Vaping & Smoking Linked to Increased Diabetes Risk: Study

While the dangers of smoking traditional cigarettes to the lungs and heart have long been documented, a growing body of research is now shedding light on the significant risks these habits pose to metabolic health, specifically the increased likelihood of developing prediabetes and type 2 diabetes. A recent study conducted by researchers at the University of Georgia adds a critical layer to this understanding, warning that the use of e-cigarettes (vaping), traditional cigarettes, or even dual use of both, is linked to a higher risk of these conditions. This research is particularly concerning given the soaring popularity of vaping, especially among young people, who may be unaware of the broader health implications beyond the lungs.

The study’s lead author, Sulakshan Neupane, highlighted the alarming findings: “At a time when e-cigarettes are marketed as a ‘safer’ alternative to smoking, this suggests they may carry a hidden danger and silently contribute to long-‘term health problems such as prediabetes and diabetes.” Neupane emphasized that the impact extends beyond respiratory health, affecting “the whole body and metabolic health.” The Centers for Disease Control and Prevention (CDC) has also noted the rising popularity of vaping, especially among youth, suggesting that diabetes rates could follow a similar upward trend as e-cigarette use expands.

The Study’s Findings: Vaping, Smoking, and Diabetes Risk

The research, published in the AJPM Focus journal, analyzed data from over 1.2 million responses collected through the Behavioral Risk Factor Surveillance System (BRFSS). The study examined the relationship between e-cigarette use, traditional cigarette smoking, dual use, and the diagnoses of prediabetes and type 2 diabetes. The findings reveal a concerning trend:

Vaping Alone: The study found that vaping alone was linked to a 7% increased risk of prediabetes. Researchers suggest that e-cigarette use might temporarily affect insulin function and contribute to weight gain, both of which are known risk factors for prediabetes. While a 7% increase might seem modest, it translates to an estimated 7,000 additional cases of prediabetes annually in the U.S. based on current population trends.
Traditional Smoking: Smoking cigarettes or cigars increased the risk of prediabetes by a more substantial 15%.
Dual Use: The highest risk was observed in individuals who engaged in both smoking and vaping. This dual use conferred an additional risk, with the likelihood of developing prediabetes increasing by 28% compared to non-users.

Sulakshan Neupane stated, “e-cigarette use alone raises the likelihood of prediabetes, and dual use confers an additional risk. This study highlights the potential cumulative harm of using both types of products.”

Demographic and Lifestyle Factors Intensify Risk

The study also identified several personal and demographic factors that further amplify the risk of developing prediabetes or diabetes:

Weight Status: Overweight or obese individuals who smoked were particularly vulnerable. Similarly, e-cigarette users with a higher Body Mass Index (BMI) fared worse than those of normal weight, indicating that metabolic health is a significant factor.
Socioeconomic Status: Individuals in the lowest income groups showed a 12% higher risk of developing both prediabetes and diabetes. Dr. Neupane explained that “people who don’t earn enough money experience mental stress and tend to smoke or use alcohol to reduce that stress, leading to these increased risk factors.” This highlights the complex interplay between socioeconomic status, stress, coping mechanisms, and chronic disease development.
Race and Ethnicity: Hispanic, Black, and Asian individuals who smoked or vaped were more frequently diagnosed with prediabetes or diabetes compared to White individuals. This points to potential disparities in health outcomes that may be influenced by a combination of genetic predispositions, targeted marketing by the tobacco industry, and socioeconomic factors.
Physical Activity: Encouragingly, regular physical activity provided some protection. Exercise was found to reduce the risk of prediabetes by 8% for smokers, suggesting that lifestyle interventions can play a role in mitigating some of the harms associated with nicotine use.

Mechanisms of Harm: How Nicotine and Other Chemicals Affect Metabolism

The link between nicotine use and metabolic dysfunction is multifaceted. Nicotine itself, a highly addictive substance, can disrupt the body’s hormonal balance and metabolic processes.

Insulin Function: Nicotine exposure, whether from smoking or vaping, has been shown in some studies to temporarily affect insulin function. Insulin resistance is a key precursor to type 2 diabetes, where the body’s cells do not respond effectively to insulin, leading to elevated blood sugar levels.
Weight Gain: Nicotine can also influence appetite and metabolism, potentially contributing to weight gain. Obesity is a major risk factor for prediabetes and type 2 diabetes, creating a compounding effect for users who are already overweight.
Inflammation and Oxidative Stress: The chemicals present in both tobacco smoke and vape aerosols, even those not directly linked to cancer, can contribute to systemic inflammation and oxidative stress. These processes can damage cells throughout the body, including those involved in glucose metabolism and insulin sensitivity.

The long-term effects of inhaling these substances, particularly the flavorings and other additives found in many vape liquids, are still under investigation. However, the short- and medium-term signals are concerning, suggesting that even without combustion, vaping products are not benign and can contribute to metabolic health issues.

Public Health Implications and Recommendations

The findings of this study have significant implications for public health efforts aimed at reducing smoking rates and improving diabetes outcomes. Dr. Neupane concluded that “these findings have important implications for public health efforts aimed at reducing smoking and improving diabetes outcomes.”

These implications suggest a need for:

Targeted Public Health Campaigns: Public health messaging needs to address the specific metabolic risks associated with vaping and dual use, not just the respiratory dangers.
Support for Quitting: Continued and enhanced support for smokers and vapers seeking to quit is essential. This includes access to evidence-based cessation tools like NRT (nicotine replacement therapy) and behavioral support, as well as education on the risks of dual use.
Regulation of Flavors and Ingredients: Further scrutiny of flavorings and other additives in both traditional cigarettes and vaping products is warranted to understand their specific impact on metabolic health.
Addressing Socioeconomic Disparities: Public health strategies must also consider socioeconomic factors, providing resources and support to low-income communities disproportionately affected by both nicotine use and chronic diseases.

While the study highlights the risks, it also points to potential protective factors like physical activity, which can mitigate some harms. Ultimately, the research underscores that while vaping may be less harmful than smoking, it is not risk-free, and the safest path for metabolic and overall health remains complete cessation from all nicotine and tobacco products.