RESEARCH DESIGN AND

Whether smoking is an indepen-dent risk factor for the develop-ment of microalbuminuria has yet to be established. Inconsistencies in previous studies (1–12) might have been due to inadequacies in assessing smoking status of patients (i.e., current, ex-, or never) (13). Moreover, although detailed quantitative assessment is critical for eval-uating smoking risks (14), the dose effect of smoking on the development of ne-phropathy is not known (13). Therefore, we examined a wide variety of smoking parameters to clarify their relationship to microalbuminuria in a cohort of Japanese patients with type 2 diabetes