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Original article Impact of electronic cigarette use on the increased risk of diabetes: the Korean Community Health Survey
Wonseok Jeong2orcid , Seungju Kim1orcid
Epidemiol Health 2024;e2024029
DOI: https://doi.org/10.4178/epih.e2024029 [Accepted]
Published online: February 13, 2024
1Department of Health System, College of Nursing, The Catholic University, Seoul, Republic of Korea, Seoul, Korea
2Division Department of Public Health, Graduate School, Seoul National University, Seoul, Republic of Korea, Seoul, Korea
Corresponding author:  Seungju Kim,
Email: sjkimn@catholic.ac.kr
Received: 5 December 2023   • Revised: 8 January 2024   • Accepted: 24 January 2024
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Only a few studies have solely investigated the health impacts of electronic cigarettes on diabetes while considering the impact of conventional cigarettes. Therefore, this study aimed to examine the effect of electronic cigarette smoking on diabetes in South Korean dual-, electronic cigarette-, conventional cigarette-, and non-smokers.
Data were obtained from the 2021 and 2022 Korean Community Health Surveys of 460,603 Korean adults. The main independent variable was smoking behavior. Participants were categorized according to their smoking behavior, as dual smokers, electronic cigarette smokers, conventional cigarette smokers, and non-smokers. The dependent variable, the presence of diabetes, was defined by a doctor’s diagnosis. Multiple logistic regression analysis was performed to examine the association between smoking behavior and diabetes. Subgroup analyses were also performed to investigate the associations among different socio-economic groups.
Conventional cigarette smokers had a higher risk of diabetes than did non-smokers (odds ratio [OR] = 1.22, 95% confidence interval [CI] = 1.19–1.26). More importantly, those who only vaped electronic cigarettes were at high risk of diabetes (OR = 1.15, 95% CI = 1.01–1.32). Lastly, dual smokers had the highest OR for diabetes among other smoking behavior groups (OR = 1.39, 95% CI = 1.22–1.58). Dual smoking was associated with the highest risk of diabetes in most subgroups.
This study suggests that conventional cigarette use and smoking electronic cigarettes negatively impact diabetes, and using both types leads to worse health outcomes. Therefore, cessation of all types of smoking is necessary for a healthy life.

Epidemiol Health : Epidemiology and Health