Biological aging acceleration associated with electronic cigarette use in the United States

Smoking combustible cigarettes accelerates biological aging and contributes to subsequent aging-related cardiovascular decline. However, the aging-related health consequences of electronic cigarette (e-cigarette) use (vaping) remain largely unknown. This study aims to investigate whether e-cigarette use is associated with biological aging acceleration using a nationally representative sample.

This cross-sectional study included 8,595 participants aged 20-79 from two cycles (2015-2016 and 2017-2018) of the National Health and Nutrition Examination Survey. Biological aging was measured using PhenoAge, a validated epigenetic biomarker of aging. Its acceleration (PhenoAgeAccel) was quantified by the residual of PhenoAge regressed on chronological age. E-cigarette use was categorized as current (N = 417), former (N = 1,253), or nonuse (N = 6,925). Linear regression models were used to assess the association between e-cigarette use and PhenoAgeAccel, adjusting for combustible cigarette use, sex, race/ethnicity, education, body mass index, alcohol use, other tobacco product use, and secondhand smoke exposure.

In the fully adjusted model, current e-cigarette use was associated with 1.20 (95% confidence interval: 0.41, 2.10) years higher PhenoAgeAccel than never use. Similarly, individuals with current cigarette use exhibited 1.50 (95% confidence interval: 1.00, 2.00) years higher PhenoAgeAccel than those who had never smoked at least 100 cigarettes in their lifetime.

This work provides the first epidemiologic evidence revealing the association between e-cigarette use and accelerated biological aging, after adjusting for smoking status. The findings underscore the potential value of public health interventions targeting reduced tobacco product use. Future longitudinal studies are needed to elucidate the underlying mechanisms.