No Association Between Exclusive E-Cigarette Use and Diabetes
A new systematic review and meta-analysis, published in Internal and Emergency Medicine (June 2026) through Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), pooled data from 10 studies covering over 2.8 million participants. It found no evidence that exclusive e-cigarette use is associated with diabetes, either in cross-sectional studies or in the only prospective cohort study currently available. The results highlight the importance of distinguishing between exclusive e-cigarette users and dual users when evaluating potential health effects.
By contrast, dual users (people who both smoked cigarettes and used e-cigarettes) showed a modest association with diabetes, which the authors attribute to continued exposure to combustible cigarette smoke and other smoking-related risk factors. This underscores the importance of distinguishing exclusive e-cigarette users from dual users when evaluating health effects
Study: doi.org/10.1007/s11739-026-04430-x