The Impact of Electronic Cigarette on Mental Health Among Adolescents and Young Adults: A Systematic Review
DOI:
https://doi.org/10.31436/ijcs.v9i1.530Keywords:
Adolescents, E-cigarette, Mental health, Young adultsAbstract
ABSTRACT
Background: The use of electronic cigarettes (e-cigarettes) has risen significantly among adolescents and young adults globally. While the physical health risks are increasingly documented, the impact of vaping on mental health in this demographic requires further synthesis of the available evidence. This literature review aims to consolidate scientific evidence about the impact of e-cigarette use on the mental health of adolescents and young adults.
Methods: A systematic literature review was conducted following the PRISMA protocol. Searches were performed in Scopus, PubMed, ProQuest, and Cochrane databases for publications from 2021 to 2025. The search strategy used keywords related to electronic cigarette, mental health, and young populations. After screening, 23 articles met the inclusion criteria for full-text analysis.
Results: E-cigarette use and mental health were found to be significantly correlated negatively in the great majority of the previous studies. The most consistently identified impacts included increased symptoms of depression, anxiety, and psychological stress. Furthermore, e-cigarette was associated with more severe outcomes, including non-suicidal self-injury, suicidal ideation, poor sleep quality, and psychological distress. Longitudinal studies indicated that persistent e-cigarette could predict the future onset of depressive symptoms. These findings were consistent across diverse geographical and cultural contexts.
Conclusion: E-cigarette use is associated with a range of adverse mental health outcomes among adolescents and young adults, from common disorders like depression and anxiety to severe risks such as suicidality. These findings point out the need for targeted public health interventions and international strategies to address the mental health risks of e-cigarette in younger populations.
References
WHO. Adolescent and young adult health [Internet]. 2024. Available from: https://www.knowledge-action-portal.com/en/content/adolescent-and-young-adult-health
CDC U. E-Cigarette Use Among Adults [Internet]. US; 2024. Available from: https://www.cdc.gov/tobacco/e-cigarettes/adults.html
Stimson G V. Estimation of the global number of vapers?: 82 million worldwide in 2021. 2025;24(2):91–103.
Jane Ling MY, Abdul Halim AFN, Ahmad D, Ahmad N, Safian N, Mohammed Nawi A. Prevalence and Associated Factors of E-Cigarette Use among Adolescents in Southeast Asia: A Systematic Review. Int J Environ Res Public Health. 2023 Feb;20(5).
Lindson N, Butler AR, McRobbie H, Bullen C, Hajek P, Wu AD, et al. Electronic cigarettes for smoking cessation. Cochrane database Syst Rev. 2025 Jan;1(1):CD010216.
Munisah S, Shoaib M, Ahmad N. Prevalence and determinants of e-cigarette use among vocational college students?: A cross-sectional study. PLoS One [Internet]. 2025;1–14. Available from: https://doi.org/10.1371/journal.pone.0311585
Gostin LO, Glasner AY. E-cigarettes, vaping, and youth. JAMA. 2014 Aug;312(6):595–6.
Javed S, Usmani S, Sarfraz Z, Sarfraz A, Hanif A. Journal of Community Hospital Internal Medicine Perspectives A Scoping Review of Vaping , E-Cigarettes and Mental Health Impact?: Depression and Suicidality A Scoping Review of Vaping , E-Cigarettes and Mental Health Impact?: Depression. J Community Hosp Intern Med Perspect. 2022;12(3):33–9.
Jenssen BP, Boykan R. Electronic Cigarettes and Youth in the United States: A Call to Action (at the Local, National and Global Levels). Child (Basel, Switzerland). 2019 Feb;6(2).
Vogel EA, Cho J, McConnell RS, Barrington-Trimis JL, Leventhal AM. Prevalence of Electronic Cigarette Dependence Among Youth and Its Association With Future Use. JAMA Netw open. 2020 Feb;3(2):e1921513.
Marynak KL, Cohen JE, Thrul J, Kennedy RD, Limaye R, Moran MB. Effects of E-Cigarette Warning Labels About Mental Health Consequences of Nicotine Addiction Among Young Adults in the USA: Results From a Randomized Controlled Experiment. Nicotine Tob Res [Internet]. 2025;27(6):1006–15. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-105005883799&doi=10.1093%2Fntr%2Fntae298&partnerID=40&md5=3368148951f4005703fb8d06a8b4163b
Service PH. £ -Cigarette Use Among Youth and Young Adults A Report of the Surgeon General E-Cigarette Use Among Youth and Young Adults?: A Report of the Surgeon General. 2016.
Vogel EA, Prochaska JJ, Ramo DE, Andres J, Rubinstein ML. Adolescents’ E-Cigarette Use: Increases in Frequency, Dependence, and Nicotine Exposure Over 12 Months. J Adolesc Heal Off Publ Soc Adolesc Med. 2019 Jun;64(6):770–5.
Yuan M, Cross SJ, Loughlin SE, Leslie FM. Nicotine and the adolescent brain. J Physiol. 2015 Aug;593(16):3397–412.
Demissie Z, Everett Jones S, Clayton HB, King BA. Adolescent Risk Behaviors and Use of Electronic Vapor Products and Cigarettes. Pediatrics. 2017 Feb;139(2).
Snyder H. Literature review as a research methodology: An overview and guidelines. J Bus Res. 2019;104:333–9.
Elbarazi A. Association between depression , anxiety , stress , and vaping among university students in Egypt. Popul Medinice. 2025;3:1–7.
Farrell KR, Karey E, Xu S, Gibbon G, Gordon T, Weitzman M. E-Cigarette Use, Systemic Inflammation, and Depression. Int J Evironmental Res Public Heal. 2021;18:1–13.
Han MA. Smoking Cessation and Mental Health According to Use of E ? cigarettes and Heated Tobacco Products by Korean. Int J Ment Health Addict [Internet]. 2022;2559–70. Available from: https://doi.org/10.1007/s11469-021-00698-6
Ibrahim FM, Shahrour G, Hashim A, Yasin A, Allam AR. E-cigarette usage and mental health among undergraduate medical and health sciences students. Nature. 2025;15:1–9.
Lee B, Levy D, Seo DC. Underlying patterns of the co-occurrence of tobacco use and mental health among youth. J Behav Med. 2023 Aug;46(4):668–79.
Phetphum C, Keeratisiroj O, Prajongjeep A. Perception of e-cigarette control policies and education in schools on increased legal knowledge, harm perception, susceptibility and e-cigarette use among students in Thailand: A cross-sectional classroom-based survey. Tob Induc Dis [Internet]. 2024;22(May). Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85195885163&doi=10.18332%2Ftid%2F187840&partnerID=40&md5=d3f825256a2eef26216acbe0ad583ae6
Safarini OA, Taya H, Abu Elhija Y, Qadous M, Farhoud A, Thabaleh A, et al. Assessment of the Relationship of Depression With Tobacco and Caffeine Use Among University Students: A Cross-Sectional Study. Cureus. 2021 Oct;13(10):e19098.
Evans SL, Alkan E. Personality Risk Factors for Vape Use amongst Young Adults and Its Consequences for Sleep and Mental Health. Healthc (Basel, Switzerland). 2024 Feb;12(4).
Barry CM, Jagtiani A, Skinner JR, Gassaway AN, Komro KA, Livingston MD. Loneliness among emerging adults in rural reservation-based communities?: longitudinal effects of 12th grade substance use and mental health symptoms. Nature. 2025;15:1–8.
VanFrank B, Williams TR, Alcantara IC, Hertz M, Al-Shawaf M, Meyers C, et al. E-Cigarette Use and Symptoms of Depression and Anxiety Among US Middle and High School Students. Prev Chronic Dis. 2025 Aug;22:E51.
Wang Y, Xu S, Zhang X, Zhang Y, Feng Y, Wang Y, et al. Effects of Tobacco Versus Electronic Cigarette Usage on Nonsuicidal Self-Injury and Suicidality Among Chinese Youth: Cross-Sectional Self-Report Survey Study. JMIR Public Heal Surveill [Internet]. 2023;9. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85164251422&doi=10.2196%2F47058&partnerID=40&md5=20ca6104a52b82dbe75fa6e95cc74878
Graham-DeMello A, Sanders C, Hosking R, Teddy L, Ball J, Gallopel-Morvan K, et al. Lived experiences of stigma and altered self-perceptions among young people who are addicted to ENDS: a qualitative study from Aotearoa New Zealand. Tob Control [Internet]. 2024; Available from: https://tobaccocontrol.bmj.com/content/early/2025/01/19/tc-2024-058946
Phetphum C, Prajongjeep A, Phuengnam K. Relationship between electronic cigarette use, dual smoking habits, and psychological distress among youth in Northern Thailand: A cross-sectional study. Tob Induc Dis [Internet]. 2024;22. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85194363358&doi=10.18332%2Ftid%2F186860&partnerID=40&md5=f76e7d7ca6047d2f366673d1a3f6015e
Seo Y gyun, Lee S, Lim MK, Paek Y jin. Heated Tobacco Product Use and Mental Health?: Korean National Health and Nutrition Examination Survey. Int J Ment Health Addict. 2024;22:979–94.
To T, Borkhoff CM, Chow CW, Moraes TJ, Schwartz R, Vozoris N, et al. Association of ever use of e-cigarettes with health and lifestyle variables among young adults: a Canadian health measure survey study. Eur J Pediatr. 2024 Jun;183(6):2521–6.
Harlow AF. Vaping transitions and incident depressive symptoms among young adults?: a marginal structural model analysis. 2025;746–54.
Sheikhattari P, Ara R, Barsha A, Egboluche C. Use of Electronic and Conventional Cigarettes and Self-Rated Mental Health in High School Students. 2025;1:1–12.
Thepthien B on, Tinn CS, Sharma R. Establishing the Association Between Traditional Tobacco , E ? cigarette and Dual Use and Mental Health Problems Among High School Students?: Results from a 2022 Behavioral Surveillance Survey. Int J Ment Health Addict [Internet]. 2024;22(6):4148–68. Available from: https://doi.org/10.1007/s11469-023-01109-8
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