Study illustrates link between e-cigarette use and increased risk of prediabetes

An analysis of data from a large national survey representative of the US population shows that e-cigarette use is associated with an increased likelihood of prediabetes. The findings, which are reported in the American Journal of Preventive Medicinepublished by Elsevier, provide important evidence on the health effects of e-cigarettes and can help shape best public health practice.

Our study demonstrated a clear association between the risk of prediabetes and the use of electronic cigarettes. With the dramatic increase in e-cigarette use and the prevalence of prediabetes over the past decade, our finding that e-cigarettes carry a similar risk to traditional cigarettes with respect to diabetes is important for understanding and treat vulnerable people..”

Shyam Biswal, PhD, Study Principal Investigator, Bloomberg School of Public Health, Johns Hopkins University

According to the Centers for Disease Control and Prevention (CDC), traditional cigarette smokers are 30-40% more likely than non-smokers to develop type 2 diabetes, which increases their risk of cardiovascular diseases such as atherosclerotic disorders , stroke and peripheral disorders. vascular diseases. Electronic cigarettes are sometimes promoted as a harm reduction product for current traditional cigarette smokers. The use of electronic cigarettes is increasing among young people, which remains a public health problem.

To determine the association between e-cigarette use and prediabetes, researchers analyzed data from 2016 to 2018 from the Behavioral Risk Factor Surveillance System (BRFSS). It is the largest nationally representative annual survey of US adult health with data on health outcomes, health-related risk behaviors, preventive services, and chronic disease.

Of the 600,046 respondents, 9%, or more than 66,000 people, were current e-cigarette users who self-reported diagnoses of prediabetes. The data also showed that e-cigarette users have a higher prevalence of high-risk lifestyle factors and poorer self-related mental and physical health status than non-smokers.

Survey respondents were 50.4% female, 67.7% non-Hispanic white, 12.2% non-Hispanic black, 5% Hispanic, and 28.6% were 35 or older. In this representative sample of American adults, e-cigarette use was associated with a higher risk of prediabetes compared to those who did not use e-cigarettes or traditional cigarettes.

The association of e-cigarettes with prediabetes raises significant concerns for public health officials. “We were surprised by the findings associating prediabetes with e-cigarettes, as they are touted as a safer alternative, which we now know is not the case,” commented Dr Biswal. “In the case of smoking, nicotine has a detrimental effect on insulin action, and it appears that e-cigarettes may also have the same effect.”

Prediabetes is reversible with lifestyle management. Based on these findings, the authors make a compelling recommendation to target e-cigarette use reduction and education in young adults as a therapeutic lifestyle management strategy for diabetes risk reduction. .

“Our efforts to quit smoking have led to a decrease in the consumption of traditional cigarettes. With this information, it is time for us to step up our public health efforts to promote e-cigarette cessation,” Dr. Biswal warned. .

Prediabetes is defined as the presence of impaired fasting blood glucose (greater than 100–125 mg/dL), impaired glucose tolerance (greater than 140-199 mg/dL two hours after oral intake of 75 g of glucose) or hemoglobin A1c between 5.7–6.4%), which indicate a glycemic state intermediate between normal glycemia and diabetes.

The CDC has reported that prediabetes has become increasingly common in recent decades, and recent estimates indicate that 38% of American adults have the disease. It is also on the rise among an increasingly young population. Projections estimate that by 2030, more than 470 million people worldwide will be diagnosed with prediabetes.


Journal reference:

Zhang, Z. et al. (2022) The association between e-cigarette use and prediabetes: findings from the behavioral risk factor surveillance system, 2016-2018. American Journal of Preventive Medicine.

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