Bi-directional associations of electronic and combustible cigarette use onset patterns with depressive symptoms in adolescents

Abstract

Whether well-documented patterns of mental health comorbidity with adolescent combustible cigarette use extend to e-cigarette use is unclear. Demonstrating associations between e-cigarette and combustible cigarette use with mental health symptomatology across adolescence may be important for promoting accurate perceptions of populations at risk for and potential consequences of tobacco product use. Adolescents (N = 2460; mean age at baseline = 14.1; 53.4% female; 44.1% Hispanic) who had never previously used combustible or e-cigarettes were assessed at baseline, and 6- and 12-month follow-ups in Los Angeles, CA (2013–2014). Logistic regression was used to examine associations between baseline depressive symptoms and onset of e-cigarette and cigarette single product and dual use at follow-ups. Latent growth modeling was used to examine associations between sustained use of either product (vs. non-use) and changes in depressive symptoms over 12-months. Higher baseline depressive symptoms predicted subsequent onset of cigarette (OR = 1.024, 95% C.I. = 1.009−1.055), e-cigarette (OR = 1.015, C.I. = 1.003−1.023), and dual use of both products (OR = 1.021, C.I. = 1.003−1.043). Sustained use of e-cigarettes over the 12-month observation (vs. non-use) was associated with a greater rate of increase in depressive symptoms over time (b = 1.272, SE = 0.513, p = 0.01). Among those who sustained use of e-cigarettes, higher frequency of use was associated with higher depressive symptoms at the final follow-up (B = 1.611, p = 0.04). A bi-directional association of depressive symptoms with e-cigarette use onset across mid adolescence was observed. Further research on the causal nature, etiological underpinnings, and intervention implications of mental health and tobacco product use comorbidity is warranted.

Co-occurrence of tobacco product use, substance use, and mental health problems among youth: Findings from wave 1 (2013–2014) of the population assessment of tobacco and health (PATH) study

“…Similarly, the assessment of the association between youth tobacco use and mental health problems is generally limited to cigarette smoking. Studies suggest a positive association between youth tobacco use and internalizing problems including depressive symptoms (Lechner, Janssen, Kahler, Audrain-McGovern, & Leventhal, 2017;Leventhal et al, 2016;Mistry, Babu, Mahapatra, & McCarthy, 2014;Tercyak & Audrain, 2002) and anxiety Zehe, Colder, Read, Wieczorek, & Lengua, 2013). Youth cigarette smoking has also been associated with externalizing disorders involving disruptive behavior, including conduct disorder (Armstrong & Costello, 2002;Colder et al, 2013;Leventhal et al, 2016; National Center for Chronic Disease Prevention and Health Promotion (US) Office on and Smoking Health, 2012), oppositional defiant disorder, and attention-deficit/hyperactivity disorder (ADHD) (Brinkman, Epstein, Auinger, Tamm, & Froehlich, 2015;Elkins, McGue, & Iacono, 2007;Groenman et al, 2013;S.…”

Characterizing Polytobacco Use Trajectories and Their Associations With Substance Use and Mental Health Across Mid-Adolescence

“… 19 Additionally, prospective data indicates that more frequent e-cigarette and combustible cigarette use may also be associated with increased severity of depressive symptomology. 20 , 21 However, it is unknown if specific polytobacco use trajectories are longitudinally associated with increases in substance use and mental health problems during mid-adolescence.…”

Measuring characteristics of e-cigarette consumption among college students

“…In general, the literature shows that higher frequency of e-cigarette use is associated with a higher rate of concurrent use of tobacco products, as well as a higher level of nicotine dependence, bronchitis, and depression symptomatology. [4][5][6][7] Quantifying e-cigarette consumption, on the other hand, is not at all straightforward. Multiple quantity measures have been proposed such as the number of puffs, episodes, cartridges, and milliliters of e-liquid; yet, information about the reliability and validity of the alternative measures is very limited.…”