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Youth Mental Health and Vaping: Is There an Overlap?

Key Points:

  • The mental health of young people is currently an area of great concern.

  • Anxiety, depression and stress are linked to vaping prevalence in young individuals.

  • Addressing mental health concerns in youth may help deter vaping use.

Stressed teen vaping and looking out window

Adolescence, in general, can create much stress with hormonal changes, peer pressure, seeking independence and experimentation. Add in disruption from the COVID-19 pandemic, and not surprisingly, mental health among teens has been further impacted.

Even before the pandemic, youth mental health was declining – while vaping use was increasing steadily. The Centers for Disease Control and Prevention (CDC) found that persistent feelings of sadness and hopelessness in high school students increased by 40% from 2009 to 2019. In October 2021, three leading pediatric associations declared a joint “national emergency” in youth mental health.

So, this raises the question: is there a connection between youth mental health and vaping?

COVID-19 implications

In a study of Texas youth ages 16 to 24, mental health symptomatology, smoking and vaping behaviors were examined over one year from before to during the first year of the COVID-19 pandemic. Not surprisingly, researchers found modest increases in symptoms of anxiety and depression among participants. But after adjusting for sociodemographic factors, they also found that worse mental health predicted increases in cigarette, e-cigarette and marijuana use behaviors despite COVID-19.

teen leaning on chair

A separate online cross-functional survey of more than 5,000 US adults ages 18 and up found similar results. The survey examined substance use, mental health, COVID-19 impact, and participants’ sociodemographic characteristics. Individuals aged 18–25 had a higher frequency of e-cigarette use than people aged 26 or more. The study authors write, “It is also plausible that COVID-19 stressors such as job loss, social isolation, cessation of normal life activities, and psychological distress may have resulted in the increased use of e-cigarettes as a coping strategy.”

Delving into depression and vaping

Using nationally representative data from the 2017 to 2019 Monitoring the Future survey of more than 32,000 US 8th, 10th and 12th-grade students, researchers sought to examine associations between depression and vaping. They discovered:

  • Depressive symptoms were associated with two to three times the odds of vaping in combination with cigarette use among 8th and 10th-grade students.

  • Eighth graders with depressive symptoms were two times more likely to vape nicotine without cigarette use than their peers.

  • In 8th graders with depression, there was a greater association with vaping nicotine than binge drinking or using marijuana.

Mental disorders may begin during adolescence

Maturing teen brain puzzle

Since the teen brain is still developing and maturing, teens may respond to stress differently than adults, which could contribute to stress-related mental diagnoses such as anxiety and depression. Ongoing changes in the brain may explain why adolescence is a time when mental disorders can emerge.

Being mindful of mental health

More research is needed on the linkage between worsening youth mental health and vaping use. But addressing mental health and intervening as warranted may help curtail this dangerous behavior. It is important to urge adolescents, especially those with depression and other mental health issues, to avoid ever starting to vape – or supporting them to stop. Highlighting that vaping nicotine and marijuana may likely exacerbate their symptoms – and will not provide the emotional support they seek – is important.

By Linda Antinoro

Reviewed by Cindy Bistany, DHSc


  1. Adzrago D, Sulley S, Mamudu L, Ormiston CK, Williams F. (2022). The influence of COVID-19 pandemic on the frequent use of e-cigarettes and its association with substance ue and mental health symptoms. Behavioral Sciences, 12(11):453.

  2. American Academy of Pediatrics. (2021, October 19). AAP-AACAP-CHA declaration of a national emergency in child and adolescent mental health.

  3. Baiden P, Szlyk HS, Cavazos-Rehg P, Onyeaka HK, Peoples JE, Kasson E. (2022). Use of electronic vaping products and mental health among adolescent high school students in the United States: The moderating effect of sex. J Psychiatr Res, 147:24-33.

  4. Centers for Disease Control and Prevention. (2022, March 31). New CDC data illuminate youth mental health threats during the COVID-19 pandemic.

  5. Centers for Disease Control and Prevention. (n.d.) Mental health among adolescents.

  6. Clendennen SL, Chen B, Sumbe A, Harrell MB. (2022). Patterns in mental health symptomatology and cigarette, e-cigarette, and marijuana use among Texas youth and young adults amid the coronavirus disease 2019 pandemic, Nicotine & Tobacco Research, ntac205,

  7. Gorfinkel L, Hasin D, Miech R, Keyes KM. (2021). The link between depressive symptoms and vaping nicotine in US adolescents, 2017-2019. J Adolesc Health.S1054-139X(21)00345-1.

  8. National Institute of Mental Health. (2020). The teen brain: 7 things to know.,last%20brain%20regions%20to%20mature.


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