Depression, anxiety, stress, and current e-cigarette use: Results from the Truth Longitudinal Cohort of youth and young adults (2022-2023).

OBJECTIVE

To examine associations between depression, anxiety, and stress, as measured by the Depression, Anxiety and Stress Scale (DASS-21) scale, with current e-cigarette use.

METHODS

Data from the Truth Longitudinal Cohort - a nationally representative sample of youth and young adults - was collected between October 2022 to February 2023. The analytic sample was comprised of participants who provided information on e-cigarette use and the DASS-21 scale (N = 4198). Chi-square statistics were used to determine differences by current e-cigarette use across covariates and DASS-21 items. Logistic regression analyses were applied to the cross-sectional data to determine which scales predicted current e-cigarette use, adjusted for the effects of age, gender identity, race and ethnicity, parental educational attainment, perceived financial situation, and current use of alcohol, marijuana, and other tobacco use.

RESULTS

Those who had severe/extremely severe levels of depression, anxiety, and stress had greater odds of current e-cigarette use, relative to those who had normal levels of depression, anxiety, and stress, even after adjusting for covariates. Results also demonstrated associations between age, race/ethnicity, parental education, and current use of alcohol, marijuana, and other tobacco products with current e-cigarette use.

LIMITATIONS: Cross-sectional analyses of self-reported data limit the ability to determine directionality of effects between depression, anxiety, stress, and current e-cigarette use.

DISCUSSION: More severe levels of depression, anxiety, and stress were associated with a greater likelihood of current e-cigarette use. Future research is needed to evaluate changes in e-cigarette use, in response to depression, anxiety, and stress symptomatology.