Understanding the longitudinal associations between e-cigarette use and general mental health, social dysfunction and anhedonia, depression and anxiety, and loss of confidence in a sample from the UK: A linear mixed effect examination

Abstract

Objective: Our objective was to the longitudinal associations between e-cigarette use and general mental health, social dysfunction & anhedonia, depression & anxiety, and loss of confidence in a sample from the UK.

Methods: We analyzed data of 19,706 participants from Wave 9 (collected from 2017 to 2018) and Wave 10 (collected from 2018 to 2019) of the Understanding Society: the UK Household Longitudinal Study using a confirmatory factor analysis, linear mixed effect model, and one-sample t-tests.

Results: We found that there is a significant time by e-cigarette use status interaction on mental health issues (b = 0.32, p < 0.001, 95 % C.I. [0.15, 0.49]), social dysfunction & anhedonia (b = 0.36, p < 0.001, 95 % C.I. [0.18, 0.54]), and loss of confidence (b = 0.24, p < 0.01, 95 % C.I. [0.06, 0.41]). Indeed, participants who became e-cigarette smokers at Wave 10 had worse mental health (t(107) = 2.64, p < 0.01, 95 % C.I. [0.07, 0.48], Cohen's d = 0.28), social dysfunction & anhedonia (t(107) = 3.16, p < 0.01, 95 % C.I. [0.12, 0.52], Cohen's d = 0.32), and loss of confidence (t(107) = 2.08, p < 0.05, 95 % C.I. [0.01, 0.37], Cohen's d = 0.19) comparing to one year ago.

Limitation: Limitations of this study included its self-report measures, unclassified e-cigarette type, limited generalizability to other populations, and lack of experimental manipulations.

Conclusion: We revealed longitudinal associations between e-cigarette initiation and adverse general and dimensions of mental health except for depression and anxiety, which have significant implications for public health, specifically in terms of e-cigarette product regulation and advertising.