New research from the University of Georgia has revealed that people who use e-cigarettes, regular cigarettes, or both are more likely to develop diabetes or prediabetes.
The study warns that vaping, often seen as a safer alternative to smoking, may actually carry serious health risks—especially for long-term conditions like diabetes.
The study was led by Sulakshan Neupane, a doctoral student at the UGA College of Agricultural and Environmental Sciences. He explained that the health effects of vaping go beyond the lungs.
“It’s not just about breathing anymore,” Neupane said. “We need to think about the whole body, including how vaping affects metabolism and blood sugar levels.”
Using data from more than 1.2 million people who took part in a large U.S. health survey, researchers looked at how smoking and vaping habits affected people’s chances of being diagnosed with diabetes or prediabetes. The results were eye-opening.
People who only vaped had a 7% higher risk of developing prediabetes. Although this number may sound small, it adds up to thousands of extra cases every year. Those who smoked regular cigarettes had a 15% higher risk, and people who used both cigarettes and e-cigarettes had a 28% higher risk.
The risk of full-blown diabetes also rose. People who vaped were 7% more likely to have diabetes, while those who smoked were 9% more likely. These findings suggest that using both products together has an even stronger effect on blood sugar and insulin function.
Vaping and smoking may affect how the body handles insulin, the hormone that helps control blood sugar. The researchers believe vaping may temporarily damage insulin’s ability to do its job, while also increasing weight gain—both of which can lead to prediabetes or diabetes.
The risks were not the same for everyone. Certain groups faced even higher chances of developing health problems. People with higher body weight had worse outcomes if they smoked or vaped.
Black, Hispanic, and Asian individuals also had higher rates of prediabetes or diabetes compared to white individuals. People with lower incomes faced a 12% higher risk, possibly because financial stress can lead to unhealthy habits like smoking and poor diet.
Neupane explained that many people under financial stress may turn to smoking or alcohol to cope, which then increases their health risks. He also pointed out that regular physical activity could help reduce some of these risks. For smokers, exercise lowered the risk of prediabetes by 8%.
The researchers say their findings could help guide public health policies. Right now, e-cigarettes are often advertised as a safer option than cigarettes, but this study suggests they may come with hidden dangers. If vaping continues to grow in popularity, especially among young people, diabetes rates could rise as well.
This research was published in the journal AJPM Focus. Neupane was joined by co-authors Professor Wojciech J. Florkowski and Chandra Dhakal, who now works with the CDC Foundation.
Their work sends a clear message: both smoking and vaping carry serious health risks that go beyond the lungs and can affect long-term metabolic health.
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The study is published in AJPM Focus.
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