Study finds depressed adolescents twice as likely to vape

A study on vaping behavior among Australian high school students has found those who reported severe depressive symptoms were over twice as likely to have tried e-cigarettes, compared to those reporting no depressive symptoms.

Data showed overall higher e-cigarette use among those with poorer mental health, including severe depressive symptoms, moderate and high stress, and low well-being.

The findings show a critical need for effective mental health support at the same time as vaping prevention during early adolescence—when these issues first emerge.

The researchers surveyed over 5,000 Year 7 and 8 students from 40 schools in New South Wales, Queensland and Western Australia in 2023 (May–October), creating one of the largest datasets on adolescent vaping currently available in the country.

Out of the 5,157 students who took part in the study, 8.3% reported having used e-cigarettes before.

E-cigarette use was also 74% higher for students who reported moderate stress, and 64% higher for people who reported high levels of stress.

E-cigarette use was also 105% higher for students who reported low well-being compared to high well-being. Anxiety symptoms were not associated with e-cigarette use.

The data were drawn from a survey within the "OurFutures Vaping Trial," the first, and currently only, clinical trial of a school-based e-cigarette prevention program in Australia.

The trial aims to rigorously test if vaping uptake can be prevented in Australian adolescents.

"There is a lack of data on the links between adolescent vaping and mental health, especially in the unique Australian context. It was important we addressed this as we are witnessing both vaping and mental ill-health increase among young people," says Dr. Lauren Gardner from the University of Sydney's Matilda Center, who co-leads the OurFutures Vaping Trial with Professor Nicola Newton.

"More research is needed to understand the complex relationship between mental health and vaping. However, these findings highlight the urgent need for prevention and early intervention approaches, backed by evidence, to support both the short- and long-term health and well-being of young people."

The results, published in Australian and New Zealand Journal of Psychiatry, are consistent with research in other age groups and countries, including the United States that has linked adolescent e-cigarette use with depressive and anxiety symptoms and stress.

The Matilda Center previously found the average age a teenager begins to vape is 14. Other research (independent to the University of Sydney) has found vaping rates among 12 to 15 years increasing from 10% to 24% between 2017 to 2023.

"There is a growing body of evidence of a relationship between vaping and mental health: vaping has been linked with the onset of mental health problems, and vice versa," says co-author Associate Professor Emily Stockings from the Matilda Center.

"Although not explored in our study, it is possible that this relationship can be explained by shared social, environmental and genetic risk factors, or it may point to possible self-medicating behaviors.

"In the short term, nicotine may reduce feelings of anxiety and stress, and young people may be reaching for vapes as a coping mechanism.

"Regardless of whether mental ill-health influences smoking or vice-versa, it is clear that if we are to prevent vaping onset, we need to address mental health at the same time."