Nicotine uptake and teenagers, a long story that repeats with e-cigarette use?

Dr Frank Bandiera and his coauthors from the University of Texas Health Science Center [1] paid attention to the associations between e-cigarette use and elevated depressive symptoms and mental health problems among revealed by cross-sectional studies and designed a longitudinal study to address the issue.

Again, nicotine use by teenagers is the target of researchers and a very hot topic in the current regulatory context in the USA. The lead author, Cheryl Perry, when she was a Professor at the Division of Epidemiology of the University of Minnesota in Minneapolis, untangled the complicated relationship between the tobacco industry and youth smoking. Based on the documents she evaluated in the framework of a lawsuit opposing the State of Minnesota to Philip Morris, she declared that “actions concerning youth smoking should be closely scrutinized and monitored because the industry’s survival depends on underage youths to be “replacement smokers” for those smokers who quit or die”.

“E-cigarette use did not predict elevated depressive symptoms at 6-month and 1-year follow-ups. However, depressive symptoms predicted e-cigarette use at both 6-month and 1-year follow-ups.” Bandiera et al., 2017

Carried out on 5445 college students in Texas, this longitudinal survey was conducted with two follow-ups at 6 months and 1 year. A bi-directional relationships between current, or past 30-day, e-cigarette use and elevated depressive symptoms across the three study waves was investigated by the researchers.

The study established in a temporal relationship, that students who experienced elevated levels of depressive symptoms were significantly more likely than students who did not to start using e-cigarettes six months later. However, e-cigarette use did not appear to lead to depression among Texan students, which is good news.

Depression, a growing phenomenon among students

The reasons why depression is happening and is growing in this population are largely unknown but it appears to be one of the factors that may explain why students are taking up e-cigarettes. Prevalence of depression in adolescents and young adults has dramatically increased in recent years with an increase of 12-month prevalence of major depressive episodes from 8.7% in 2005 to 11.3% in 2014 in adolescents (aged 12 to 17) and from 8.8% to 9.6% in young adults (aged 18 to 25) [2].