ArticleAddiction (Abingdon, England)2023
The interaction of e-cigarette use and mental health symptoms on risk of cigarette smoking initiation among young adults in the United States.
Article in Addiction (Abingdon, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Prevalence and Mental Health Correlates of Electronic Cigarette Use Among Pediatric Primary Care Patients.Clinical pediatrics · 2026Article
- Vaping and mental health: A cross-sectional study among university students in Bangladesh.PloS one · 2026Article
- Prospective associations of subjective and objective neighborhood disadvantage with cannabis and nicotine vaping among Southern California adolescents.Health & place · 2025Article
- Nicotine-Cannabis Transitions and Nicotine Abstinence Among United States Adults.Epidemiology (Cambridge, Mass.) · 2025Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND AND
aimsIt is unknown whether young adults who vape nicotine and have poor mental health have greater risk of smoking initiation than expected based on individual risks of vaping and mental health alone. This study aimed to estimate the joint association of vaping and mental health symptoms with smoking initiation among young adults, and test for additive interaction between vaping and mental health in smoking initiation risk.
designUsing five waves of the Population Assessment of Tobacco and Health (wave 1, 2013-2014; wave 2, 2014-2015; wave 3, 2015-2016; wave 4, 2016-2018; wave 5, 2018-2019), we estimated risk differences (RD) for the association of time-varying and time-lagged vaping and internalizing (e.g., anxiety, depressive) and externalizing (e.g., inattention/hyperactivity) mental health symptoms with cigarette smoking initiation at follow-up, over four 1-year intervals. We calculated interaction contrasts (IC) to estimate the excess risk of smoking initiation attributable to the interaction of vaping and mental health symptoms.
settingUnited States.
participantsA total of 6908 cigarette-naïve individuals aged 18-24 years. MEASUREMENTS: Exposures included current (past-30 day) vaping and internalizing and externalizing mental health symptoms (high vs moderate/low symptoms). The outcome was smoking initiation (ever cigarette use) after 1 year.
findingsThe per-interval risk of smoking initiation was 7.6% (1039 cases/13 712 person-intervals). Compared with noncurrent vaping and moderate/low mental health symptoms, adjusted RDs for current vaping and high mental health symptoms were 17.2% (95% confidence interval [CI]: 7.2% to 27.3%) for internalizing and 18.7% (95%CI: 8.1% to 29.2%) for externalizing symptoms. The excess risk attributed to interaction of current vaping and high externalizing symptoms was IC = 11.3% (95%CI: 1.3% to 21.2%; P = 0.018), with inconclusive findings for internalizing symptoms (IC = 7.7% [95%CI: -2.2% to 17.7%; P = 0.097]).
conclusionsThere is possible, but inconclusive, superadditivity between vaping and mental health in risk of smoking initiation among young adults in the United States.
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