Objectives: To investigate the association between smoking status, total life expectancy and the number of years lived with and without diabetes. In addition, to examine whether total life expectancy and life expectancy with and without diabetes is different between normal-weight smokers and overweight/obese ex-smokers.

Methods: The study included 10,739 participants aged 45+ years from the population-based Rotterdam Study. We developed a multistate life table to calculate life expectancy for individuals who were (i) current, former and never smokers (reference) as well as for (ii) normal-weight current smokers (reference), overweight and obese ex-smokers.

Results: Compared to never smoker, current male smoker lived 6.6 (95% confidence interval -8.4 to -3.9) years fewer overall, of which 6.0 (-7.8 to -3.0) years fewer without diabetes and 0.6 (-1.8 to 1.3) years longer with diabetes; whereas current female smoker lived 5.1 (-8.4 to -3.9) years fewer overall of which 5.4 (-7.8 to -3.0) years fewer without diabetes and 0.3 (-1.8 to 1.3) years more with diabetes. Additionally, obese and overweight former male smoker lived 4.8 (6.1 to 8.4) and 4.0 (6.3 to 8.4) years longer than current normal-weight smoking men, of which 0.1 (-3.5 to 6.2) and 2.4 (0.7 to 6.4) years more without diabetes and, 4.7 (1.3 to 10.4) and 1.6 (1.1 to 6.0) years longer with diabetes, respectively. Among women, obese and overweight ex-smokers lived 9.2 (6.1 to 8.4) and 8.0 (6.3 to 8.4) years longer than their current normal-weight counterparts, of which 1.3 (-3.5 to 6.2) and 3.4 (0.7 to 6.4) years longer without diabetes and 7.8 (1.3 to 10.4) and 4.6 (1.1 to 6.0) years longer with diabetes, respectively.

Conclusions: We found that the benefits of quitting smoking outweigh the risk of weight gain associated with smoking cessation in terms of life expectancy and years of life lived with and without diabetes.


E. Asllanaj: None. T. Voortman: None. M. GLisic: None. O. Franco: None. T. Muka: Employee; Self; Novo Nordisk A/S.

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