E-Cigarette Use Increases Odds of Prediabetes, Study Results Show


Important evidence about the health effects of e-cigarettes can help shape public health best practices in the United States, the findings of an analysis suggest.

E-cigarette use is associated with increased odds of prediabetes, an analysis of data from a large survey representative of the US population showed.1

The findings, published in American Journal of Preventive Medicine, suggested important evidence about the health effects of e-cigarettes that can help shape public health best practices, according to investigators.1

“Our study demonstrated a clear association of prediabetes risk with the use of e-cigarettes,” Shyam Biswal, PhD, from the Department of Environmental Health and Engineering at Johns Hopkins Bloomberg School of Public Health, said in a statement. “With both e-cigarette use and prevalence of prediabetes dramatically on the rise in the past decade, our discovery that e-cigarettes carry a similar risk to traditional cigarettes with respect to diabetes is important for understanding and treating vulnerable individuals.”1

To determine the association between e-cigarette use and prediabetes, the investigators analyzed data from the Behavioral Risk Facto Surveillance System between 2016 and 2018.1

The survey is the largest annual health survey representative of US adults and provides data on chronic medical conditions, health outcomes, health-related risk behaviors, and preventive services.1

Among the 600,046 respondents, approximately 66,000 individuals were current e-cigarette users who reported a prediabetes diagnosis. The data also showed that these individuals had a higher prevalence of high-risk lifestyle factors and a worse mental and physical health status than non-smokers.1

The survey respondents were approximately 50.4% female, 67.7% non-Hispanic white, 12.2% non-Hispanic Black, and 5% Hispanic. Additionally, approximately 28.6% were aged 35 years and older.1

E-cigarette use was associated with greater odds of prediabetes compared with those who did not use e-cigarette or traditional cigarettes.1

“We were surprised by the findings associating prediabetes with e-cigarettes, because they are touted as a safer alternative, which we now know is not the case,” Biswal said. “In the case of cigarette smoking, nicotine has a detrimental effect on insulin action, and it appears that e-cigarettes may also have the same effect.”1

E-cigarettes are sometimes promoted as a safer alternative or a risk reduction product for those who smoke traditional cigarettes. However, the use of e-cigarettes has risen among younger individuals, which is an ongoing public health concern.1

Individuals who smoke cigarettes are about 30% to 40% more likely to develop type 2 diabetes than individuals who do not smoke, according to the CDC.2

Individuals with diabetes who smoke are also more likely than those who do not smoke to have trouble with insulin dosing and managing their diabetes. This can include other serious health problems involving heart disease, kidney disease, peripheral neuropathy, poor blood low in the legs, and retinopathy.2

Prediabetes is a reversable lifestyle that is manageable, according to the statement.1

Investigators recommend that targeting the reduction in e-cigarette use and educating younger adults could help reduce this risk of diabetes.1


1. Evidence links e-cigarette use with increased odds of prediabetes. EurekAlert, News release. March 3, 2022. March 4, 2022. https://www.eurekalert.org/news-releases/945011

2. Tips from former smokers: diabetes. CDC. Updated February 8, 2022. Accessed March 4, 2022. https://www.cdc.gov/tobacco/campaign/tips/diseases/diabetes.html#:~:text=In%20fact%2C%20people%20who%20smoke,people%20who%20don't%20smoke.&text=People%20with%20diabetes%20who%20smoke,and%20with%20managing%20their%20condition

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