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Epidemiology/health services research
Association between secondhand smoke and obesity and glucose abnormalities: data from the National Health and Nutrition Examination Survey (NHANES 1999–2010)
  1. Dulcie Kermah1,
  2. Magda Shaheen1,
  3. Deyu Pan1,
  4. Theodore C Friedman2
  1. 1Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
  2. 2Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
  1. Correspondence to Dr Theodore C Friedman; theodorefriedman{at}cdrewu.edu

Abstract

Objective The objective of this study is to investigate the relationship between cotinine level-confirmed secondhand smoke (SHS) exposure and glycemic parameters and obesity.

Research design and methods We examined a cohort of 6472 adults from the National Health and Nutrition Examination Surveys, 1999–2010. Serum cotinine levels and self-reported data on smoking were used to determine smoking status. The outcome variables were body mass index (BMI) and glycemic status (HbA1c), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and fasting plasma glucose (FPG). Descriptive, bivariate, and multivariate analyses were conducted.

Results Using cotinine level-confirmed smoking status, 1794 (27.4%) of the sample were current smokers, 1681 (25.0%) were former smokers, 1158 (17.8%) were secondhand smokers, and 1839 (29.8%) were non-smokers. In a generalized linear model after controlling for potential confounding variables, secondhand smokers had higher adjusted levels of HOMA-IR, FPG, and BMI compared with non-smokers (p<0.05). Adjustment for BMI demonstrated that some, but not all, of the detrimental effects of SHS on glycemic parameters are mediated by the increased body weight of secondhand smokers.

Conclusions We conclude that SHS is associated with obesity and worsening glycemic parameters. More studies are needed to show a causal relationship between SHS and glycemic parameters and to understand the mechanisms involved in the association.

  • Nicotine
  • Smoking
  • Epidemiology
  • Obesity

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2016-000324

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    Footnotes

    • Contributors TCF, MS, and DK had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. DK, MS, DP, and TCF were involved in study concept and design, interpretation of data, drafting of the manuscript and statistical analysis. DK, MS, and TCF were involved in the critical revision of the manuscript for important intellectual content. TCF obtained funding.

    • Funding Funding for this project came from NIH-NIMHD grant number U54MD007598 (formerly U54RR026138), MIDARP/DIDARP grant number R24DA017298, NIMHD grant number S21 MD000103 and NIH/NCATS grant number UL1TR000124.

    • Disclaimer The funding sources had no role in the writing of the manuscript or the decision to submit it for publication as the corresponding author, TCF, had full access to all the data in the study and had the final responsibility for the decision to submit for publication.

    • Competing interests All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Original data sets are available on request.