Association between electronic cigarette and combustible cigarette use with cardiometabolic risk biomarkers among U.S. adults

Purpose: To determine the association between cigarette use (i.e., never-use – reference group, exclusive e-cigarette users, exclusive cigarette smoking, and dual use of both products) with cardiometabolic risk biomarkers. Methods: Data came from two cycles (2015–2016 and 2017–2018) of the National Health and Nutrition Examination Survey. We used weighted logistic regression models to determine the association of cigarette use and reduced high-density lipoprotein cholesterol (HDL-C; <40 mg/dL, for men and <50 mg/dL for women), elevated low-density lipoprotein cholesterol (LDL-C; ≥130 mg/dL), elevated triglycerides (TG; ≥150 mg/dL), elevated fasting blood glucose (FBG; (≥100 mg/dL), and high blood pressure (HBP; Systolic ≥130 mm Hg/Diastolic ≥85 mm Hg). Results: Of the 8688 adults 18+ years of age included, 2.7%, 3.2%, and 14.9% self-reported exclusive e-cigarette, dual use, and exclusive cigarette smoking respectively. After adjusting for covariates, exclusive e-cigarette use was significantly associated with increased odds of HBP (adjusted odds ratio [aOR] = 2.05, 95% confidence interval [CI] = 1.03, 4.08). Dual use was associated with increased odds of reduced HDL-C (aOR = 1.64, 95% [CI] = 1.01, 2.70). Exclusive cigarette smoking was significantly associated with reduced HDL-C (aOR=1.80, 95% [CI]=1.45, 2.23) and elevated TG (aOR = 1.59, 95% [CI] = 1.01, 2.52). Conclusions: Results are preliminary and warrant replication from larger samples with longitudinal follow-up.