LATEBREAKER
Mental Health
Exploring the relationship between adolescent tobacco use and mental health: national youth tobacco survey Noor Abdulhay* Noor Abdulhay Ruchi Bhandari R. Constance Wiener Bethany Barone Gibbs Sijin Wen
Introduction: Adolescent tobacco use, especially with the introduction of Electronic Nicotine Delivery Systems (ENDS), has posed a significant threat to adolescent mental health. The objective of this study is to investigate the relationship between tobacco use and mental health among adolescents.
Methods: The 2021 and 2022 National Youth Tobacco Survey assessed anxiety and depression using the four-item Patient Health Questionnaire (PHQ-4), which was recoded into two separate binary variables (<3 vs. >/=3). Tobacco use was categorized into four groups: ENDS users, Combustible Tobacco Product (CTP) users, dual users, and non-users. Descriptive statistics and weighted regression models were used to examine the odds ratio (OR) and 95% confidence intervals (CI) between tobacco use and mental health, adjusting for potential confounders. Analysis was conducted using R version 4.1.1.
Results: Among the 48,704 adolescents included in the analysis, 10,824 reported depression and 12,439 reported anxiety. Adjusted odds of depression were higher among dual users (OR:2.03, CI:1.45-3.03), ENDS users (OR:1.68, CI:1.50-1.85), and CTP users (OR:1.47, CI:1.22-1.85) compared to non-users. The adjusted odds of anxiety were higher among ENDS users (OR: 1.66, CI: 1.47-1.89), dual users (OR: 1.48, CI: 1.33-1.65), and CTP users (OR: 1.39, CI: 1.16-1.76) compared to non-users.
Conclusion: This study highlights a significant association between tobacco use and poor mental health among adolescents, particularly in those who use both CTP and ENDS. Future longitudinal research should observe the direction of this relationship, determining whether poor mental health outcomes precede tobacco use, if tobacco use intensifies mental health issues, or if a bidirectional relationship exists among this vulnerable age group.