Tram Pham1, Jeanne V A Williams2, Asmita Bhattarai3, Ashley K Dores4, Leah J Isherwood5, Scott B Patten6. 1. School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada. Electronic address: tram.pham@alumni.ubc.ca. 2. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada. Electronic address: Jvawilli@ucalgary.ca. 3. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada. Electronic address: Asmita.bhattarai1@ucalgary.ca. 4. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada. Electronic address: Akdores@ucalgary.ca. 5. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada. Electronic address: Leah.isherwood@ucalgary.ca. 6. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada; The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada; The Department of Psychiatry, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW Calgary, Alberta T2N 4N1, Canada; Cuthbertson and Fischer Chair in Pediatric Mental Health, Canada. Electronic address: Patten@ucalgary.ca.
Abstract
BACKGROUND: To examine the association between electronic cigarette (e-cigarette) use and adverse mental health status. METHODS: A cross-sectional analysis was conducted using data from the 2015 and 2016 Canadian Community Health Survey (n = 53,050). Sampling weights and associated bootstrap procedures were used to account for survey design effects. Multivariable logistic regression was employed to examine the association between e-cigarette use and the following mental health outcomes: depressive symptom ratings (using the Patient Health Questionnaire 9), self-reported professionally diagnosed mood and anxiety disorders, perceived mental health, suicidal thoughts/attempts, and binge drinking. RESULTS: The overall prevalence of past 30-day e-cigarette use was 2.9% (95% CI: 2.6-3.1). 11.5% (95% CI: 10.4-12.7) of smokers reported also using e-cigarettes. Dual users had the highest prevalence of adverse mental health status. The association between e-cigarette use and mental health was found to be modified by smoking status and sex in most of the logistic models. E-cigarettes had less than multiplicative effects among smokers. Female e-cigarette users tended to have higher odds of adverse mental health than male users. Overall, in the multivariable modeling, e-cigarette use was consistently associated with poor mental health among non-smokers and women, a finding that persisted after adjustment for additional covariates. CONCLUSIONS: These results indicate that e-cigarette use is associated with adverse mental health status, particularly among the non-smoking general population and women. LIMITATIONS: The study relied on respondent self-report, and the cross-sectional nature of the study does not allow us to clarify the direction of this association.
BACKGROUND: To examine the association between electronic cigarette (e-cigarette) use and adverse mental health status. METHODS: A cross-sectional analysis was conducted using data from the 2015 and 2016 Canadian Community Health Survey (n = 53,050). Sampling weights and associated bootstrap procedures were used to account for survey design effects. Multivariable logistic regression was employed to examine the association between e-cigarette use and the following mental health outcomes: depressive symptom ratings (using the Patient Health Questionnaire 9), self-reported professionally diagnosed mood and anxiety disorders, perceived mental health, suicidal thoughts/attempts, and binge drinking. RESULTS: The overall prevalence of past 30-day e-cigarette use was 2.9% (95% CI: 2.6-3.1). 11.5% (95% CI: 10.4-12.7) of smokers reported also using e-cigarettes. Dual users had the highest prevalence of adverse mental health status. The association between e-cigarette use and mental health was found to be modified by smoking status and sex in most of the logistic models. E-cigarettes had less than multiplicative effects among smokers. Female e-cigarette users tended to have higher odds of adverse mental health than male users. Overall, in the multivariable modeling, e-cigarette use was consistently associated with poor mental health among non-smokers and women, a finding that persisted after adjustment for additional covariates. CONCLUSIONS: These results indicate that e-cigarette use is associated with adverse mental health status, particularly among the non-smoking general population and women. LIMITATIONS: The study relied on respondent self-report, and the cross-sectional nature of the study does not allow us to clarify the direction of this association.
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