Teen vapers and smokers have a higher rates of depression and anxiety, study finds
Tobacco use has previously been found to lead to a deterioration in mental health, but there has been much less research into the link between teenagers using vapes and cigarettes and mental health.
Understanding the link is vital, because they are in a critical developmental period during which many health-related risk-taking behaviours begin, study authors at West Virginia University explain.
In the study, published in the journal PLOS Mental Health, researchers used data on tobacco use, depression and anxiety symptoms among different demographics from the 2021-2023 National Youth Tobacco Survey.
Among the 60,072 middle school and high school students who completed the questionnaire, 21.31 per cent used tobacco products, 9.94 per cent used e-cigarettes, with just 3.61 per cent only using conventional tobacco products – cigarettes, cigars, hookah and pipes – and 7.80 per cent used both.
Overall, the survey revealed 25.21 per cent of respondents said they had symptoms associated with depression and 29.55 per cent reported anxiety symptoms.
In comparison to teens who had not used any tobacco products, smokers and vapers had displayed a potentially heightened risk of depression and anxiety, while those who used conventional tobacco products as well as nicotine products had the highest odds of reporting mental health struggles.
In the UK an estimated 1.1million young people between the ages of 11 and 17 vape and 100,000 smoke, according to Action on Smoking and Health (ASH).
Meanwhile one in six young people in England aged five to 16 experienced a mental health problem in 2020, up from one in nine in 2017.
The study authors concluded: 'While causality cannot be determined, the results from this study showed that all forms of tobacco use were significantly associated with mental health issues. There is a need to continue promoting mental health support and implementing tailored interventions to combat all forms of tobacco use among adolescents'.
Dr Lion Shahab, chartered member of the British Psychological Society, said there is a risk the study did not control for important factors that influence both e-cigarette use and mental health symptoms. He suggested the study did not account for family history of mental health problems, which could explain the association.
However, he agrees there is a link between addiction and mental health. He explained that there are studies showing a strong link between those with mental health problems starting to use e-cigarettes.
He told the Independent: 'There are now many more teenagers reporting that they are addicted to vaping. The level of addiction that they report is quite similar to what you see with cigarettes and so addiction in itself may not be very good for mental health.'
Although the study does find a link between teenagers trying cigarettes and vapes and reporting depression and anxiety, it doesn't mean that one causes the other, said Dr Johnathan Livingstone-Banks Researcher in Evidence-Based Healthcare at University of Oxford.
'It could just as easily be that young people with poor mental health are more likely to experiment. However, that does not mean that this correlation shouldn't be taken seriously, and there is evidence in adults that quitting smoking can improve mental health,' he said.
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