School of Medicine Publications and Presentations

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Background: This study examines whether symptoms of depression, anxiety, or comorbid depression and anxiety are associated with future use of nicotine or THC in e-cigarettes.

Methods: Data were from an online survey of youth and young adults in urban areas of Texas with complete data (n = 2,307) in spring 2019 (baseline) and spring 2020 (12-month follow-up). Multivariable logistic regression models examined associations between self-reported symptoms of depression, anxiety, or comorbid depression and anxiety at baseline and past 30-day e-cigarette use with nicotine or THC at 12-month follow-up. Analyses adjusted for baseline demographics and baseline past 30-day e-cigarette, combustible tobacco, marijuana, and alcohol use and stratified by race/ethnicity, gender, grade level, and SES.

Results: Participants were 16-23 years old, 58.1% female and 37.9% Hispanic. At baseline, 14.7% reported symptoms of comorbid depression and anxiety, 7.9% depression, and 4.7% anxiety. Prevalence of past 30-day e-cigarette use at 12-month follow-up was 10.4% with nicotine and 10.3% with THC. Symptoms of depression and comorbid depression and anxiety at baseline were significantly associated with both nicotine and THC use in e-cigarettes 12 months later. Symptoms of anxiety were associated with nicotine use in e-cigarettes 12 months later.

Conclusions: Symptoms of anxiety and depression may be important indicators of future nicotine and THC vaping among young people. Clinicians should be aware of groups most at risk who may benefit from substance use counseling and intervention.


Original published version available at

Publication Title

Subst Use Misuse



Academic Level

medical student

Mentor/PI Department

Population Health and Biostatistics

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Public Health Commons



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