A new study finds a hidden risk of diabetes in vaping

“In an era where e-cigarettes are marketed as a ‘safer’ alternative to smoking, this suggests they may carry a hidden danger and may quietly contribute to long-term health problems such as prediabetes and diabetes,” said Sulakshan Neupane, lead author of the study and a doctoral student in UGA’s College of Agricultural and Environmental Sciences. “With the rapid rise in e-cigarette use, it’s important to understand their broader health impacts. It’s no longer just about the lungs, it’s about the entire body and metabolic health.”

The Centers for Disease Control and Prevention notes that the popularity of e-cigarettes continues to grow, especially among young people. The study results suggest that diabetes rates may also rise within these groups as e-cigarette use expands.

The researchers also reported that the likelihood of developing diabetes or prediabetes is higher for Hispanic and Black individuals who live in economically disadvantaged places, along with people who already have underlying health problems.

Dual users experience sharp increases in diabetes

Using more than 1.2 million responses from the Behavioral Risk Factor Surveillance System survey, the research team examined how e-cigarette use and traditional smoking are associated with prediabetes and diabetes diagnosis.

The analysis showed that vaping alone was associated with a 7% increase in the risk of developing prediabetes. The researchers suggested that e-cigarette use may temporarily impair insulin function and contribute to weight gain, both of which are linked to diabetes.

Although 7% may seem modest, it represents approximately 7,000 additional cases of diabetes each year in the United States based on current population trends.

The study also found that smoking cigarettes or cigars increases the risk of diabetes by 15%. The risk rose even more for people who smoked and vaped, reaching 28%.

Individuals who used e-cigarettes and cigarettes were also more likely to develop diabetes itself, with risks rising by 7 and 9%, respectively.

“E-cigarette use alone increases the likelihood of developing prediabetes, with dual use conferring additional risk. This study highlights the potential double harm from using both types of products,” Neupane said.

Weight, income and demographics affect risk levels

The researchers noted that some personal and demographic factors increase the likelihood of developing prediabetes or prediabetes.

People who were overweight or obese and smokers were particularly at risk, with e-cigarette users with a higher body mass index having worse outcomes than those of normal weight. Hispanic, Black, and Asian individuals who smoke or use e-cigarettes were more frequently diagnosed with prediabetes or diabetes than white individuals.

Low income was another major contributor. Those in low-income groups were 12% more likely to have both conditions.

“People who do not earn enough money suffer from mental stress and tend to smoke or abuse alcohol to reduce this stress, which leads to an increase in these risk factors,” Neupane said.

However, regular physical activity provides some protection. Exercise reduced the risk of prediabetes in smokers by 8%, offering a potential way to counteract some of the harmful effects.

“These findings have important implications for public health efforts to reduce smoking and improve diabetes outcomes,” Neupane said.

The study was published in Focus AJPM. Co-authors included Professor of Agricultural and Applied Economics Wojciech J. Florkowski and Chandra Dhakal, Ph.D. He graduated from UGA and now works at the CDC Foundation.