Electronic cigarette vaping has recently been chosen as a smoking alternative for those who want to quit smoking, but some of the electronic cigarette users use both traditional and electronic cigarettes (dual smoking) without stopping smoking. This study investigated the association between smoking behavior and metabolic syndrome among Korean adults. Data from 14,607 participants (6142 males and 8465 females) were examined. They were divided into four categories: dual smoking (both conventional and e-cigarettes), single smoking (only conventional cigarettes), previously smoking, and non-smoking. Metabolic syndrome risk was calculated as a continuous variable using the lipid accumulation product (LAP) index. Multiple linear regression analyses were performed to examine the association of log-transformed LAP with smoking behavior. Among the total participants, 187 males and 35 females were dual smokers and 1850 males and 372 females were single smokers. LAP was significantly higher in male who practiced dual and single smoking than LAP of non-smokers-dual: β = 0.27, standard error (SE) = 0.06, p < 0.0001; single: β = 0.18, SE = 0.03, p < 0.0001. In female, LAP was significantly higher among those who practiced only single smoking than LAP of non-smokers (β = 0.21, SE = 0.04, p < 0.0001). Dual and single smoking were significantly associated with higher LAP, a strong predictor of metabolic syndrome. Further studies and awareness regarding the adverse effects of dual smoking are required.
Keywords: dual smoking; electronic cigarette vaping; lipid accumulation products; metabolic syndrome.