TOPLINE

Current e-cigarette use was associated with an increased risk for incident rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) compared with no use.

METHODOLOGY

• Researchers conducted a matched cohort study using data from the All of Us Research Program, a US longitudinal cohort study, to investigate whether current e-cigarette use was associated with the risk of developing incident RA or SLE.
• The study included 15,909 current e-cigarette users matched to an equal number of nonusers comprising both past and never users (mean age, 39.3 years).
• Incident RA or SLE, confirmed through at least two diagnostic codes after enrollment, served as the primary outcome.
• Participants were followed up from enrollment until the first diagnosis of RA or SLE, death, 5 years of follow-up, or the end of the study, whichever occurred first, with a mean follow-up duration of 2.9 years.

TAKEAWAY

• A total of 66 incident cases of RA or SLE occurred among current e-cigarette users over 46,038 person-years (incidence rate, 1.43/1000 person-years) vs 43 incident cases among matched nonusers over 46,203 person-years (incidence rate, 0.93/1000 person-years).
• Current e-cigarette use was associated with an increased risk for incident RA or SLE (adjusted hazard ratio [HR], 1.49; 95% CI, 1.01-2.20).
• Overall, 80 new cases of RA and 29 new cases of SLE were identified.
• Among those who were never cigarette smokers, current e-cigarette use was not associated with RA or SLE.

IN PRACTICE

"[The study] findings may support cigarette and e-cigarette cessation efforts by improving understanding of the potential long-term health risks associated with e-cigarette use, particularly among young people who are increasingly using vaping products," the authors wrote.

SOURCE

The study was led by Jeong Yee, Sungkyunkwan University, Suwon, South Korea. It was published online on August 19, 2026, in Seminars in Arthritis and Rheumatism.

LIMITATIONS

The information about e-cigarette use was based on self-report, and details about duration and intensity of use were lacking. The study did not assess various lifestyle factors such as diet, physical activity, and sleep, which might have introduced residual confounding. The number of incident RA and SLE cases was relatively small, which may have limited the statistical power.

DISCLOSURES

This study was supported by the National Institutes of Health (NIH), Sungkyunkwan University, the Ministry of Education of Korea, and the National Research Foundation of Korea. One author reported receiving financial support from the NIH, and another reported receiving support from Sungkyunkwan University and the BK21 FOUR funded by the Ministry of Education and the National Research Foundation of Korea.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.