Abstract
This study investigated the association of smoking behaviors, including dual smoking (smoking both cigarettes and e-cigarettes), cigarettes smoking, and previous smoking, with glycated hemoglobin (HbA1c) levels. National Health and Nutrition Examination Survey (KNHANES) data from 2014⁻2016 was used. Associations between smoking behavior patterns and HbA1c levels were analyzed via multiple regression. Among 8809 participants, individuals who were dual smokers and cigarettes smokers had significantly higher HbA1c levels than non-smokers (dual: β = 0.1116, p = 0.0012, single: β = 0.0752, p = 0.0022). This relationship strengthened in subgroups of men (dual: β = 0.1290, p = 0.0013, single: β = 0.1020, p = 0.0014, ex: β = 0.0654, p = 0.0308), physically inactive subjects (dual: β = 0.1527, p = 0.0053, single: β = 0.0876, p = 0.0197), and overweight (dual: β = 0.1425, p = 0.0133) and obese individuals (dual: β = 0.1694, p = 0.0061, single: β = 0.1035, p = 0.0217). This study suggests that smoking behaviors are likely to increase the risk of HbA1c level in a general population. The health effects of dual smoking remain uncertain and should be addressed in the future.