From the Guidelines
Vaping poses significant health risks, including lung damage, cardiovascular problems, and nicotine addiction, and individuals with diabetes should be advised to avoid vaping and using e-cigarettes. The most recent and highest quality study, published in 2025 1, highlights the importance of avoiding vaping and e-cigarettes due to their potential health risks, which affect the cardiovascular and respiratory systems.
Key Risks Associated with Vaping
- Lung damage and cardiovascular problems
- Nicotine addiction
- Serious lung injuries, including EVALI (e-cigarette or vaping product use-associated lung injury)
- Explosion and burn risks from high-powered batteries
- Gateway to traditional cigarette smoking, especially among young people
Recommendations for Individuals with Diabetes
- Avoid vaping and using e-cigarettes
- Include smoking cessation counseling and other forms of treatment as a routine component of diabetes care
- Address smoking cessation as part of diabetes education programs for those in need
The evidence from the 2025 study 1 and other recent studies 1 emphasizes the importance of avoiding vaping and e-cigarettes due to their potential health risks. While vaping might help some smokers transition away from combustible cigarettes, it is not approved as a smoking cessation tool, and non-smokers should avoid starting vaping due to these substantial health risks.
Importance of Smoking Cessation Counseling
- Brief counseling and pharmacologic therapy can be effective in reducing tobacco use
- Assessment of level of nicotine dependence is essential to prevent smoking or encourage cessation
- Diabetes education programs can offer potential to systematically reach and engage individuals with diabetes in smoking cessation efforts
Overall, the risks associated with vaping and e-cigarettes outweigh any potential benefits, and individuals with diabetes should be advised to avoid these products and focus on evidence-based smoking cessation methods.
From the Research
Risks of Vaping
- The use of electronic cigarettes (e-cigarettes) may pose health risks, including cardiovascular and respiratory diseases 2.
- Acute lung injury may also be associated with the use of e-cigarettes, but the underlying cause remains unknown 2.
- The components and constituents of e-cigarettes, such as propylene glycol and glycerin, may adversely impact health by generating pulmonary irritants and carcinogenic carbonyl compounds 3.
- Metals contained in heating coils and cartridge casings may leach metals such as aluminum, chromium, iron, lead, manganese, nickel, and tin, which can be harmful to health 3.
- Flavoring agents, such as diacetyl, have known pulmonary toxicity with inhalational exposures leading to bronchiolitis obliterans 3.
Health Consequences of Vaping
- The outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) in 2019 highlighted the need for regulation of e-cigarette devices and e-liquids 3.
- Vitamin E acetate (VEA) used as a diluent in tetrahydrocannabinol vape cartridges is implicated in EVALI, and its use can lead to the accumulation of VEA in pulmonary tissue 3.
- Patients with EVALI present with a constellation of respiratory, gastrointestinal, and constitutional symptoms, and radiographically have bilateral ground glass opacifications 3.
- As of February 18,2020, the Centers for Disease Control has identified 2807 hospitalized patients diagnosed with either "confirmed" or "probable" EVALI in the US 3.
Comparison with Smoking Cessation Methods
- Nicotine replacement therapy (NRT), bupropion, and varenicline are commonly used methods for smoking cessation, but their effectiveness may vary 4, 5, 6.
- Varenicline has been shown to be as effective as or more effective than bupropion for smoking cessation 4, 6.
- Combination NRT and higher-dose NRT did not demonstrate consistent effects over other interventions, and their benefits were not retained in the long term 6.