Vaping and mental health disorders among medical trainees

ABSTRACT Objective Electronic cigarettes (e-cigarettes) have gained popularity among young people and, like tobacco smoking, may be associated with mental health disorders. In this secondary analysis of the Global Vaping Study, we aimed to investigate the association between vaping dependence and mental health, including anxiety, depression, and substance use disorders. Methods The Global Vaping Study was a multinational web-based survey conducted between October 2020 and November 2021 in Brazil (BR), the United States (US), and India (IN), investigating patterns of use, knowledge, and attitudes of medical trainees toward e-cigarettes and hookah. This study’s primary outcome was vaping dependence, defined as the presence of at least two symptoms from the Hooked on Nicotine Questionnaire. Depression, anxiety, and alcohol use disorder were measured with validated questionnaires, whereas other substances were measured using adapted National Survey questions. A mixed effects model was employed to evaluate associations with mental health and substance use. Results Of 6,160 respondents from BR and US, 946 (15.3%) were active e-cigarette users (BR=612, US=334). Among users, 534 (59.6%) reported e-cigarette dependence. Psychiatric treatment in the previous year (OR=1.56, 95%CI=1.10–2.22) and male gender (OR=1.46, 95%CI=1.05–2.04) were linked with vaping dependence. Conclusion This study reveals a high prevalence of vaping dependence among medical trainees, particularly among males and those with prior psychiatric treatment. Coordinated efforts involving medical schools, healthcare providers, and regulatory bodies may support education, population-level screening, and referral strategies to address vaping dependence without replacing clinical care.