Passive exposure to e-cigarette emissions is associated with worsened mental health

• Published in: BMC public health Vol. 22; no. 1; pp. 1138 - 12
• Main Authors: Farrell, Kayla Rae, Weitzman, Michael, Karey, Emma, Lai, Teresa K Y, Gordon, Terry, Xu, Shu
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07.06.2022; BioMed Central; BMC
• Subjects: Adult; Analysis; Anxiety disorders; Cigarette smoke; Cigarette smoking; Cigarettes; Disorders; E-cigarette emissions; E-cigarette use; Electronic cigarettes; Electronic Nicotine Delivery Systems; Emissions; Exposure; Health aspects; Health problems; Health risks; Hispanic people; Humans; Internalizing disorders; Mental disorders; Mental Health; Nicotiana; Nicotine; Passive smoking; Public health; Regression analysis; Secondhand smoke; Signs and symptoms; Smokers; Smoking; Social research; Teenagers; Tobacco; Tobacco Products; Tobacco Smoke Pollution - adverse effects; Vaping; Vaping - adverse effects; Vaping - epidemiology; United States; United States > US; Secondhand smoke; E-cigarette use; Internalizing disorders; E-cigarette emissions; Mental health; Smoking
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-022-13470-9

Cigarette smoking, secondhand cigarette smoke (SHS) exposure, and e-cigarette use ("vaping") are each associated with increased rates of depressive symptoms and other internalizing mental health disorders. The prevalence of vaping has increased greatly, yet the mental health correlates of secondhand exposure to e-cigarette emissions are as yet to be investigated. This study examined the potential adverse mental health outcomes associated with different tobacco exposures (direct and passive), with a particular focus on the mental health correlates of secondhand exposure to e-cigarette emissions. The Population Assessment of Tobacco and Health Study data collected from a sample of 16,173 Wave 4 adults were used to test the hypothesis that secondhand e-cigarette emissions exposure is associated with increased odds of internalizing mental health disorders. Individuals were categorized as exclusive cigarette smokers, exclusive e-cigarette users, cigarette and e-cigarette dual users, exclusive noncombustible tobacco users, secondhand smoke exposed non-users, secondhand e-cigarette emissions exposed non-users, and non-users with no current SHS/secondhand e-cigarette aerosol exposure. Adjusted weighted logistic regression analysis was used to investigate the association between exposure type and internalizing problems as assessed by scores on the Global Appraisal of Individual Needs-Short Screener (GAIN-SS), a widely used instrument for assessing mental health problems. Cigarette smokers (AOR = 2.53, 95% CI: 2.19-2.92), e-cigarette users (AOR = 3.14, 2.41-4.09), dual users (AOR = 3.37, 2.85-4.00), noncombustible tobacco users (AOR = 1.48, 1.01-2.17), SHS exposed non-users (AOR = 1.63, 1.37-1.94), and secondhand e-cigarette emissions exposed non-users (AOR = 1.43, 1.03-1.99) were each associated with increased odds of moderate to severe internalizing mental health problems as compared to unexposed non-users. Odds of internalizing problems among SHS and secondhand e-cigarette emissions exposed non-users did not differ (p = 0.46). This is the first study, to our knowledge, to identify an association between recent secondhand exposure to e-cigarette emissions and mental health problems, and the risk is comparable to that of SHS. Corroboration of this relationship needs further research to explicate directionality and mechanisms underlying this association.