Combustible Cigarette Smoking, Electronic Cigarette Use, and Metabolic Syndrome in a Working Population

Background: Metabolic syndrome is a major public health concern because of its association with cardiovascular disease and type 2 diabetes. Tobacco exposure, including combustible cigarette smoking and electronic cigarette use, has increasingly been linked to cardiometabolic dysfunction; however, evidence in occupational populations remains limited. Objectives: This study evaluated the association of combustible cigarette smoking, electronic cigarette use, and dual use with metabolic syndrome in a working population from southwestern Colombia. Methods: We conducted a cross-sectional study of 822 workers from formal companies. Tobacco exposure was self-reported and categorized as exclusive electronic cigarette use, exclusive combustible cigarette smoking, dual use, or non-use. Sociodemographic, anthropometric, and metabolic variables were collected using standardized procedures. Logistic regression models were fitted to estimate crude and adjusted odds ratios with 95% confidence intervals. Results: Metabolic syndrome was identified in 39.8% of participants. It was more frequent in men, who also exhibited a greater accumulation of metabolic abnormalities. Hypertriglyceridemia and low high-density lipoprotein cholesterol were the components most strongly associated with metabolic syndrome. Compared with non-use, the odds of metabolic syndrome were higher across all tobacco-exposed groups, with odds ratios of 3.02 for exclusive electronic cigarette use, 7.29 for exclusive combustible cigarette smoking, and 4.75 for dual use. The strongest association was observed for exclusive combustible cigarette smoking. Conclusions: Metabolic syndrome was prevalent in this occupational population, and tobacco-related exposures were associated with a less favorable cardiometabolic profile. These findings support integrated workplace prevention strategies that combine smoking control with early detection of metabolic risk.