E-cigarette users were twice as likely than people who had never used e-cigarettes to report having clinical depression, according to a new study conducted by researchers from Johns Hopkins University and funded through the Tobacco Center of Regulatory Science of the American Heart Association, published online in JAMA Network Open.
The findings come from a cross-sectional study of the Behavioral Risk Factor Surveillance System 2016 to 2017 database, the largest national telephone-based survey of randomly sampled adults in the United States. Nearly 900,000 participants age 18 and older with information on e-cigarette use and depression were included. Data analysis was conducted in May 2019.
More than twice as likely to report having clinical depression
Researchers found that current e-cigarettes users were more than twice as likely to report having clinical depression than people who had never used e-cigarettes – 34% vs. 15%. Moreover, former e-cigarette users were more likely to report having clinical depression than people who had never used e-cigarettes, but to a lesser degree – 27% vs. 15%. Results were similar in men and women and across different ethnic groups.
Depression was highest among college age students
The findings also didn’t differ much across age groups, but the correlation of current e-cigarette use, and depression was highest among college age students — 18 to 25. Researchers conducted a targeted sub-study of this population because of previous findings that college students are more likely to explore new products, including e-cigarettes. Also, tobacco companies tailor marketing strategies to this group.
“This highlights the potential susceptibility of e-cigarette users in this group to depression at a particularly vulnerable time in their lives, but also warrants pause in what this kind of nicotine addiction may be doing to our children, high schoolers and younger, who we know are using e-cigarettes in epidemic proportions,” said Mariell Jessup, M.D., FAHA, American Heart Association Chief Science and Medical Officer. “Mental health plays an important role in overall health and wellbeing and this connection of e-cigarettes and depression raises even more concern about how these products will impact public health for generations to come.”
Careful and thorough evaluation in youth and adults with depression
The researchers write that their findings, “…warrant careful and thorough evaluation of e-cigarette use in both youth and adults with depression. Physicians should consider routine collection of information pertaining to e-cigarette use during clinic visits, especially in patients with depression, and routine counseling for those who use e-cigarettes, offering support to those who express willingness to quit.”
Researchers said the study provides additional evidence to establish an association between e-cigarette use and depression, which could have potentially significant implications for public health, clinical practice and health policy. The potential mental health consequences may also have regulatory implications for novel tobacco products.
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