Despite being leaner and having improved insulin resistance, current smokers had greater CIMT than nonsmokers (least square mean±SE: 0.853±0.009, 0.796±0.013 and 0.801±0.006 mm in current, former, and never smokers, respectively; p<0.0001, adjusted for race, sex, leisure time physical activity, alcohol intake, LDL cholesterol, insulin, medications for type 2 diabetes, hypertension, and high cholesterol, LDL cholesterol, insulin, and metabolic syndrome); however, there was no significant difference in CIMT between former and never smokers (p = 0.72). Here, INS is linked to hypertensive disorder.