A Comparison of Mental Health Symptoms among Adults Who Vape Nicotine, Cannabis, or Both

Abstract

Objectives

Dual use of combustible cannabis and nicotine is related to worse mental health symptoms (MHS); however, little is known about MHS among those who vape cannabis and nicotine. The current study aimed to determine if dual use of cannabis and nicotine vapes is associated with worse MHS compared to single use and to identify correlates of MHS for dual users.

Methods

We used Amazon Mechanical Turk to survey adults (N = 492) who used nicotine or cannabis vapes in the past 30 days on stress, anxiety, depression, vape use behaviors and sociodemographic information. We conducted hierarchical linear regressions to compare MHS between dual vs. single substance vape use and to identify correlates of MHS, including sociodemographic variables and vape use characteristics.

Results

The final sample was 37.6% female, 87.6% White, and 11% Hispanic/Latinx with a mean age of 34.15 years. After controlling for sociodemographic characteristics and combustible product use, dual users had significantly higher mean MHS severity than single users. For dual users, younger age and being married were associated with higher symptoms of depression and stress. Holding a medical cannabis card was associated with higher anxiety symptoms.

Conclusion

The findings suggest that dual use of cannabis and nicotine vapes is associated with worse MHS severity compared to single substance use.

Keywords:

• Nicotine
• cannabis
• vape
• mental health

Disclosure statement

J.F. has received grants from the National Institutes of Health (NIH); has previously received a grant, personal fees, and nonfinancial support (eg, study drug) from Pfizer Inc, unrelated to this article; in the past, has done paid consulting for pharmaceutical companies involved in manufacturing smoking-cessation medications (eg, GlaxoSmithKline, Johnson & Johnson); and has acted as a deposed and compensated expert witness on behalf of plaintiffs suing cigarette manufacturers. All other authors have no conflicts of interest to disclose.

Declaration of interest

No potential conflict of interest was reported by the author(s).

Data availability statement

Data used for this manuscript is available upon reasonable request and with proper data use agreements. Please contact the corresponding author, Kalin Salinas for data requests.

Additional information

Funding

The following authors are supported by grants from the National Institutes of Health: ALH [K23-DA045081]; SIA [K01-DA053410]; JF, JMY, & NMK [U01-DA045517 and R01-DA048428].