Abstract
Cigarette smoking, vaping, and excessive alcohol consumption are established risk factors for many diseases, but few studies have examined these health-risk behaviors in relation to cardiovascular-kidney-metabolic syndrome. This study aims to assess the odds of current smoking, vaping, and heavy drinking by cardiovascular-kidney-metabolic syndrome stage and whether the odds vary by sex. This cross-sectional study used pooled data on 538,123 adults from the 2021 and 2023 waves of the Behavioral Risk Factor Surveillance System survey. Multivariable binomial logistic models stratified by sex and age group were estimated to assess the predicted probabilities of respective health risk behaviors for cardiovascular-kidney-metabolic syndrome stages, determined by self-reported health conditions. In addition, the interaction between sex and cardiovascular-kidney-metabolic syndrome stage was assessed to determine whether there were differences between males and females at different cardiovascular-kidney-metabolic syndrome stages. The likelihood of current smoking and vaping was higher among those with an advanced cardiovascular-kidney-metabolic syndrome stage (i.e., 4) than among adults with lower cardiovascular-kidney-metabolic syndrome stages (i.e., 0, 1). Although males had a higher likelihood of smoking and vaping at cardiovascular-kidney-metabolic syndrome stages 0 and 1, no differences between males and females were found at cardiovascular-kidney-metabolic syndrome Stage 4. In contrast, the likelihood of heavy drinking was lower among females at cardiovascular-kidney-metabolic syndrome Stage 4 and higher among males at cardiovascular-kidney-metabolic syndrome Stages 2 and 3 than among those at lower cardiovascular-kidney-metabolic syndrome stages. Findings of this observational study suggest a higher likelihood of smoking and vaping among adults with advanced cardiovascular-kidney-metabolic syndrome stages, highlighting the scope for improving awareness about health-risk behaviors among patients to help them better manage their cardiovascular-kidney-metabolic syndrome conditions.