E-cigarettes linked to greater odds for prediabetes

E-cigarette use was associated with greater odds for prediabetes among U.S. adults, according to findings published in the American Journal of Preventive Health.

“CDC has reported that people who smoke traditional cigarettes are 30 to 40% more likely to get 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 nicotine and chemicals in cigarette smoke, which hampers the action of insulin. The use of e-cigarettes in the younger population is on the rise and these products have nicotine and many chemicals. From this and several other studies, there is enough evidence that e-cigarettes are not harmless. Clearly, use of e-cigarettes increases the odds of prediabetes.”

Biswal and colleagues analyzed 2016 to 2018 data from the Behavioral Risk Factor Surveillance System, a nationally representative health survey of U.S. adults. In total, the analysis included self-reports from 600,046 respondents. Among the cohort, 28.6% of respondents were aged younger than 35 years, 50.4% were women, 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 education level, physical activity, medical history of heart disease, cancer, depressive disorder, COPD and asthma, cigarette use, use of smokeless tobacco products and blood sugar tests in the past 3 years.

Overall, an average of 10.9% (95% CI, 10.7-11.1) of respondents who reported never using e-cigarettes had prediabetes compared with 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) of e-cigarette users who never smoked combustible cigarettes. In addition, Biswall and colleagues reported that 9.3% (95% CI, 9.1-9.6) of respondents who never smoked combustible cigarettes had prediabetes compared with 13.4% (95% CI, 13-13.7) of current smokers and 10.2% former and dual 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 with respondents who never used e-cigarettes, according to the fully adjusted model. Moreover, the ORs for prediabetes were 1.54 (95% CI, 1.17-2.04) among sole e-cigarette users and 1.14 (95% CI, 0.97-1.34) among dual users compared with respondents who never used e-cigarettes or combustible cigarettes.

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

Among those attempting to quit smoking combustible cigarettes, previous research has shown that the use of e-cigarettes for smoking cessation did not significantly prevent relapse or successful termination, Healio reported.

“More and more evidence is piling up that e-cigarettes are not safe,” Biswal said. “I think there is sufficient evidence for doubling down on public health measures to prevent the initiation and use of e-cigarettes, at least amongst youth.”

References:

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

Evidence links e-cigarette use with increased odds 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.

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