December 04, 2019
2 min read

E-cigarette users prone to depression

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People who use electronic cigarettes were more likely to report a history of clinically diagnosed depression than nonusers, according to results of a cross-sectional study published in JAMA Network Open.

“Our study could inform clinical practice, providing information that clinicians could consider in counselling patients seeking information about e-cigarettes, especially those with depression,” Olufunmilayo H. Obisesan, MD, MPH, of the American Heart Association Tobacco Regulation and Addiction Center in Dallas, told Healio Psychiatry. “It also highlights the need for routine collection of e-cigarette use information during clinic visits, particularly among individuals with mental health conditions.”

According to the researchers, a recent study concluded e-cigarette use prevalence was 9.1% among those with depression, compared with 4.5% in the general U.S. population. Because of this and similar findings, the researchers hypothesized that e-cigarette users may be more likely to have depression and that individuals with depression may be more likely to use e-cigarettes. To test this, they conducted a cross-sectional study between 2016 to 2017 of the Behavioral Risk Factor Surveillance System, which contains data for 892,394 individuals with information on depression and e-cigarette use.

Of all participants, there were 28,736 (4.4%) current users, with 13,071 (62.1%) aged between 18 and 39 years. Current e-cigarette users were more likely to be male, single and younger than age 40 years, and they were also more likely to be current combustible cigarette smokers. According to multivariable adjusted models, former e-cigarette users had 1.6-fold (95% CI, 1.54-1.67) higher odds of clinically diagnosed depression history than never users. Current users had 2.1-fold (95% CI, 1.98-2.23) higher odds. The researchers observed higher odds of reporting depression with increased frequency of use among current users compared with never users, with a daily use odds ratio of 2.39 (95% CI, 2.19-2.61) and occasional use odds ratio of 1.96 (95% CI, 1.82-2.1). They also observed similar results in subgroup analyses by smoking status, sex, student status and race/ethnicity.

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,” Mariell Jessup, MD, FAHA, chief science and medical officer of the American Heart Association, said in a press release. “Mental health plays an important role in overall health and well-being and this connection of e-cigarettes and depression raises even more concern about how these products will impact public health for generations to come.”by Joe Gramigna


American Heart Association. E-cigarette use associated with self-reported clinical depression. Accessed Dec. 4, 2019.

Disclosures: Obisesan reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.