Differential associations between smoking, e-cigarette use, and diabetes prevalence
Abstract
BACKGROUND: Cigarette smoking is a well-established risk factor for diabetes, but the relationship between e-cigarette use and diabetes remains uncertain. Evidence to date has been drawn almost entirely from North America and Asia, with little information from European populations. METHODS: We conducted a cross-sectional study of 17,854 adults aged 16 years and older from the 2017, 2018, 2019, and 2021 waves of the nationally representative Scottish Health Survey. Diabetes status was based on self-report of doctor-diagnosed diabetes. Participants were classified into six mutually exclusive categories of smoking and e-cigarette use: never users of either cigarettes or e-cigarettes, ex-smokers (former smokers who never used e-cigarettes), current exclusive cigarette smokers, current exclusive e-cigarette users, current dual users, and former e-cigarette users. Weighted prevalence estimates and survey-weighted binary logistic regression models were used to examine associations, adjusting for age group, sex, education, deprivation quintile, ethnicity, alcohol use, physical activity, and hypertension. RESULTS: Diabetes prevalence was highest among ex-smokers (11.3 %, 95 % CI: 10.1-12.5). Prevalence was 5.7 % (95 % CI: 5.2-6.2) among never users of either cigarettes or e-cigarettes, 6.2 % (95 % CI: 4.9-7.9) among current exclusive cigarette smokers, 4.9 % (95 % CI: 3.4-7.1) among current exclusive e-cigarette users, 8.3 % (95 % CI: 5.8-11.8) among current dual users, and 5.1 % (95…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 17,854 participants or records.
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