As we enter into the summer where many students are experiencing changes in routines and possible loss of the same social network they experience during the school year, now is a prime time to talk about mental health and its relationship to tobacco use. While things may be approaching a new normal post – COVID, the pandemic has effected mental health across all communities. A report from the Pew Research Center released before the pandemic stated that 70% of young people said anxiety and depression were major problems among peers in their communities. Since then, according to Truth Initiative, the prevalence of depression and anxiety symptoms in youth has doubled compared to pre-pandemic levels. Along with these concerning trends, E-cigarette use has also been on the rise with young people with as many as 1 in 5 high school students vaping according to the National Youth Tobacco Survey. So what do e-cigarettes and mental health have to do with each other? While nicotine has not been found to directly cause menta health conditions, researchers are continuing to find troubling links between the two. Numerous peer-reviewed studies revealed that nicotine can worsen symptoms of depression and anxiety.
Many students and adults alike have been mislead by tobacco companies and the media to see cigarettes and other tobacco products as stress relievers. In fact, a Truth Initiative survey found that a large majority of young people who have used e-cigarettes started vaping to lessen feelings of stress, anxiety, or depression. This could not be further than the truth.
So what are the facts? Research has shown:
- Nicotine can worsen anxiety symptoms and amplify feelings of depression.
- Current e-cigarette users have doubled the odds of having a diagnosis of depression compared to those who have never vaped.
- Using e-cigarettes at a higher frequency was associated with higher depressive symptoms – including feeling sad or having crying spells – a year later
- Vaping is significantly associated with higher levels of ADHD symptoms.
Why is nicotine seen as a stress reliever in the first place?
Simply put, nicotine causes your brain to produce dopamine, which is one of the “feel good” chemicals in the brain. This heightened level of dopamine can cause your brain to build a tolerance with consistent nicotine use and is a leading factor in nicotine addiction. This tolerance can then lead to the symptoms of withdrawal a habitual tobacco/nicotine user experiences when going a certain amount of time without nicotine. Through this process of addiction and changes in the brain, users might be interpreting the ability of the products to curb the symptoms of nicotine withdrawal as a beneficial effect on mental health, according to research on the effects of quitting smoking on mental health published in 2014. According to the paper, smokers experience irritability, anxiety, and depression when they have not smoked for a while, feelings which are relieved by smoking. The cycle of symptoms followed by relief from smoking can create the perception that smoking has psychological benefits.
What can we do?
The most important factor is having honest conversations with youth. Finals, summer jobs, distance from friends, and loss/ change of routines can be large transitions for students and may cause feelings of stress and anxiety. Most youth are not aware of the mental health effects of vaping. Go over the facts with them, and most importantly work with them to find health coping mechanisms for the stress and anxiety they may be feeling that don’t involve nicotine. Focus on support in stead of punishment, many students may hide their vaping habits for fear of getting in trouble. This may in turn be causing them to hide their mental health concerns as well. And keep in mind, if a youth in your life comes to you about a “friend” who is struggling with vaping, they may be probing to see the response they might get if they reveal their own struggles. This a great opportunity to offer support and have a meaningful conversation about stress and the resources available for help.
If you know youth in your life who are currently using e-cigarettes, encourage them to reach out to cessation resources like My Life My Quit (mylifemyquit.org). My Life My Quit is a free cessation coaching resource staffed 24/7 by experts who are trained specifically how to help youth quit vaping. They can help them develop a quit plan and establish healthy stress coping mechanisms to help curb symptoms of withdrawal which helps build healthy habits for life going forward.
For more information about mental health and nicotine, and for sources of the data provided please see the Truth Initiatives Mental Health and Nicotine Report.
This post was written by Madison Witczak, a public health educator and the Tobacco Program coordinator at Hamilton County Public Health.