Q&A: Vaping dependence linked to higher depression risk in young people
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Key takeaways:
- Higher vaping dependence scores were significantly linked to higher depression symptoms scores for youth and young adults.
- However, vaping frequency alone was not associated with depression.
Young people who vape, especially those dependent on nicotine, are at higher risk for depression, and primary care physicians should make vaping cessation a priority to improve their mood, according to an expert.
Michael Chaiton, PhD, a senior scientist at the Centre for Addiction and Mental Health’s Institute for Mental Health Policy Research in Ontario, and colleagues conducted a longitudinal study to learn more about the relationship between e-cigarette use and depression in adolescents and young adults. They published their results in the American Journal of Preventive Medicine.
Healio spoke with Chaiton to learn more about the study, what primary care physicians need to know and more.
Healio: Why did you decide to research this subject? Why is it important?
Chaiton: I've been researching the associations between tobacco dependence and depression among youth since my PhD thesis. The global burden of both tobacco and mental health are very large, and we've known that there has been a strong association between tobacco use and poor mental health; however, the mechanisms underlying that association are not clear. The emergence of e-cigarettes and their popularity among youth, particularly youth who do not use cigarettes, adds another angle to the issue. Can nicotine alone lead to depression among youth? If it does, that suggests significant harm for people who vape but have never smoked that needs to be taken into account in our policies.
Healio: What were your findings and what are their clinical implications?
Chaiton: In this longitudinal study of a large number of youth who vape but do not smoke (n = 1,226) followed every 3 months for up to 1year, higher vaping dependence scores were significantly associated with increased depression symptoms scores at follow up among youth and adults. However, vaping frequency alone was not associated with depression, and there was no bidirectional relationship found — those with higher levels of depressive symptoms were not more likely to vape. This suggests that becoming addicted to vaping may worsen symptoms of depression — and that stopping vaping may improve them.
Healio: How are vaping frequency and dependency linked? Can someone be using frequently without being dependent on nicotine?
Chaiton: Frequency of use and dependence are correlated, but we also measured 12 other items of dependence that aren't frequency, such as experiencing cravings or needing to wake at night to vape. This study demonstrated that these other, more psychological measures of dependence drove the relationship between vaping and depressive symptoms. This relationship is also consistent with a theory of the relationship between substance use and mental health in which it is the stressful cycles of withdrawal and relief that cause a decline in mental health, not the use of the drug per se.
Healio: What is the take-home message for primary care physicians? What should they know about your study?
Chaiton: Youth who are vaping, and especially those experiencing symptoms of dependence, are at higher risk of depression. Stopping vaping should be a priority to help improve their mood. Many people who vape say that they do so to relieve stress, but this study shows that stress relief is only temporary — a function of the relief of withdrawal symptoms — and that overcoming the addiction can lead to more effective recovery.
Healio: Is there anything else you would like to add?
Chaiton: Cigarettes are also strongly associated with depression and have much more severe health effects. It is important not to switch from vaping to smoking as that is literally jumping from the frying pan into the fire!