Vaping and mental health: What’s the connection?

Vaping devices, also known as e- cigarettes, e-hookahs, mods, vape pens, vapes, tank systems, and electronic nicotine delivery systems, are used to inhale aerosols. Some e-cigarettes look like regular cigarettes, pipes, pens, or USB drives. It contains a heating element to vaporize a liquid that can include flavor compounds, nicotine, or cannabis-derived compounds such as tetrahydrocannabidiol (THC) and cannabidiol (CBD). It is not approved by FDA but is often used as an aid to quit smoking.

Harmless or harmful?

E-cigarettes are popular among teens and young adults. CDC reported 19.6% of high school students and 4.7% of middle schoolers currently use e-cigarettes. Many reported using it on a daily basis. More than half of the students reported using flavored e-cigarettes. Some of the flavors used may be harmful when heated and inhaled in form of aerosol.

Social or peer pressure has been reported as one of the most common reasons for increased use by adolescents. The marketing strategies and misinformation on social media deceives the public on the use of nicotine-containing products.

Vape products are perceived as a safe and harmless alternative to combustible cigarettes. However, e-cigarette aerosols aren’t harmless. They can contain potentially harmful substances, including heavy metal. The ultrafine particles inhaled have been known to cause lung damage.

Impact on mental health

Like with any addiction, nicotine affects the physical and mental health of smokers. The impact on mental health has been overshadowed by the concerns about physical health. Contrary to popular belief, nicotine content in some vaping devices is much higher than combustible cigarettes. Some nicotine pods like the Juul pod contain as much nicotine as one pack of cigarettes.

Researchers have studied several mental health issues associated with vaping in adolescents and young adults. Dependence on nicotine has been associated with impulsivity, mood disorders, anxiety, suicidality and depression. The highly addictive nicotine has been studied and reported to affect certain brain regions that poses a risk for long-term damage as well.

Vaping is often used as a coping strategy by individuals suffering from depression, anxiety or other mental health conditions. However, it could potentially worsen the existing mental health conditions. Nicotine interrupts the cerebral dopamine pathway leading to an increase in depressive symptoms.

Nicotine also increases sensitivity to stress, and alters the coping mechanism in the brain. These changes lead to an increased dose-response relationship – meaning an increase in symptoms with increased exposure to nicotine. Depression and vaping, in particular, have been shown to have a bidirectional association.

Treatment and prevention strategies

Those who want to quit smoking cigarettes should seek advice from their healthcare provider instead of self-prescribing e-cigarettes. Pharmacological (nicotine replacement therapy) and behavioral treatment aim to effectively reduce withdrawal symptoms. Additionally, there are several evidence-based prevention programs that educate teenagers on the potential harm of vaping. One such program, CATCH My Breath, has successfully reached out to millions of school aged children.

Prevention strategies can help reduce the chances of vaping-related illnesses and improve the overall health of communities.

-By Dr. Namrata Walia, postdoctoral research fellow in the Department of Family and Community Medicine at Baylor College of Medicine

Additional Resources

Vaping: A new epidemic among our youth

E-cigarettes disrupt lung function and raise risk of infection