Could Smoking and Vaping Be Making Teen Mental Health Worse? Study Sheds Light - Video

Adolescents who use e-cigarettes or conventional tobacco products are significantly more likely to report symptoms of depression and anxiety than their non-using peers, according to a new study published in PLOS Mental Health. The research, led by Noor Abdulhay of West Virginia University, adds to growing evidence of a link between youth tobacco use and mental health struggles.

With rising rates of anxiety, depression, and suicide among U.S. teens and shifting patterns in tobacco use understanding how these factors intersect has become increasingly urgent.

In this new analysis, researchers examined data from the 2021–2023 National Youth Tobacco Survey, which includes responses from 60,072 middle and high school students across the United States. The survey assessed students’ use of tobacco products, including e-cigarettes and conventional tobacco products (CTPs) such as cigarettes, cigars, hookah, and pipes, as well as self-reported symptoms of depression and anxiety.

Of all respondents, 21.37% reported using some form of tobacco. Specifically, 9.94% used only e-cigarettes, 3.61% used only conventional tobacco products, and 7.80% used both. When it came to mental health, 25.21% of participants reported symptoms associated with depression, while 29.55% experienced anxiety symptoms.

Compared to adolescents who had never used tobacco, those who used e-cigarettes or conventional tobacco products were more likely to report symptoms of depression and anxiety. The highest risk was observed among youth who used both product types.

While the study does not establish a direct cause-and-effect relationship, the findings underscore a clear and concerning association. “While causality cannot be determined, the results from this study showed that all forms of tobacco use were significantly associated with mental health issues,” the authors stated.

The researchers emphasize the need for continued promotion of mental health support among teens and the implementation of targeted interventions to reduce all forms of tobacco use.

Reference: Abdulhay N, Wiener RC, Wen S, Gibbs BB, Bhandari R (2025) Mental health outcomes associated with electronic cigarette use, combustible tobacco use, and dual use among U.S. adolescents: Insights from the National Youth Tobacco Survey. PLOS Ment Health 2(7): e0000370. https://doi.org/10.1371/journal.pmen.0000370