Vaping transitions and incident depressive symptoms among young adults: a marginal structural model analysis

• Harlow, Alyssa F ^[1] ; Stokes, Andrew C ^[2] ; Han, Dae-Hee ^[1] ; Leventhal, Adam M ^[1] ; Barrington-Trimis, Jessica L ^[1]
  1. [1] University of Southern California

     University of Southern California

     Estados Unidos

     
  2. [2] Boston University

     Boston University

     City of Boston, Estados Unidos

     
• Localización: American journal of epidemiology, ISSN-e 1476-6256, ISSN 0002-9262, Vol. 194, Nº. 3, 2025, págs. 746-754
• Idioma: inglés
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  • Abstract The extent to which vaping influences depression is unclear but could be estimated through application of novel epidemiologic methods. Among a prospective cohort of young adults from California who screened negative for depression, we estimated repeated-measures marginal structural models to examine the association of 4 vaping transitions from time T to T + 1 (persistent use, discontinuation, initiation, persistent nonuse) with risk of clinically significant depressive symptoms at T + 1, simultaneously across three ~ 1.5-year time intervals between 2017 and 2021. Stabilized inverse probability of treatment and censoring weights adjusted for time-dependent confounders and selection bias. Among n = 3496 observations (1806 participants, mean pooled baseline age = 19.5), 8.1% reported persistent vaping from T to T + 1, 6.2% reported discontinuation (ie, use at T and no use at T + 1), 6.5% initiated e-cigarettes (ie, no use at T and use at T + 1), and 79.2% reported persistent nonuse at both time points. Compared to persistent vaping at 2 waves, persistent nonuse (relative risk [RR] = 0.76; 95% CI, 0.62-0.93) and discontinuation (RR = 0.71; 95% CI, 0.52-0.96) were associated with lower risk of depression. Associations were robust to sensitivity analyses, including restricting to tobacco-naive participants and varying temporal assumptions to reduce potential for reverse causation. Young adults who consistently avoid or discontinue vaping may be protected from depressive symptom occurrence.