Internalizing Mental Health Symptoms and Nicotine Use Among Adolescents in Canada, England, and the US from 2020-2022
Bibliographic record
Abstract
Background: There is a well-established bi-directional relationship between cigarette smoking and internalizing mental health (IMH) symptoms (e.g., symptoms of depression, symptoms of anxiety). However, it is unclear whether IMH symptoms are associated with using different types of nicotine products among adolescents, as adolescents are using a variety of nicotine products, including combustible products (cigarettes), non-combustible products (e-cigarettes), or combinations of both types of products. This dissertation examines associations between IMH symptoms and current use of various types of nicotine products across three countries from 2020-2022. Methods: Data come from the 2020-2022 waves of the International Tobacco Control (ITC) Adolescents Tobacco and Vaping Survey, an online repeat cross-sectional survey of adolescents aged 16-19 in Canada, England, and the US (n=67946). In the full sample, current nicotine use was examined in four categories: 1) no use, 2) exclusive non-combustible product, 3) exclusive combustible product use, and 4) use of both product types. Respondents reported current symptoms of depression or anxiety, and we generated a dichotomous IMH symptoms variable (yes vs. no). Respondents also reported their age race, sex, gender identity, and socioeconomic status. We examined the association between IMH symptoms and current nicotine use using multinomial logistic regression models that adjusted for covariates. Among the respondents that reported using cigarettes and/or e-cigarettes (n=15522), we also examined the association between IMH symptoms and nicotine dependence indicators and cessation variables (quit intention, quit attempt). Results: IMH symptoms were most strongly associated with use of both product types, followed by exclusive non-combustible use, and then exclusive combustible use. Nicotine use and IMH symptoms varied by gender identity. Among adolescents reporting current e-cigarette use, IMH symptoms were positively associated with nicotine dependence indicators. However, for those reporting cigarette use, this association varied by whether they were dual using e-cigarettes. For both products, IMH symptoms were positively associated with quit attempt and unassociated with quit intention. Conclusions: This dissertation provides an up-to-date examination of the relationship between mental health and nicotine use among adolescents. Results indicate that non-combustible product use may have a particularly strong relationship with poor mental health among adolescents. Longitudinal research is needed to better understand directionality. Results also provide an understanding of the relationship between gender identity and nicotine use.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".