Teen Vaping and Mental Health

by Afamefuna Onyeogulu
May 31, 2024 at 8:05 AM UTC

Teen vaping has surged among younger teens, while researchers worry about the long-term effects on their mental health.

Clinical Relevance: Teen vaping has surged among younger teens, while researchers worry about the long-term effects on their mental health.

  • Rates of vaping among teens and young adults have skyrocketed over the last decade.
  • Certain social and biological factors make teens and young adults more likely to vape.
  • Vaping is both a consequence and risk factor for neuropsychiatric illnesses like anxiety and major depressive disorders.

Teen vaping has skyrocketed in recent years, alarming parents and health experts alike. What started as a safe alternative has quickly escalated into a widespread issue with serious mental health implications. Regulators and researchers are increasingly concerned about the impact on adolescent brains and mental well-being.

Research shows that rates of teen vaping in the United States and the United Kingdom have risen steadily over the last decade. Worryingly, studies also suggest that teens are picking up the habit at younger ages, with even more severe forms of addiction noted.

The most recent statistics from the Annual National Youth Tobacco Survey demonstrate a drop in tobacco use among high schoolers (driven mainly by a fall in e-cigarette use). Still, there was a worrying increase in vaping among middle schoolers.

There are several possible reasons for this rapid rise:

  • The perceived safety of vaping compared to traditional smoking.
  • Youth-targeted marketing by e-cigarette brands through bright colors and flavoring.
  • Social influence and peer pressure.
  • As a means of dealing with stress.
  • The nicotine found in e-cigarettes is more potent.

Biology could be another important factor. Like the body, the adolescent brain grows at different rates. And it doesn’t reach maturity until around the mid to late 20s.

Studies suggest the development of the reward-related regions of the brain outpaces that of the prefrontal cortex. This could explain why young adults are prone to engage in risky behavior like vaping – despite knowing better.

Dangers of Teen Vaping

Scientists still don’t completely understand the long-term mental effects of vaping. However, nicotine and tetrahydrocannabinol (THC) are common components of these devices whose effects on the developing brain have been well-studied.

A 2023 survey among 2,505 adolescents and young adults led by the American Heart Association highlighted a higher risk of anxiety, depression, and suicidal thoughts among vapers when compared to non-vapers.

The study also found that this age group has embraced dual vaping – using both nicotine and THC-laced e-cigarettes. Worryingly, this appears to be tied to an increased risk of nicotine addiction when compared to nicotine vaping alone.

Effects of Nicotine and THC on the Developing Brain

Scientists suspect these substances harm developing brains in two areas – the motivational systems and executive functions.

Researchers found that early nicotine exposure causes structural changes to the areas of the brain associated with anxiety and fear learning behavior, reward sensitivity and cravings, as well as impulse control and mood regulation.

Teen Vaping and the Risk of Neuropsychiatric Illness

Research paints a complicated picture of the relationship between nicotine, THC, and neuropsychiatric illness. Vaping is both a risk factor and a consequence of neuropsychiatric illness.

According to a study by the American Heart Association, vaping does cause anxiety and depression:

  • Vaping causes anxiety with 60 percent of vapers self-reported experiencing anxiety symptoms recently. This is in contrast to non-vapers where only 40 percent reported similar symptoms. Anxiety symptoms were also found to be most common among THC-only vapers. Several studies back this up by establishing a link between early nicotine/THC vaping and anxiety disorders.
  • Over 50 percent of vapers reported experiencing symptoms of depression within a week of the survey, compared to non-vapers where only 25 percent reported similar symptoms. This coincided with a significantly higher rate of suicidal ideation, which was reported in more than half of vapers versus less than a third of non-vapers.

Influence of Neuropsychiatric Illness on the Odds of Vaping

Studies have found that certain anxiety disorders make you more likely to consume nicotine, worsen symptoms of nicotine withdrawal, make quitting more difficult, and increase your risk of relapse.

Some nicotine-dependent individuals reported that vaping does help relieve anxiety symptoms. However, researchers believe this is the short-term relief of acute withdrawal symptoms rather than any actual long-term reduction in anxiety symptoms.

Similarly, many individuals consume cannabis as a means of dealing with anxiety. Although effective at low doses for temporarily relieving anxiety, there is still much debate on the long-term efficacy of cannabis use for anxiety disorders.

Not unlike anxiety, nicotine dependence was associated with three to four times the risk of developing major depression. The link between cannabis use and depression is a bit more complicated. Some research pointed at cannabis use as a risk factor for developing major depressive disorder, while stronger evidence highlighted depression as a risk factor for cannabis use and dependence.

Hope on the Horizon

Teen vaping does emotional damage and is a consequence of and risk factor for neuropsychiatric illness. While the surge in teen vaping paints a grim picture, hope remains. Researchers have found that the adolescent brain has a great degree of neural plasticity. And teens are more likely than adults to drop dangerous habits as they mature.

But this doesn’t mitigate the importance of deepening our understanding of the effects of vaping on teen mental health and the need for policies to help teenagers stop vaping.

Further Reading

Psychotropic Use in Youth With MDD and ADHD

Teenagers Appear to be ‘Spreading’ Mental Illness

Mental Health Diagnoses Take Unprecedented Leap

Commentary

Learning by Doing: Can Our Collective Experiences as Clinicians Improve Mental Health Care?

Drs Rush and Tramontin discuss how simple outcomes, often patient reported, could facilitate evidence-based decision making by clinicians, administrators, and payors and provide the foundation for a learning health care system.

A. John Rush and others

Letter to the Editor

Psychiatric History of Presenting Illness Mnemonic

In this letter to the editor, the author presents a mnemonic created to help clinicians obtain a psychiatric history.

Abdulsamad A. Aljeshi