Georgia State University (GSU) researchers conducted a study to understand the link between teen e-cigarette use and subsequent cannabis use, and they found that teens who vaped and exhibited certain risk-taking behaviors (categorized as externalizing mental health) were more likely to use cannabis than teens who did not vape. The analysis included four years of data collected from the Population Assessment of Tobacco and Health (PATH), and the results were published in the American Journal of Preventive Medicine. The purpose of the study was to discover the mechanisms that trigger the transition from e-cigarettes to cannabis use.
The GSU researchers explored the relationship between vaping behavior and mental health status, and they found that the type and severity of mental health issues determined the path of teen use. They examined two main groups of teens: those with Internalizing Mental Health (IMH) which is marked by anxiety and depression and teens with Externalizing Mental Health (EMH) which is characterized by risk taking and impulsive behavior. Teens who reported having high IMH were less likely to seek cannabis than those with EMH.
Type of mental and behavioral health as well as many other factors influence why and how a teen uses substances. According to study author Jidong Huang, “People with internalizing mental health problems may be using substances on a more regular basis or using them alone, because that’s their coping mechanism. But those with externalizing mental health problems might only use substances on occasions when they’re with their peers, because it’s a way of acting out.” Huang indicated that more research on the various subgroups and their reasons for engaging in tobacco, e-cigarette and/or cannabis use.
Teen e-cigarette use has dramatically increased in the past decade. Between 2017 and 2018, e-cigarette use increased by 78% among high school students and 48% among middle school students. Parents and health officials have advocated for more aggressive policy measures and advertising regulations to reduce teen access and impetus to use e-cigarettes. The GSU study concluded that increasing access to quality mental health services and educating teens about vaping risks are critical to limiting teen cannabis use.