Combining vaping and smoking may raise risk of diabetes and prediabetes, study finds

Vaping may increase the risk of prediabetes, a condition marked by higher-than-normal sugar levels that could lead to type 2 diabetes, a new study has found. 

In addition, combining vaping with traditional cigarette use may raise the risk of diabetes, according to the research published in The American Journal of Preventive Medicine Focus (AJPM Focus). 

E-cigarette use is on the rise among young people in Europe, with 22 per cent of 15- and 16-year-old students vaping regularly, according to a 2025 report. 

“As the use of e-cigarettes rises rapidly, it’s vital we understand their broader health impacts. This is not just about the lungs anymore, but the entire body and metabolic health,” Sulakshan Neupane, lead author of the study and doctoral student at the University of Georgia (United States), said in a statement. 

The study analysed a large health dataset in the United States to identify links between smoking, vaping, and the risk of prediabetes and diabetes.

The scientists found that e-cigarette users have a 7 per cent higher risk of developing prediabetes compared with non-smokers. For those who smoke conventional cigarettes, the risk rises to 15 per cent, and it jumps to 28 per cent for people who combine both vaping and combustible cigarettes. 

For diabetes, dual users of cigarettes and e-cigarettes face a 9 per cent higher risk than non-smokers, while cigarette smokers have a 7 per cent higher likelihood of developing the condition. Yet no significant link between vaping alone and the risk of diabetes has been found by the study. 

“In an era when e-cigarettes are marketed as a ‘safer’ alternative to smoking, this suggests they may carry a hidden peril and may be quietly contributing to long-term health problems like prediabetes and diabetes,” Neupane said. 

The study also highlighted characteristics that can further elevate the risk of prediabetes and diabetes among smokers. 

For example, being overweight or obese, identifying as Hispanic, Black, or Asian, and coming from a low-income background were all associated with a higher likelihood of developing these diagnoses. 

These findings align with previous research on e-cigarettes. Health organisations and scientists have long raised concerns about the health risks of vaping, and some studies have already suggested a possible link between vaping and prediabetes.

These concerns have even prompted some European governments to adopt restrictive measures. For example, the Spanish government recently approved a bill banning people from smoking and vaping on restaurant terraces. 

The study noted several limitations, as it cannot establish a cause-and-effect relationship between e-cigarette use and prediabetes. In addition, it relies on self-reported data and does not account for genetic predispositions, family history of diabetes, or information on physical activity.