Abstract

Introduction: Previous studies have identified associations between nicotine and marijuana vaping among youth. Studies also have identified associations between vaping and both anxiety and depression among young adults. Hypothesis: We hypothesized that mental health differences would be evident across current nicotine-only vapers, current vapers of both nicotine and THC, and never vapers. Methods: A national online survey was conducted among 2,505 youth and young adults aged 13-24 during June and July 2022. The participants were recruited via an online panel and received an incentive to complete the survey. Parent consent was obtained for minors and informed consent was obtained from participants. Quotas were established for vaping and THC use. This analysis focuses on current vapers and never vapers (n=1,762). Current use was defined as having vaped in the past 30 days. Of the participants, 1,200 were current nicotine vapers (370 nicotine-only vapers and 830 dual vapers of nicotine and THC); 562 have never vaped nicotine or THC. Results: Dual vapers were significantly more likely than nicotine-only vapers to indicate addiction to nicotine, as defined as waking up at night to vape (55% vs. 45%, p<0.05). Both vaping groups were significantly more likely than never vapers to report mental health concerns. Anxiety was more prevalent among dual vapers (60%) and nicotine-only vapers (58%) than never vapers (43%) (p<0.05). Depression was more prevalent among dual vapers (52%) and nicotine-only vapers (53%) than never vapers (25%) (p<0.05). And having suicidal thoughts was more prevalent among dual vapers (51%) and nicotine-only vapers (53%) than never vapers (33%) (p<0.05). About one in four dual vapers (24%) and nicotine-only vapers (28%) started vaping nicotine to calm down/feel less stressed or anxious; one in three dual vapers (30%) and nicotine-only vapers (35%) currently vaped nicotine for this reason. One in five vapers (19% of dual vapers and nicotine-only vapers) started vaping to help feel less depressed, and currently vaped for this reason (20% of dual vapers and 21% of nicotine-only vapers). Dual vapers were significantly more likely than nicotine-only vapers to say they were less depressed after starting vaping (46% vs. 31%, p<0.05); nicotine-only vapers were more likely to say vaping had no impact on their depression (38% vs. 27%, p<0.05). Conclusions: In conclusion, our analysis shows an association between mental health symptoms with vaping nicotine and THC. Dual use may either compound the addictive nature of vaping or attract those more prone to addiction, as well as have an impact on depression. Anxiety and depression symptoms were notable among both groups, compared with never vapers, and were cited as reasons for nicotine vaping. These findings suggest the importance of addressing the use of THC and the need for building resilience skills in vaping prevention efforts.

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