Smoking, All-Cause, and Cause-Specific Mortality in Individuals with Type 2 Diabetes in Mexico-An Analysis of the Mexico City Prospective Study (MCPS)

Background: Cigarette smoking increases the already elevated risk of mortality observed in adults with type 2 diabetes but prospective data on the association between smoking and mortality among Mexican adults with type 2 diabetes are lacking. Methods: We analyzed data from the MCPS, which surveyed 150,000 adults between 1998-2004. We performed Cox proportional hazard models and Fine and Gray sub distribution hazard models to estimate adjusted relative risk for all-cause and cause-specific mortality, respectively. Results: Among 25,141 individuals with diabetes, 50.7% were never smokers, 26% former smokers, and 23.2% active smokers. Compared to non-smokers (Fig 1A), former smokers had an increased risk of all cause-mortality at 7.5 years of follow-up (HR 1.15 [95% CI 1.05-1.26]), with this risk receding completely after 7.5 years. Compared to non-smokers (Fig 1B), active smokers had a significantly higher risk of death after 7.5 years of follow-up (HR 1.17 [95% CI 1.07-1.28]), but not in the preceding 7.5 years. For cause-specific mortality, active smokers had an increased risk of death due to myocardial infarction, lung cancer, and COPD. Conclusions: The risk of death among Mexican adults with type 2 diabetes varies over time and according to smoking status. Strategies to support sustained smoking cessation in people with type 2 diabetes are needed. Disclosure D.Ramírez-garcía: None. C.A.Fermín-martínez: None. N.Antonio villa: None. A.Vargas-vázquez: None. L.Fernández chirino: None. J.A.Seiglie: Consultant; BDMT Global, Techspert Expert Network. O.Bello-chavolla: None.