Depressive Symptoms Are Associated With Nicotine Vaping Among Adolescents

A two-way relationship between depressive symptoms and smoking has been established. This study used nationally representative Monitoring the Future data from more than 32,000 US 8^th, 10^th, and 12^th graders to examine the association between depression and vaping.

• Among respondents without depressive symptoms, approximately 10% vaped nicotine but did not smoke combustible cigarettes, 2% vaped nicotine and smoked cigarettes, and 1% smoked cigarettes without vaping in the past month. Among respondents with depressive symptoms, prevalence increased to approximately 13%, 4% and nearly 2.5%, respectively.
• 8^th graders with depressive symptoms were two times more likely to vape without cigarette use than their peers. This association was not significant for 10^th or 12^th

Comments: Serotonin release from nicotine use has been hypothesized as one reason that people with depression smoke more. Nicotine-stimulated serotonin release may also interfere with emotional regulation causing depression, particularly during sensitive periods of development. In this study, the association between vaping without combustible cigarette use was only found among the youngest students. It is possible that nicotine introduced by vaping causes depression and thus increases the likelihood that students will use cigarettes as they get older.

Sharon Levy, MD

Reference: Gorfinkel L, Hasin D, Miech R, Keyes KM. The link between depressive symptoms and vaping nicotine in US adolescents, 2017-2019. J Adolesc Health. 2021;S1054-139X(21)00345-1.