Mental Health Problems and Initiation of E-cigarette and Combustible Cigarette Use
- PMID: 31160343
- PMCID: PMC6615573
- DOI: 10.1542/peds.2018-2935
Mental Health Problems and Initiation of E-cigarette and Combustible Cigarette Use
Abstract
Background and objectives: During adolescence, mental health problems may increase the risk of initiating combustible cigarette use. However, it is unknown if this association extends to electronic cigarettes (e-cigarettes). We examined whether internalizing and externalizing problems were associated with initiation of e-cigarette, combustible cigarette, and dual-product use among adolescents.
Methods: Participants were drawn from the Population Assessment of Tobacco and Health Study, a nationally representative longitudinal study of US adolescents followed from 2013 to 2015. The study sample included 7702 adolescents aged 12 to 17 years who at baseline reported no lifetime use of tobacco products. We examined the respective associations between baseline internalizing and externalizing problems and initiating use of e-cigarettes, combustible cigarettes, or both at 1-year follow-up.
Results: Compared with adolescents with low externalizing problems, adolescents with high externalizing problems were significantly more likely to initiate use of e-cigarettes (adjusted relative risk ratio [aRRR] = 2.78; 95% confidence interval [CI]: 1.76-4.40), combustible cigarettes (aRRR = 5.59; 95% CI: 2.63-11.90), and both products (aRRR = 2.23; 95% CI: 1.15-4.31). Adolescents with high internalizing problems were at increased risk of initiating use of e-cigarettes (aRRR = 1.61; 95% CI: 1.12-2.33) but not combustible cigarettes or both products.
Conclusions: Mental health problems are associated with increased risk for initiating e-cigarette, combustible cigarette, and dual-product use in adolescence. This association is more consistent for externalizing problems than internalizing problems. Addressing mental health problems could be a promising target for preventing initiation of nicotine- and/or tobacco-product use by adolescents.
Copyright © 2019 by the American Academy of Pediatrics.
Conflict of interest statement
POTENTIAL CONFLICT OF INTEREST: Dr Young has received research funding from Supernus Pharmaceuticals and PsychNostics, LLC; the other authors have indicated they have no potential conflicts of interest to disclose.
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References
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- US Food and Drug Administration Statement from FDA Commissioner Scott Gottlieb, M.D., on new steps to address epidemic of youth e-cigarette use. Available at: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm620185.htm. Accessed December 18, 2018
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