E-cigarettes linked to higher likelihood of prediabetes

March 09, 2022

2 minute read


Source/Disclosures


Disclosures: Biswal reports receiving support from an NIH grant. Please see the study for relevant financial information from all other authors.


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E-cigarette use was associated with a higher risk of prediabetes in American adults, according to findings published in the American Journal of Preventive Health.

“The CDC has reported that people who smoke traditional cigarettes are 30-40% more likely to develop type 2 diabetes,” Shyam Biswal, PhD, a professor in the department of environmental health and engineering at the Johns Hopkins Bloomberg School of Public Health, told Healio. “This is due to the nicotine and chemicals in cigarette smoke, which interfere with the action of insulin. The use of e-cigarettes among young people is on the rise and these products contain nicotine and many chemicals.Based on this study and several others, there is sufficient evidence that e-cigarettes are not harmless.Clearly, the use of e-cigarettes increases the risk of prediabetes.


ZhangZ, et al. Am J Prev Med. 2022: doi:10.1016/j.amepre.2021.12.009.

Biswal and colleagues analyzed data from 2016 to 2018 from the Behavioral Risk Factor Surveillance System, a nationally representative health survey of American adults. In total, the analysis included self-reports from 600,046 respondents. Among the cohort, 28.6% of respondents were under the age of 35, 50.4% were female, 67.7% were non-Hispanic white, and 12.2% were non-Hispanic black.

The results were based on two models: one adjusted for age, sex, race and BMI and the other adjusted further for level of education, physical activity, medical history of heart disease. , cancer, depressive disorders, COPD and asthma, cigarette smoking, use of smokeless tobacco products and blood sugar testing in the past 3 years.

Overall, an average of 10.9% (95% CI, 10.7-11.1) of respondents who said they had never used e-cigarettes had prediabetes, compared to 9% (95% CI, %, 8.6-9.4) of current users, 9.2% (95% CI, 8.4-10.1) of former users, and 5.9% (95% CI, 5.3- 6.5) e-cigarette users who have never smoked combustible cigarettes. Additionally, Biswall and colleagues reported that 9.3% (95% CI, 9.1-9.6) of respondents who had never smoked combustible cigarettes had prediabetes, compared to 13.4% (CI 95%, 13-13.7) of current smokers and 10.2% of former and double smokers. smokers (95% CI, 9.8-10.7).

The ORs for prediabetes were 1.22 (95% CI, 1.10-1.37) among current e-cigarette users and 1.12 (95% CI, 1.05-1, 19) among former e-cigarette users compared to respondents who have never used e-cigarettes, according to the fully adjusted model. Additionally, the ORs for prediabetes were 1.54 (95% CI, 1.17-2.04) among single e-cigarette users and 1.14 (95% CI, 0.97 -1.34) among dual users compared to respondents who have never used e-cigarettes or fuel cigarettes.

“Prediabetes is reversible with lifestyle management,” Biswal said. “Given the results, quitting e-cigarettes should be a key part of lifestyle management.”

Among those trying to quit smoking combustible cigarettes, previous research has shown that using e-cigarettes to quit smoking did not significantly prevent relapse or successful quitting, Healio reported.

“More and more evidence is mounting that e-cigarettes are unsafe,” Biswal said. “I think there is enough evidence to double down on public health measures to prevent e-cigarette initiation and use, at least among young people.”

The references:

Chen R, et al. TobControl. 2022;doi:10.1136/tobaccocontrol-2021-056901.

Evidence links e-cigarette use to an increased risk of prediabetes. https://www.elsevier.com/about/press-releases/research-and-journals/evidence-links-ecigarette-use-with-increased-odds-of-prediabetes#:~:text=A%20new%20analysis %20of%20data%20from%20a%20large%2C,help%20shape%20public%20health%20best%20practices.%20%28Credit%3A%20iStock.com%2Ftolgart%29. Published March 3, 2022. Accessed March 3, 2022.

ZhangZ, et al. Am J Prev Med. 2022: doi:10.1016/j.amepre.2021.12.009.

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