Use of Electronic Vapor Products and its association with Feelings of Depression

Use of Electronic Vapor Products and its association with Feelings of Depression

Authors: Sushaili Pradhan, Erika L. Thompson

Background: Electronic vapor products (EVPs) are the second most common form of youth substance use. EVPs were principally a means of harm reduction or cessation for smokers of cigarettes made of combustible tobacco, but this new tendency is emerging in teenagers and youths as a coping mechanism for feelings of sadness, hopelessness, stress, anxiety, or depression. There is a need for continued assessment of EVP use among adolescents. The aim of the study was to understand the epidemiology of current use of EVPs among adolescents in the U.S. and identify the association between depression and current EVPs use.

Methods: Data from the Youth Risk Behavior Surveillance System – 2019 was used. Students from grades 9 through 12 were sampled (n = 13,677) to obtain information on trends and sociodemographic disparities related to the use of EVPs. Variables included "During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities” and operationalized as yes/no and, "During the past 30 days, on how many days did you use an electronic vapor product?" (Response: 0 days, 1 or 2 days, 3 to 5 days, 6 to 9 days, 10 to 19 days, 20 to 29 days, and All 30 days) and operationalized as "no” EVP use for 0 days and "yes” for other options. ” Demographic variables included grade, sexual orientation (sexual identity and sex of sexual contact), and race/ethnicity. The associations were analyzed using t-tests and chi-square tests, with a 0.05 level of significance.

Result: Among high school students, 32.7% (95% CI: 30.7–34.8%) reported use of EVPs. Non-Hispanic-Whites were more likely to use EVPs as compared to NH-Black, Hispanic/Latinos and Asian (p-value <0.001). 9th graders were less likely than other grades (10th, 11th, and 12th) to be using EVPs currently (p-value=0.001). Bisexuals (34.5%) and gay, lesbian, or bisexual (34.1%) students used EVPs at a higher rate than heterosexual students (32.1%), but there was no statistically significant difference between them. Among high school students who reported feeling sad or hopeless, 43.5% (95% CI: 40.8–46.2) were currently using EVPs, compared to 73.5% (95% CI: 71.6 - 75.4) who did not feel sad or hopeless and were not using EVPs currently.

Conclusion: A difference was observed in the use of EVPs based on race/ethnicity and grade level, while no significant differences were observed for EVP use and sexual identity. Moreover, feeling sad or hopeless was associated with the current use of EVPs. Additional research is needed to disentangle the relationship between EVP use and mental health among adolescents, especially as mental health is a growing concern among youth in the United States.