Overview

• In the 2021–2023 National Youth Tobacco Survey, 21.37% of adolescents reported ever using tobacco products, including 9.94% who vaped only, 3.61% who smoked only and 7.80% who used both.
• Overall, 25.21% of respondents screened positive for depression symptoms and 29.55% for anxiety symptoms on the standardized PHQ-4 measure.
• Compared to non-users, dual users exhibited the greatest adjusted odds of depression (OR 1.90), anxiety (OR 1.58) and overall psychological distress (OR 1.75).
• Researchers emphasize a complex, bidirectional association between tobacco use and mental health in adolescence but caution that causality cannot be established in this cross-sectional analysis.
• Study authors urge the development of integrated, youth-focused mental health services and anti-tobacco interventions to address the heightened vulnerabilities of teen users.