# Vaping and mental health: A cross-sectional study among university students in Bangladesh

## TL;DR

This study finds that vaping among Bangladeshi university students is linked to mental health issues like depression and anxiety, especially among dual users.

## Contribution

The study provides novel insights into the mental health effects of vaping in a South Asian context, focusing on university students in Bangladesh.

## Key findings

- Vaping was associated with higher rates of psychological distress and depression among university students.
- Dual users (vaping and smoking) showed higher depression and anxiety compared to exclusive vapers.
- Vaping was linked to alcohol and recreational drug use, suggesting a pattern of risk-taking behavior.

## Abstract

Vaping has continued to rise, besides smoking, among youth in Bangladesh in recent years. While there has been evidence of the impact of vaping on physical health, studies focusing on mental health specifically from the South Asian context are almost non-existent. Therefore, this study examines the association between vaping and a spectrum of mental health issues, such as psychological distress, depression, and anxiety, among university students in Bangladesh.

A cross-sectional study with undergraduate students, aged 18−25 years, from seven universities in Bangladesh, was conducted. Data were collected using a web-based questionnaire. Data on smoking, vaping, and dual use were collected. Psychological distress was measured by using the K10 scale, while the CES-D10 and GAD-7 scales assessed depression and anxiety, respectively. Univariate and multivariate logistic regression analyses determined the relevant associations. Adjusted Odds Ratios (AORs) and 95% Confidence Intervals (CIs) were reported.

Of the 1615 study participants, males and females were distributed equally, and 54% were from two private universities. Findings revealed that one in six (15.4%, n = 248) participants were currently vaping. Exclusive current smokers were 6.2%, exclusive vape users were 6.5%, and dual users were 8.9%. Among vape users, the prevalence of psychological distress (80.5% vs. 76.6%) and depression (63.8% vs. 60.8%) was higher among dual users compared to current vape users; anxiety was similar (56.9% vs. 57.6%) in both groups. After adjusting potential confounders, current vaping was associated with drinking alcohol (AOR 11.43, 95% CI 7.41–17.63) and used of recreational drugs (AOR 4.29, 95% CI 2.36–7.79) However, dual use was associated with higher depression (AOR 1.93; 95% CI 1.04–3.57) and without a preexisting mental health condition was associated with severe anxiety (AOR 2.00, 95% CI 1.25–3.20).

The study underscores a concerning impact on mental health amongst the young group of the population who were vaping, specifically among the dual users. Besides raising awareness, university-based tobacco cessation support and counselling should be considered a student well-being support strategy.