Demographic Characteristics as Moderators for the Association Between Cigarette Smoking and Type 2 Diabetes Mellitus

Diabetes mellitus is a major public health problem and is associated with increased morbidity, mortality, and healthcare expenditure in the United States. Several studies have been conducted that showed cigarette smoking is associated with an increased incidence and prevalence of diabetes mellitus (DM); however, there is no published information in the literature on the moderating effects of gender/sex and race/ethnicity on this association. The purpose of this quantitative, cross-sectional study was to address this gap in the literature and examine the association between cigarette smoking and DM and the moderating effect of sex and race/ethnicity on the association between cigarette smoking and DM while controlling for age, myocardial infarction, angina or coronary heart disease, high blood pressure, high cholesterol, BMI, physical activity, healthy diet, alcohol consumption, education level, and income level among adults in the United States aged 18 years and older. The socioecological model serves as the theoretical framework. For this study, secondary data was used (N = 109686) from the Behavioral Risk Factor Surveillance System (BRFSS) survey published in August 2022. Data were analyzed using multiple logistic regression. The results showed there was a statistically significant moderation effect of sex and race on the association between cigarette smoking and DM. Female Asian and Hispanic smokers were at increased odds of being diagnosed with DM. The results of this study contribute to positive social change by providing a better understanding of the moderating effects of sex and race/ethnicity on the association between smoking and diabetes mellitus and provides support for the consideration of race and gender in smoking cessation efforts.