Do Teens With Mental Health Issues Vape To Self-Medicate?

By Lindsey Weedston 06/11/19

A recent study examined the association between teenage mental health issues and combustible cigarette use.

Teen vaping to self-medicate

A study recently published in Pediatrics found that teens with mental health issues are more likely to use e-cigarettes.

Researchers surveyed 7,702 adolescents ages 12 to 17 and found that those with “externalizing problems” such as “rebelliousness and sensation-seeking” were more likely to smoke both standard combustible cigarettes and e-cigarettes, while those with internalizing problems such as anxiety and depression were only more likely to use e-cigarettes.

“Our results are in line with existing literature that suggests a stronger connection between externalizing problems, like rebelliousness and sensation-seeking, and combustible cigarette use, than between internalizing problems and combustible cigarette use,” said study leader Kira Riehm, MSc, to MedPage Today.

Studies have demonstrated an association between mental health issues and combustible cigarette use. As e-cigarette use increases among underage teens to the point of being called an “epidemic” by some health experts, researchers are beginning to look into how mental health plays into the growing trend of vaping.

The findings that teens who use e-cigarettes are more likely to have internalizing mental health problems but not externalizing could suggest that vaping is more of a way to self-medicate for anxiety, depression and related issues rather than simply trying something that has become trendy.

This could be related to the current availability of information on the risks of smoking combustible cigarettes paired with a lack of information about the risks of e-cigarettes and prevalent myths.

Studies on teens' knowledge of vaping risks and even what’s in their e-cigarettes came up with alarming results, including the fact that a significant number of teens were unaware that there was any nicotine in their vaping products. This problem has repeatedly landed the nation’s biggest e-cigarette company, Juul, in hot water. 

Juul has been accused of marketing to teens with colorful packaging and fruity flavor packs that make smoking more attractive to young people. The popularity of these products, which Juul claims are meant only for adults who are trying to transition away from combustible cigarettes, is largely responsible for an increase in nicotine use among teens after years of decline.

For kids with mental health problems, e-cigarettes represent a two-way street, says Boston Children's Hospital’s Dr. Nicholas Chadi.

"We have to be careful when we think of e-cigarettes as substances because it falls in the bigger picture of substance use in general," said Chadi. "This is a two-way highway, where people with mental health problems are more likely to start using these substances, but the reverse is also true—people who start using these substances also have increased chances of developing mental health symptoms."

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Lindsey Weedston is a Seattle area writer focused on mental health and addiction, politics, human rights, and various social issues. Her work has appeared in The Establishment, Ravishly, ThinkProgress, Little Things, Yes! Magazine, and others. You can find her daily writings at Twitter: