ArticlePloS one2021
Association of cigarette and electronic nicotine delivery systems use with internalizing and externalizing problems among US adults: Findings from wave 3 (2015-2016) of the PATH study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Changes in combustible cigarette and electronic nicotine delivery system use among people with and without schizophrenia spectrum disorders in the USA (2016-2023).Tobacco control · 2026Article
- Knowledge and risk perception of e-cigarettes and hookah among young adults in Anambra State, Nigeria.BMC public health · 2025Article
- Factors associated with transitions in tobacco product use states among young adults aged 18-29 years.The American journal on addictions · 2024Article
- Cigarettes and e-cigarettes use among US adults with multimorbidity.Drug and alcohol dependence reports · 2024Article
- Combustible cigarette smokers versus e-cigarette dual users among Latinx individuals: Differences in alcohol and drug use severity.Experimental and clinical psychopharmacology · 2024Article
- Eating Disorder Symptomatology Among Young Adult Cigarette and E-Cigarette Users.Substance use & misuse · 2024Article
- Adult Electronic Nicotine Delivery System Use in the USA: a Scoping Review Through a Health Equity Lens.Current addiction reports · 2023Article
- The association of current exclusive e-cigarette use and dual use of e-cigarettes and cigarettes with psychological distress among U.S. adults.Preventive medicine reports · 2023Article
- Longitudinal transitions in e-cigarette and cigarette use among US adults: prospective cohort study.Lancet regional health. Americas · 2023Article
- Dual Use of Combustible Cigarettes and E-cigarettes: a Narrative Review of Current Evidence.Current addiction reports · 2022Article
- Passive exposure to e-cigarette emissions is associated with worsened mental health.BMC public health · 2022Article
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Authors and funding
3 authors.
Funding
Abstract
aimsElectronic Nicotine Delivery System (ENDS) use is increasing among US adults. While existing research has demonstrated higher cigarette smoking rates among people with mental health conditions, there is sparse information on the association between ENDS use and mental health such as internalizing and externalizing problems. The aim of this study was to evaluate associations between internalizing and externalizing problems for cigarette only, ENDS only, and dual users, as well as changes in mental health among those groups.
methodWe used the U.S. Population Assessment of Tobacco and Health (PATH) Study Wave 3 adult data. Internalizing and externalizing problems were self-reported and assessed via the Global Appraisal of Individual Needs-Short Screener; response options were dichotomized to reflect past 12 months and any lifetime problems. Self-reported changes in mental health over the past 12 months were also assessed. Participants' tobacco use status was categorized as ENDS only use (n = 618), cigarette only use (n = 6,779), dual use (cigarettes and ENDS) (n = 681), and non-current use (n = 16,515).
resultsLifetime and past 12 month internalizing problems were reported by 63.8% (n = 18,706) and 50.4% (n = 15,326), respectively, while lifetime and past 12 months externalizing problems were reported by 63.3% (n = 18,835) and 52.7% (n = 16,005), respectively. Six percent of participants reported worse mental health over the past 12 months. Compared to non-current use of any tobacco product, and adjusting for age, sex, race, education, and household income, those reporting ENDS use only had higher odds of ever (aOR = 1.52; 95%CI: 1.22-1.89) and past 12 months (aOR = 1.49; 95%CI: 1.22-1.84) internalizing, and externalizing problems (aOR = 1.32; 95%CI: 1.04-1.66 and aOR = 1.34; 95%CI: 1.07-1.67, respectively), and higher odds of reporting worse mental health over the past 12 months (aOR = 1.50; 95%CI: 1.05-2.12).
conclusionHealth care providers should be aware that internalizing and externalizing problems, and worsening mental health, are more common among adults who use ENDS, cigarettes, or both of these tobacco products.
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