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Introduction Recently, targeted marketing has encouraged teen e-cigarette vaping. Although e-cigarettes are often presented as a safe alternative to conventional tobacco, their toxicity is unclear. In adults, we have previously observed a link between dual usage of e-cigarettes and tobacco with increased sleep latency. We hypothesized an association between dual usage and increased sleep latency. Methods Participants were recruited to complete social media surveys. We performed three surveys: Survey 1 (n=47) in 2018, Survey 2 (n=1198) in 2019, and Survey 3 (n=564) in 2020. Surveys 1 and 2 had three sections: past and current inhalant use, the Pittsburgh Sleep Quality Index (PSQI), and the Leicester Cough Questionnaire (LCQ). Survey 3 did not include the LCQ, instead including the Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire (PHQ9). The adolescent data (aged 13–20 years; n=609) were isolated. Results Adolescents reported an increase in sleep duration with increasing age by one-way ANOVA. Males reported no change with increasing age, while, by Tukey’s multiple comparisons test, females got significantly more sleep at ages 19 and 20 than at age 14(p<0.01). There was no significant correlation between inhalant use and sleep duration. When broken down by gender, female dual users slept more than female nonsmokers,(p=0.01; mean difference=43.8 minutes; CI=0.11 to 1.36), while there was no difference in males. We observed a significant association between inhalant use and sleep(p=0.0008), with dual use correlated with a longer sleep latency than nonsmokers (mean difference=6.27 minutes; CI=1.40 to 11.13. We saw no correlation between inhalant use and anxiety or depression, nor between inhalant use and cough severity and prevalence. Conclusion In female adolescents, we observed a peak in sleep hours at age 19 but significantly less sleep in fourteen-year olds. College-aged females may have a later wake time relative to middle-school and high-school aged females. Dual inhalant use in females was associated with a long sleep duration, raising concern for sleep disruption caused by dual use. Dual use’s association with increased sleep latency raises concern for nicotine-induced wakefulness. Further data are required in order to define public health strategies. Support (if any) LCA is supported by NIH.

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