Tobacco product use and mental health status among young adults

Background: Individuals with mental health conditions represent a priority population for tobacco control. This population smokes cigarettes at disproportionately higher rates than the general population, but less is known about the relationship between non-cigarette tobacco use and mental health status. Method: In 2013, 2370 young adults recruited from 11 colleges in North Carolina and Virginia completed an online survey on tobacco use. We compared past 6-month self-reported mental health diagnosis, past 30-day depression score, and past 7-day stress score to past 30-day cigarette, e-cigarette, waterpipe, cigar, and smokeless tobacco use. Models adjusted for age, gender, race, ethnicity, and mother's education. Non-cigarette products were also adjusted for past 30-day cigarette use. Results: Among participants, 249 (10.5%) reported a mental health diagnosis, most commonly depression (5.5%), ADHD/ADD (4.5%), and anxiety (0.8%). Those who reported a mental health diagnosis had greater odds of using cigarettes (AOR = 1.55; CI = 1.01, 2.27). Mean stress score was 16.0 (SD = 6.9) of possible 40. Higher stress scale score was associated with increased odds of e-cigarette (AOR = 1.03; CI = 1.01, 1.05), waterpipe (AOR = 1.04; CI = 1.01, 1.06), and cigarette (AOR = 1.02; CI = 1.00, 1.04) use. Mean depression score was 7.2 (SD = 5.6) of possible 33. Higher depression scale score was associated with increased odds for e-cigarette (AOR = 1.04; CI = 1.01, 1.08) and cigarette (AOR = 1.03; CI = 1.01, 1.06) use. Conclusion: Findings in this study provide further evidence of a potential relationship between non-cigarette tobacco products and mental health status. Tobacco control efforts aimed at reducing tobacco use disparities among mental health populations should focus on non-cigarette tobacco products in addition to cigarettes.