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(Circulation. 1996;94:878-881.)
© 1996 American Heart Association, Inc.

Articles

Long-term Use of Nicotine Gum Is Associated With Hyperinsulinemia and Insulin Resistance

Bjorn Eliasson, MD; Marja-Riitta Taskinen, MD; Ulf Smith, MD

the Lundberg Laboratory for Diabetes Research, Department of Internal Medicine, Sahlgrenska University Hospital, Goteborg, Sweden, and the Department of Medicine, University of Helsinki (M.-R.T.), Finland.

Correspondence to Bjorn Eliasson, MD, The Lundberg Laboratory for Diabetes Research, Department of Internal Medicine, Sahlgrenska University Hospital, S-413 45 Goteborg, Sweden. E-mail bjorn.eliasson@medicine.gu.se.

Background Insulin sensitivity and cardiovascular risk profile were examined in 20 healthy, nonobese, middle-aged men who were long-term users of nicotine-containing chewing gum and in 20 matched control subjects who did not use nicotine.

Methods and Results Long-term use of nicotine-containing chewing gum was associated with insulin resistance and hyperinsulinemia. The degree of insulin sensitivity correlated negatively to the extent of nicotine use measured as plasma cotinine levels.

Conclusions These findings suggest that nicotine is the major constituent in cigarette smoke that leads to insulin resistance, metabolic abnormalities associated with the insulin resistance syndrome, and increased cardiovascular morbidity. Thus, the use of nicotine replacement therapy during smoking cessation should be transient and limited.

Key Words: insulin • smoking • insulin resistance

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