A study published in March 2022 in The American Journal of Preventive Medicine conducted by researchers from Johns Hopkins shows that e-cigarette use may increase a personÕs risk for elevated blood glucose; in fact, those who vape have a 22% increased risk of developing prediabetes compared with those who do not.

Lead author, Shyam Biswal, PhD, from the Department of Environmental Health and Engineering at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, and colleagues, explored the potential association between e-cigarette use and prediabetes by analyzing 3 years of data from 2016 to 2018 extracted from the Behavioral Risk Factor Surveillance System (BRFSS).

The BRFSS is reportedly the largest annual nationally-representative health survey of U.S. adults with data collected on chronic medical conditions, health-related risk behaviors, health outcomes, and access and use of preventive services. Survey respondents were 67.7% non-Hispanic White, 12.2% non-Hispanic Black, 5% Hispanic, and 50.4% female, and 28.6% were older than age 34 years. Roughly 9% of the 600,046 respondents admitted to being current e-cigarette users and also self-reported the diagnoses of prediabetes with an accompanying higher prevalence of high-risk lifestyle behaviors. The individuals also described worse physical health and self-reported mental health status than nonsmoker peers.

The authors emphasized the importance of their work given e-cigarette use is emerging as an alternative to traditional cigarettes, with the prevalence of e-cigarette use reported to be 4.5% in 2016 (10.8 million U.S. adult population). Previous associations between e-cigarette use and chronic obstructive pulmonary disease have already been established; however, their current study hypothesis builds upon an earlier study suggesting that cigarette smoke exposure induces insulin resistance.

According to Dr. Biswal, "Our study demonstrated a clear association of prediabetes risk with the use of e-cigarettes," and he explained, "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."

In the case of this study cohort, e-cigarette use was associated with greater odds of prediabetes compared with those who did not use e-cigarettes or traditional cigarettes.

In a recent press release, Dr. Biswal further described the study outcomes. "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," he stated. Additionally, he reported, "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."

In the case of this study cohort, e-cigarette use was associated with greater odds of prediabetes compared to those who did not use e-cigarettes or traditional cigarettes.

"Our effort for smoking cessation has led to a decrease in smoking traditional cigarettes. With this information, it is time for us to ramp up our public health efforts to promote the cessation of e-cigarettes," Dr. Biswal stated in the press release.

The authors concluded that although their study demonstrates that traditional cigarettes and e-cigarettes may increase a person's risk for prediabetes and type 2 diabetes, more research needs to be done to determine the magnitude of this risk.

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