Psychosocial stressors and current e-cigarette use in the youth risk behavior survey

Abstract

Background This study explores the association between psychosocial stressors and current e-cigarette use among adolescents in the United States. Methods We used data from 12,767 participants in the 2019 National Youth Risk Behavioral Survey to examine the association between psychosocial stressors (bullying, sexual assault, safety-related absence from school, depressive symptoms, suicidal ideation, physical altercation, and weapon threats) and past-30-day e-cigarette use using multivariable-adjusted logistic regression models. We examined the association for each stressor and then as a burden score (0–7). To compare the strength of the association between stressors and current e-cigarette use to current combustible cigarette use, we additionally examined the association between each stressor and current combustible cigarette use. Results Approximately 32.7% reported current e-cigarette use. The weighted prevalence of current e-cigarette use was higher among individuals who experienced stressors than those who did not. For example, bullying (43.9% vs. 29.0%). Similar prevalence patterns were seen among other stressors. Individuals who experienced stressors had significantly higher adjusted odds of current e-cigarette use than those who did not (OR [Odds Ratio] range: 1.47–1.75). Similarly, individuals with higher burden scores had a higher prevalence (zero [20.5%], one [32.8%], two [41.4%], three [49.6%], four to seven [60.9%]) and higher odds of current e-cigarette use (OR range: 1.43–2.73) than those with a score of zero. The strength of the association between the stressors and e-cigarette use was similar to that between the stressors and combustible cigarette use. Conclusion The study demonstrates a significant association between psychosocial stressors and adolescent e-cigarette use, highlighting the potential importance of interventions, such as targeted school-based programs that address stressors and promote stress management, as possible means of reducing adolescent e-cigarette use. Future research directions include exploring underlying mechanisms linking stressors to e-cigarette use and evaluating the effectiveness of interventions addressing stressors in reducing adolescent e-cigarette use.

E-Cigarette Use Among US Adults in the 2021 Behavioral Risk Factor Surveillance System Survey

“…26,27 Moreover, the heightened psychosocial stress experienced during the pandemic may have resulted in more individuals turning to e-cigarettes as a coping mechanism. 28,29 We observed a high proportion (71.5%) of individuals aged 18 to 20 years who reported current e-cigarette use without concurrent use of combustible cigarettes. This proportion is numerically higher than those observed in prior BRFSS years (63.3% in 2017, 66.1% in 2018, and 70.4% in 2020).…”

“…The higher prevalence of e-cigarette use observed in 2021 may have been due to changes that occurred during the pandemic, such as increased online sales, which facilitated easy accessibility and concomitant stockpiling . Moreover, the heightened psychosocial stress experienced during the pandemic may have resulted in more individuals turning to e-cigarettes as a coping mechanism …”

“…There seem to be many implications of our data for policy and public health, particularly for those aged 18 to 20 years. Some researchers have viewed data such as ours as a reflection of mental health, considering the interplay of stress and substance use, and as a call for tighter regulation of existing policies, such as Tobacco 21 legislation and the e-cigarette flavor ban, considering the high prevalence of e-cigarette use among young adults . Others have suggested that tighter control of online purchases may limit e-cigarette use among young adults .…”

“… 26 , 27 Moreover, the heightened psychosocial stress experienced during the pandemic may have resulted in more individuals turning to e-cigarettes as a coping mechanism. 28 , 29 …”

Examining the correlates of cigarette smoking, e-cigarette use and dual use among Canadian post-secondary students

“… 13 - 16 Many of these factors also play a role in e-cigarette use. 13 - 18 However, there have been conflicting findings regarding the correlates of e-cigarette use and smoking. For example, sport participation has been positively associated with e-cigarette use but negatively associated with smoking among secondary students.…”