quitters with weight gain of more than 5.0 kg, 0.71 (0.60-0.83) among longer-term quitters (>6 years since smoking cessation), and 0.51 (0.45-0.59) among never-smokers. Similar results were observed for CVD, cancer, and all-cause mortality, although the associations did not reach statistical significance among recent quitters with weight gain. Conclusions: Smoking cessation was associated with a lower risk of CVD incidence among men and women with diabetes, even among those who gained weight after quitting. A health benefit of smoking cessation on mortality was also observed.