The Association Between E-Cigarette Use and Prediabetes: Results From the Behavioral Risk Factor Surveillance System, 2016–2018


      Both E-cigarette use and the prevalence of prediabetes have risen dramatically in the past decade. It is crucial to understand whether E-cigarette use is associated with the risk of prediabetes.


      Participants who completed the prediabetes and E-cigarette modules of the Behavioral Risk Factor Surveillance System survey (2016–2018) were included in this study. E-cigarette use information was collected by asking: Have you ever used an e-cigarette or other electronic “vaping” product, even just one time, in your entire life? We defined sole E-cigarette users as current E-cigarette users who are never combustible-cigarette users, and dual users were defined as both current E-cigarette and combustible-cigarette users. Participants with prediabetes were identified by asking: Ever been told by a doctor or other health professional that you have prediabetes or borderline diabetes? Multivariable logistic regression was used to determine the association between E-cigarette use and prediabetes.


      Among the 600,046 respondents, 28.6% of respondents were aged <35 years. The prevalence of prediabetes among current E-cigarette, sole E-cigarette users, and dual users was 9.0% (95% CI=8.6, 9.4), 5.9% (95% CI=5.3, 6.5), and 10.2% (95% CI=9.8, 10.7), respectively. In the fully adjusted model, the ORs for prediabetes were 1.22 (95% CI=1.10, 1.37) for current E-cigarette users and 1.12 (95% CI=1.05, 1.19) for former E-cigarette users compared with that of never E-cigarette users. The ORs for prediabetes were 1.54 (95% CI=1.17, 2.04) for sole E-cigarette users and 1.14 (95% CI=0.97, 1.34) for dual users.


      In this representative sample of U.S. adults, E-cigarette use was associated with greater odds of prediabetes. The results were consistent in sole E-cigarette users.
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