People who use e-cigarettes have a 20% higher risk of developing prediabetes, according to a study just published in the American Journal of Preventive Medicine. In addition, people who used e-cigarettes in the past but have since quit still face greater odds of prediabetes.
An e-cigarette is different from a traditional cigarette because it delivers nicotine in a vapor rather than in smoke (which is why using an e-cigarette is also know as “vaping”). E-cigarettes use batteries to heat a liquid into an aerosol that the user breathes in. The makers of these devices promote them as tools for quitting tobacco, but the jury is still out on their effectiveness and evidence is accumulating that they might be harmful in other ways — such as by containing other toxins besides nicotine, by producing secondhand vapors, and by possibly causing brain damage. Some evidence indicates they might be even more addictive than regular cigarettes. The U.S. Food and Drug Administration classifies them as tobacco products and regulates them in a similar way.
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The authors of the new report drew their data from an initiative called the Behavioral Risk Factor Surveillance System (BRFSS), which, according to the U.S. Centers for Disease Control (CDC) is “the nation’s premier system of health-related telephone surveys that collect state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services.”
The study included some 600,000 respondents who were interviewed by phone. The researchers limited their analysis to the survey participants who responded to the sections on prediabetes and e-cigarette use. The researchers asked, “Have you ever used an e-cigarette or other electronic ‘vaping’ product, even just one time, in your entire life?” Those who answered “yes” were then asked if they still used e-cigarettes so the researchers could separate former users from current users. The researchers then identified participants with prediabetes by asking, “Ever been told by a doctor or other heath professional that you have prediabetes or borderline diabetes?” Respondents were also classified by age group, education level, gender, race, weight, chronic health conditions, and lifestyle habits. In the survey group, about a quarter (28.6%) were above 35, two-thirds were white, 12.2% were Black, and slightly more than half were women.
E-cigarette use linked to increased prediabetes risk
The investigators determined that current e-cigarette users had a 20% higher risk of developing prediabetes than people who never used them. People who once smoked e-cigarettes also have a higher risk, but not as much. Unsurprisingly, people who currently smoke conventional combustible cigarettes or who had smoked them in the past also were at higher risk of prediabetes. In general, the authors reported, not only did sole e-cigarette users have a higher risk of prediabetes, but they also had “a higher prevalence of high-risk lifestyle factors and worse self-related mental and physical health status.”
As for a causal link between e-cigarette use and prediabetes, the authors wrote that the causality is “not fully understood” and “a causal relationship between e-cigarette use and prediabetes cannot be inferred.” They remarked, however, that earlier research has reported a link between nicotine and elevation in blood glucose concentrations as well as an association between nicotine exposure and increased HbA1c (a measure of long-term glucose control). They also said nicotine “has been shown to cause gastrointestinal tract and nervous system impairment, obesity, inflammation, and interruption of glucose homeostasis, therefore potentially playing a vital role in the pathophysiology of prediabetes.”
They concluded by stating, “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…. 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.”
Want tips for kicking butts? Read “Quitting Smoking With Diabetes.”
Want to learn more about prediabetes? Read “What Is Prediabetes? Symptoms, Treatment, and More,” “Prediabetes Treatment” and “Diabetes Prevention: Eat to Beat Diabetes.”