Nursing faculty, alumni published in Journal of Pediatric Nursing

Their integrative review, “Physical and mental health outcomes associated with adolescent e-cigarette use,” sought to summarize current knowledge about physical and mental health outcomes associated with e-cigarette use among adolescents.

The team found, through examination of 18 studies, that e-cigarette use is associated with negative physical outcomes, including oral health and respiratory issues and nicotine dependence, and negative mental health outcomes, including depression and suicidal ideation.

They also note that using e-cigarettes tends to be associated with more problems than non-use but presented fewer problems than conventional cigarette use. Use of both e-cigarettes and conventional cigarettes was associated with the greatest harm.

“Although these studies have identified various physical and mental health problems associated with e-cigarette use among adolescents, mixed findings make it impossible to draw firm conclusions about the association between e-cigarette use and negative health outcomes,” they write.

Importantly, the review points to significant gaps in our understanding of the physical and mental health consequences associated with e-cigarette use due to the dearth of longitudinal research studies that focus on adolescent populations.

The authors conclude that future research needs to be conducted among diverse populations of adolescents, as different patterns of use may be associated with different risk factors and health outcomes. Additionally, because individuals who use both e-cigarettes and conventional cigarettes appear to be at greatest risk for negative outcomes, the authors say more research is needed to understand who is most likely to engage in dual use.

They also note that lack of regulation of vaping solutions, and the variety of e-cigarette devices and chemicals in vaping solutions, present a challenge – most of the studies they reviewed did not include this information.

The authors recommend longitudinal studies to better understand the progression of e-cigarette use and long-term health impact, noting an urgent need for reliable and valid assessment tools.

Though future research is needed, the researchers say because “several studies indicate some physical and mental problems are associated with e-cigarette use in adolescents … healthcare providers should screen for mental and physical outcomes … among e-cigarette users.” They also recommend screening for e-cigarette and cigarette use when adolescents present with these health issues.

E-cigarette use has become increasingly prevalent among adolescents, who often perceive it as harmless.  The results of this review show that it is not harmless, underscoring the urgent need for more research and prevention programming targeting adolescents.

-Sarah Goldthrite