TY - JOUR
T1 - Association between e-Cigarette Use and Depression in the Behavioral Risk Factor Surveillance System, 2016-2017
AU - Obisesan, Olufunmilayo H.
AU - Mirbolouk, Mohammadhassan
AU - Osei, Albert D.
AU - Orimoloye, Olusola A.
AU - Uddin, S. M.Iftekhar
AU - Dzaye, Omar
AU - El Shahawy, Omar
AU - Al Rifai, Mahmoud
AU - Bhatnagar, Aruni
AU - Stokes, Andrew
AU - Benjamin, Emelia J.
AU - Defilippis, Andrew P.
AU - Blaha, Michael J.
N1 - Publisher Copyright:
© 2019 AMA. All rights reserved.
PY - 2019/12/4
Y1 - 2019/12/4
N2 - Importance: The prevalence of the use of electronic cigarettes (e-cigarettes) in the United States has grown rapidly since their introduction to the market more than a decade ago. While several studies have demonstrated an association between combustible cigarette smoking and depression, the association between e-cigarette use and depression has not been thoroughly studied. Objective: To examine the association between e-cigarette use and depression in a nationally representative sample of the adult population in the United States. Design, Setting, and Participants: Cross-sectional study of the Behavioral Risk Factor Surveillance System database, 2016 to 2017. The Behavioral Risk Factor Surveillance System is the largest national telephone-based survey of randomly sampled adults in the United States. A total of 892394 participants with information on e-cigarette use and depression were included. Data analysis was conducted in May 2019. Exposures: Electronic cigarette use status defined by self-report as never, former, or current use. Main Outcomes and Measures: Self-reported history of a clinical diagnosis of depression. Results: Of the 892394 participants (414326 [29.0%] aged ≥60 years; 502448 [51.3%] women), there were 28736 (4.4%) current e-cigarette users, of whom 13071 (62.1%) were aged between 18 and 39 years. Compared with never e-cigarette users, current e-cigarette users were more likely to be single, male, younger than 40 years, and current combustible cigarette smokers (single, 120797 [24.3%] vs 10517 [48.4%]; men, 318970 [46.6%] vs 14962 [60.1%]; aged 18-39 years, 129085 [32.2%] vs 13071 [62.1%]; current combustible cigarette use, 217895 [7.9%] vs 8823 [51.8%]). In multivariable adjusted models, former e-cigarette users had 1.60-fold (95% CI, 1.54-1.67) higher odds of reporting a history of clinical diagnosis of depression than never users, whereas current e-cigarette users had 2.10 (95% CI, 1.98-2.23) times higher odds. Additionally, higher odds of reporting depression were observed with increased frequency of use among current e-cigarette users compared with never users (daily use: odds ratio, 2.39; 95% CI, 2.19-2.61; occasional use: odds ratio, 1.96; 95% CI, 1.82-2.10). Similar results were seen in subgroup analyses by sex, race/ethnicity, smoking status, and student status. Conclusions and Relevance: This study found a significant cross-sectional association between e-cigarette use and depression, which highlights the need for prospective studies analyzing the longitudinal risk of depression with e-cigarette use. If confirmed by other study designs, the potential mental health consequences may have regulatory implications for novel tobacco products.
AB - Importance: The prevalence of the use of electronic cigarettes (e-cigarettes) in the United States has grown rapidly since their introduction to the market more than a decade ago. While several studies have demonstrated an association between combustible cigarette smoking and depression, the association between e-cigarette use and depression has not been thoroughly studied. Objective: To examine the association between e-cigarette use and depression in a nationally representative sample of the adult population in the United States. Design, Setting, and Participants: Cross-sectional study of the Behavioral Risk Factor Surveillance System database, 2016 to 2017. The Behavioral Risk Factor Surveillance System is the largest national telephone-based survey of randomly sampled adults in the United States. A total of 892394 participants with information on e-cigarette use and depression were included. Data analysis was conducted in May 2019. Exposures: Electronic cigarette use status defined by self-report as never, former, or current use. Main Outcomes and Measures: Self-reported history of a clinical diagnosis of depression. Results: Of the 892394 participants (414326 [29.0%] aged ≥60 years; 502448 [51.3%] women), there were 28736 (4.4%) current e-cigarette users, of whom 13071 (62.1%) were aged between 18 and 39 years. Compared with never e-cigarette users, current e-cigarette users were more likely to be single, male, younger than 40 years, and current combustible cigarette smokers (single, 120797 [24.3%] vs 10517 [48.4%]; men, 318970 [46.6%] vs 14962 [60.1%]; aged 18-39 years, 129085 [32.2%] vs 13071 [62.1%]; current combustible cigarette use, 217895 [7.9%] vs 8823 [51.8%]). In multivariable adjusted models, former e-cigarette users had 1.60-fold (95% CI, 1.54-1.67) higher odds of reporting a history of clinical diagnosis of depression than never users, whereas current e-cigarette users had 2.10 (95% CI, 1.98-2.23) times higher odds. Additionally, higher odds of reporting depression were observed with increased frequency of use among current e-cigarette users compared with never users (daily use: odds ratio, 2.39; 95% CI, 2.19-2.61; occasional use: odds ratio, 1.96; 95% CI, 1.82-2.10). Similar results were seen in subgroup analyses by sex, race/ethnicity, smoking status, and student status. Conclusions and Relevance: This study found a significant cross-sectional association between e-cigarette use and depression, which highlights the need for prospective studies analyzing the longitudinal risk of depression with e-cigarette use. If confirmed by other study designs, the potential mental health consequences may have regulatory implications for novel tobacco products.
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U2 - 10.1001/jamanetworkopen.2019.16800
DO - 10.1001/jamanetworkopen.2019.16800
M3 - Article
C2 - 31800073
AN - SCOPUS:85076046314
SN - 2574-3805
VL - 2
JO - JAMA Network Open
JF - JAMA Network Open
IS - 12
M1 - e1916800
ER -