Associations Between Tobacco Use Behaviors and Metabolic Syndrome in Korean Adults: Analysis of the 2020-2022 KNHANES.

OBJECTIVES

This study examined the association between various tobacco product use behaviors and metabolic syndrome (MetS) among Korean adults.

METHODS

Data from 15 359 adults aged ≥19 years who participated in the 2020-2022 Korea National Health and Nutrition Examination Survey were analyzed. Participants were classified as dual users, e-cigarettes (EC; nicotine-containing liquid-type)/ heated tobacco products (HTP) users, cigarette-only users, ex-smokers, or non-smokers. MetS was defined according to the NCEP ATP III criteria. Subgroup analyses were conducted by survey year and age group. Complex-sample cross-tabulation and logistic regression analyses were performed.

RESULTS

All types of tobacco product use were associated with an increased likelihood of MetS compared with non-smokers. This association was particularly evident among dual users (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.12 to 1.94) and cigarette-only users (OR, 1.19; 95% CI, 1.01 to 1.41). The highest risk was observed among adults aged 19-39 years and among dual users in 2020.

CONCLUSIONS

Dual use and cigarette smoking were associated with a higher likelihood of MetS, particularly among younger adults. Efforts are needed to reduce the misconception that EC/HTP products are less harmful alternatives and to strengthen education and prevention in order to prevent changes in tobacco use behavior from leading to new health risks.