Using a national telephone-based survey, American researchers explored the relationship between e-cigarettes and depression.
When e-cigarettes first came to market, they were touted as a safer alternative to combustible cigarettes. Although a promising substitute in the beginning, it has been shown that e-cigarettes contain unregulated concentrations of chemicals and toxic metals, such as arsenic and lead. Roughly 10.8 million adults in the United States use e-cigarettes, with 3.6 million adults using them daily.
Multiple studies have established an association between depression and cigarette smoking: individuals with depression are more likely to smoke than those without a mental health condition. Furthermore, those individuals are less likely to quit smoking due to the withdrawal symptoms.
But, what about e-cigarettes? Is there an association between e-cigarettes and depression, similar to what has been found with regular cigarettes?
In order to study this relationship, American researchers randomly sampled adults in the United States using a national telephone-based survey. Their results were published in JAMA Network Open.
Adults in the survey were asked about their past and current e-cigarette use, their answers subsequently sorted into four categories: everyday user, some days user, former user, and never user.
The adults were then asked if they had ever been told that they had a depressive disorder by a doctor. If the answer was “no,” researchers asked the participants if they had poor mental health in the past 30 days to evaluate subjective mental health symptoms.
Is there an association between e-cigarettes and depression?
After randomly calling 892,394 participants across the United States, the researchers found a relationship between e-cigarettes and depression. Those who currently or formerly used e-cigarettes were more likely to have depression than those who never used e-cigarettes. Additionally, more frequent e-cigarette use increased the odds that the individual had depression.
As college students are the primary target audience for tobacco companies, the researchers also investigated the relationship within the college subgroup of participants. They found that current e-cigarette users were twice more likely to have depression than those who never used e-cigarettes. The researchers warn that this subgroup could be more prone to developing depression due to the exploratory nature of college students and their willingness to try new things, even if those things are potentially dangerous.
Gateway to combustible cigarettes
The researchers are concerned that, rather than be a substitute for regular cigarettes, e-cigarettes could lead to regular cigarette use due to an addiction to nicotine. Cigarettes already interfere with psychiatric medications, making it difficult to treat mental health conditions. Likewise, e-cigarettes contain compounds that could also disrupt psychiatric medications.
Call for longitudinal studies
Although the study was based on self-reported data and the brands of e-cigarettes were not documented, the study does indicate an association between e-cigarettes and depression. More long-term studies are needed to further evaluate this relationship in order to inform public health policies and regulation of marketing materials. With additional research, doctors can better inform potentially susceptible populations, like those with mental health conditions, about the risks of using e-cigarettes.
Written by Shayna Goldenberg
Reference: Obisesan, O., Mirbolouk, M., Osei, A., Orimoloye, O., Uddin, S., Dzaye, O., El Shahawy, O., Al Rifai, M., Bhatnagar, A., Stokes, A., Benjamin, E., DeFilippis, A. and Blaha, M. (2019). Association Between e-Cigarette Use and Depression in the Behavioral Risk Factor Surveillance System, 2016-2017. JAMA Network Open, 2(12), p.e1916800.
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