Vaping and Mental Health Struggles During the COVID-19 Pandemic

Youth vaping has increased dramatically in the past decade, with about 1 in 5 teens reporting past-month vape use in early 2020. Over that same time frame, we’ve also seen a significant increase in teen mental health struggles. As part of our campaign development work, we’re continually conducting research with teens who vape to test new messaging approaches and stay abreast of the latest trends in teen vaping. In this recap of our presentation at the 2021 APHA Annual Meeting & Expo, we provide our research insights about the association of vaping, mental health, and the impact of the COVID-19 pandemic.

The overlap of vaping and mental health

To learn more about the impact of mental health on vaping, we conducted qualitative and quantitative research with teens across several states.

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We found that rates of current vape use were significantly higher among those who reported feeling sad than those who did not: 22% vs. 14%. Additionally, among those who vaped in the past month, those who reported feeling sad vaped 13.6 days, compared to 10 days among those who did not feel sad.

Flipping our variables so we can think about this from both angles: among those who vaped, almost 68% reported feeling sad, compared to 55% among those who did not vape. Both rates are incredibly high, but the rate among those who vape is significantly and meaningfully higher. The association persisted when we conducted a series of logistic regressions while controlling for demographics. Feeling sad or hopeless was associated with a 73% increase in odds of current vape use (p = .001). Current vape use was associated with a 74% increase in odds of feeling sad or hopeless (p = .001).

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The impact of COVID-19 on vaping and mental health

COVID-19 impacted teens’ vaping habits differently, depending on whether they were infrequent or frequent users prior to the start of the pandemic. Infrequent users actually reduced their vape use, due to limited access and no longer being in social situations with implicit pressure to vape. Inversely, those who were vaping several times a week or daily before the pandemic found that vaping became a coping mechanism for them, as they struggled with the increase in stress, anxiety, and depression that the pandemic brought on.

We now have a generation of teens in which much of their high school careers have been upended by the pandemic, and they’re understandably upset about that experience. Even once kids are back in school, teens’ sense of security has been fundamentally altered in a way that is going to impact their mental health in the long term. It’s now critical to understand how to address this association in our vaping prevention work.

READ MORE: What Does Intentional Equity Mean in Public Health Campaigns?

Complementary approaches to urgently address teen vaping

To address teen vaping, we need to be focused on both prevention and cessation. We’re continually conducting focus groups, interviews, and surveys to develop, test, and revise new campaign content, so we can stay on top of the latest trends in teen vaping. This approach has allowed us to quickly integrate a mental health lens into our ready-made teen vaping prevention and cessation programs, making them more intentionally equitable.

Our prevention campaign, Behind the Haze, focuses on providing science-heavy, fact-based vape messaging that highlights the specific risks of vaping and the chemicals found in vapes. The goal is to prevent youth who’ve never vaped or are experimenting from becoming regular vape users. Behind the Haze is currently active in 12 states across the U.S.

Quit the Hit is our cessation support group that educates young people about how to quit vaping through group chats on Instagram. Created in partnership with Hopelab and UCSF’s Center for Tobacco Control Research and Education, Quit the Hit provides 30 days of online quit support in groups of 10-15 participants with active moderation by a cessation coach.

To learn more about bringing a ready-made vaping prevention and cessation program to your community, please reach out to Krysten Isaac, Group Management Director of Tobacco Control Programs.


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