Associations between depression, stress, and e-cigarette use among OEF/OIF veterans

ABSTRACT

The COVID-19 pandemic has had profound mental and behavioral health implications for the general U.S. population. However, little is known regarding outcomes for U.S. veterans, who represent a population with high rates of depression, stress, and e-cigarette use. One month prior to the pandemic-related closures (February 2020), 1230 OEF/OIF veterans (ages 18–40) completed an online baseline survey. Six months later, participants completed a follow-up survey (83% retention rate). Hierarchical negative binomial regressions were used to examine the relationship between baseline depression and past 30-day e-cigarette use at follow-up and whether baseline stress moderated this relationship. Veterans who screened positive for depression or who endorsed higher stress levels reported greater e-cigarette use at follow-up. Stress also moderated the relationship between depression and e-cigarette use, such that regardless of stress levels, a positive depression screen was associated with greater rates of later e-cigarette use. However, for those with a negative depression screen, higher stress levels were associated with greater e-cigarette use relative to lower stress levels. Veterans with pre-pandemic depression and stress may be at highest risk for e-cigarette use. Ongoing assessment and treatment for depression and promoting stress management skills for veterans in e-cigarette use prevention and intervention programs may be valuable.

KEYWORDS:

• E-cigarettes
• veterans
• COVID-19
• depression
• stress

Disclosure statement

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

Data Availability Statement

We will make the dataset and associated documentation available outside our team under a data-sharing agreement that provides for (1) a commitment to using the data only for research purposes and not to identify any individual participant, (2) a commitment to securing the data using appropriate computer technology, and (3) a commitment to destroying or returning the data after analyses are completed. Contact the senior author if interested in obtaining data from this project.

Additional information

Funding

This research was funded by from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) [grant number R01AA026575, supplement R01AA026575-02S1] and a Keck School of Medicine COVID-19 Research Funding Grant awarded to Eric R. Pedersen.