Electronic cigarette use and sleep health in young adults

Abstract

Poor sleep health is associated with numerous health concerns, and sleep problems are exacerbated by cigarette smoking. Although rates of traditional tobacco use are declining, rates of electronic cigarette (e-cigarette) use are comparatively high and growing. Given that nicotine is a primary mechanism by which smoking negatively impacts sleep health, e-cigarette use may also be linked to poor sleep health; however, no research has investigated this association. Participants were 1,664 college students, 40.9% of whom reported ever trying or currently using an e-cigarette. Questionnaires assessed demographic information, sleep health and e-cigarette use status and patterns. All measures were completed remotely via a secure online survey. Analysis of covariance was used to compare the sleep health of daily/non-daily e-cigarette users to (a) non-users and (b) users of combustible cigarettes. Gender and drinks per week were included as covariates in analyses. Current combustible and e-cigarette users reported significantly more sleep difficulties than never users.Users of e-cigarettes reported greater use of sleep medication than combustible cigarette users. Similar to combustible cigarette smoking, e-cigarette use (vs. nonuse) was associated with worse sleep health, even among non-daily e-cigarette users.These findings may indicate a need for assessment of and education on the role of e-cigarette use in sleep health among individuals who report experimentation with or current use of e-cigarettes. Future research should examine these relationships prospectively. K E Y W O R D Scollege students, ENDS, insomnia, nicotine, sleep quality

Main and Interactive Effects of Nicotine Product Type on Sleep Health Among Dual Combustible and E‐Cigarette Users

“…Given nicotine's function as a stimulant, the use of nicotine products might be expected to delay sleep onset, particularly if used near bedtime. However, the present study as well as a previous study 25 observed no significant association with SOL. This may be due, in part, to the method of assessing e‐cigarette use.…”

“…By comparison, only a handful of studies have examined the impact of e‐cigarette use on sleep health. Emerging work has found e‐cigarette users report poorer subjective sleep quality and increased use of sleeping medications compared with nonusers 25 . Importantly, overall sleep quality was significantly worse among e‐cigarette and combustible cigarette users compared with nonusers, highlighting a potentially deleterious effect of e‐cigarette use on sleep; further, these findings suggest that the adverse effects of e‐cigarettes are comparable to those of combustible cigarettes.…”

“…Despite emerging work on e‐cigarette use and dual use on important behavioral health outcomes, including sleep, some limitations are notable. First, prior studies have used participants who either generally identified as users 30 or quantified frequency of “ever” use 25 . A key assumption is that nicotine disrupts the sleep/wake cycle through its stimulating properties; thus, there is a need to understand the nuanced association between frequency of nicotine intake and sleep health.…”

Smoking and Incidence of Insomnia: a systematic review and meta-analysis of cohort studies

“…Although previous studies suggested that smoking might be a contributing factor for insomnia, there were considerable differences among the results of studies [14,19,20]. Besides, most of the studies were cross-sectional studies, which couldn't re ect the sequential order and causal relationship between smoking and insomnia.…”

Restless legs syndrome, sleep over the lifespan, sleep in the severely ill, shift‐work and sleep loss

“…Brett et al. (2020), probably for the first time ever, conducted a questionnaire study via the internet to investigate the impact of electronic cigarette use on sleep in young adults. There is a growing concern regarding electronic cigarette use in the last years, because of reported severe side effects, so it seems timely to collect data on the impact of this kind of nicotine consumption.…”