Vaping E-Cigarette and Smoking Conventional Cigarettes are Associated with Depression Regardless of Gender, Race, and Ethnicity: Analysis of the Health Information National Trends Survey (HINTS) 2022

Abstract

Background: While previous research has explored the bidirectional relationships between smoking, vaping, and depression, limited attention has been given to examining potential gender-, race-, and ethnic- specific patterns in these associations. Aims: This study aimed to investigate gender, race, and ethnic differences in the associations between smoking conventional and vaping e-cigarettes and depressive symptoms. Methods: Data from the Health Information National Trends Survey (HINTS–2022) survey were analyzed, including a representative sample (probability sample) of US adults. Variables of interest included smoking status, e–cig use, depression (PHQ-4), and demographic characteristics. Binary logistic regression models were employed to assess the association between smoking and e-cig use (current and ever), and depression overall, adjusting for covariates (age, education, marital status, and employment). Statistical Package for the Social Sciences (SPSS) software was used for data analysis, using univariate, bivariate, and multivariable models. We tested potential interactions between race, ethnicity, gender, and depression. Results: The study findings indicated significant associations between smoking, e-cig use, and depression. Individuals who were experiencing depression compared to those non-depressed were more likely to use conventional (p<0.05) and e-cig (p<0.05). However, no significant interactions were found for gender, race, or ethnicity. Conclusions: This study suggests that the association between smoking, e-cig use, and depressive symptoms is not different by race, sex, and gender. These findings contribute to the existing literature, emphasizing the need for universal approaches to promote mental health as a tool to help individuals quit smoking and vaping, regardless of their gender, ethnicity, and race.