Sep 30, 2025 12:00:00

E-cigarettes may increase risk of prediabetes

Some people are tempted to cut down on

cigarette smoking and switch to e-cigarettes because of the perceived odor reduction and lower health risks compared to cigarettes. However, a study led by a team of health economists at the University of Georgia found that e-cigarettes may increase health risks related to diabetes.

Heterogeneous Association Between E-Cigarette Use and Diabetes Prevalence Among US Adults - AJPM Focus
https://www.ajpmfocus.org/article/S2773-0654(24)00099-3/fulltext

Vaping Increases Your Risk of Prediabetes, Study Suggests : ScienceAlert
https://www.sciencealert.com/vaping-increases-your-risk-of-prediabetes-study-suggests

E-cigarettes are devices that use a heated aerosolized liquid (liquid) made from water, flavorings, nicotine, etc., and are said to contain significantly less harmful substances than cigarettes. However, nicotine addiction still exists, and the long-term effects of some additives on the lungs and cardiovascular system have not been fully elucidated, so it is generally believed that 'although they contain fewer harmful substances than cigarettes, they are not without adverse health effects.'

Scientifically speaking, which is worse for you: cigarettes or e-cigarettes?

One of the known health risks of smoking is diabetes. In addition to causing cancer and heart disease, smoking is known to directly harm the kidneys through multiple mechanisms, and kidney damage can lead to a variety of health problems, including diabetes.

A research team led by Surakshan Neupane, a health economist at the University of Georgia, examined the impact of e-cigarettes, which are often thought to have low health risks but whose effects on the metabolic system are largely unknown, on the risk of developing diabetes compared with cigarette users.

The research team collected data from over 1.2 million public surveys in the United States and classified participants into 'non-smokers,' 'e-cigarette users only,' 'cigarette users only,' and 'e-cigarette and cigarette users.' After adjusting for variables such as age and gender, they analyzed the prevalence of diabetes at risk (pre-diabetes) in each group.

The results showed that e-cigarette users had a 7% higher risk of pre-diabetes compared with non-smokers. While the risk for e-cigarette users was 15% higher than for non-smokers, meaning the risk was lower for e-cigarette users than for cigarette users, those who combined e-cigarettes and cigarettes had a 28% higher risk of pre-diabetes compared to non-smokers, a significant finding.

'The use of e-cigarettes alone increases the risk of pre-diabetes, and using them in combination with cigarettes poses even greater risks,' said Neupane. 'While e-cigarettes are marketed as a 'safer' alternative to smoking, our findings suggest that e-cigarettes may pose hidden risks and contribute to long-term health problems, including pre-diabetes and diabetes.'

'This study is interesting because it examines the metabolic risks of e-cigarettes, a topic often discussed in relation to their effects on the respiratory and cardiovascular systems, using a large sample size. 'With the rapid increase in e-cigarette use, it is essential to understand its broader health effects. This is no longer just a pulmonary issue, but a whole-body and metabolic health issue,' said Neupane.

However, because this was an observational study based solely on self-reported data, it is important to note that it does not prove a causal relationship between e-cigarettes and pre-diabetes. It is possible that factors such as stress, which tend to increase the frequency of e-cigarette use, may have a direct impact on the risk of pre-diabetes. Furthermore, because the data collection period was limited and long-term effects were not directly tracked, long-term longitudinal studies are needed in the future.