For traditional cigarette smokers, e-cigarettes have been touted as a safer alternative. E-cigarette use is on the rise among the younger population, which is a public health problem.

Analysis of data from a large, national survey of the US population shows that people who use e-cigarettes are more likely to have pre-diabetes.

The findings, which were published in Elsevier’s American Journal of Preventive Medicine, contribute to the body of knowledge concerning the health implications of e-cigarettes and can help shape public health policy.

“Our study demonstrated a clear association of prediabetes risk with the use of e-cigarettes,” says lead investigator Shyam Biswal.

“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.”

Traditional cigarette smokers are 30 percent to 40 percent more likely than non-smokers to develop type 2 diabetes, which increases their risk of cardiovascular diseases such as atherosclerotic disorders, stroke, and peripheral vascular diseases, according to the Centers for Disease Control and Prevention (CDC). For present traditional cigarette smokers, e-cigarettes are occasionally sold as a risk-reduction device. E-cigarette use is on the rise among the younger population, which is a public health problem.

The researchers looked at data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2016 to 2018 to see if there was a link between e-cigarette usage and prediabetes. It is the biggest annual nationwide health survey of US adults, collecting information on health outcomes, risk behaviors, preventative treatments, and chronic medical disorders. 9 percent, or more than 66,000 persons, of the 600,046 respondents were current e-cigarette users who self-reported prediabetes diagnoses. E-cigarette users also have a higher incidence of high-risk lifestyle characteristics and a lower self-related mental and physical health status than non-smokers, according to the findings.

50.4 percent of survey respondents were female, 67.7 percent were non-Hispanic White, 12.2 percent were non-Hispanic Black, 5 percent were Hispanic, and 28.6 percent were 35 or older. When compared to individuals who did not use e-cigarettes or regular cigarettes, those who used e-cigarettes or traditional cigarettes had a higher risk of prediabetes.

This new finding raises serious concerns for public health experts.

“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,” adds Dr. Biswal. “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.”

Prediabetes can be reversed by changing one’s lifestyle. The authors make a solid case for targeting the decrease of e-cigarette use and education of young adults as a therapeutic lifestyle management method for lowering diabetes risk based on their findings.

“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,” warns Dr. Biswal.

What is Prediabetes?

Prediabetes is characterized as impaired fasting glucose (more than 100–125 mg/dL), impaired glucose tolerance (greater than 140–199 mg/dL two hours after a 75-g oral glucose consumption), or hemoglobin A1c between 5.7–6.4 percent, all of which suggest a glycemic state midway between normal and diabetes.

Prediabetes has been more frequent in recent decades, according to the CDC, with recent estimates indicating that 38 percent of American people have the illness.

It’s also becoming more common among a younger generation. Prediabetes is expected to affect more than 470 million individuals worldwide by 2030, according to projections.

Source: 10.1016/j.amepre.2021.12.009

Image Credit: Getty

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