Suicidal thoughts and behaviors by past-month electronic vapor product use frequency among high school students in the 2023 Youth Risk Behavior Survey

AI Summary

Current electronic vapor product use associated with substantially higher odds of sadness, suicidal ideation, suicide plan, and attempt; adjusted ORs range 3.15 to 5.13.
Frequent use (20–30 vs 1–19 days) linked to higher odds of sadness, suicidal ideation, and suicide plan; adjusted ORs 1.48 to 1.68.
Daily electronic vapor product use associated with higher odds of all four outcomes versus non-daily use; adjusted ORs 1.51 to 1.83.

Addict Behav. 2026 Oct 17;185:108882. doi: 10.1016/j.addbeh.2026.108882. Online ahead of print.

ABSTRACT

BACKGROUND: Electronic vapor product use has been linked to suicidal thoughts and behaviors among adolescents; however, associations with use frequency remain underexplored. We examined associations between electronic vapor product use frequency and four mental health and suicide-related outcomes among a nationally representative sample of U.S. high school students.

METHODS: We analyzed cross-sectional data from the 2023 Youth Risk Behavior Survey (n = 18,606). Primary independent variable was current electronic vapor product use (≥1 vs. 0 days of past 30-days). Subsample analyses among students reporting current use examined frequency (20-30 vs. 1-19 days) and daily use (30 vs. 1-29 days). Outcomes were past-year sadness/hopelessness, suicidal ideation, suicide plan, and suicide attempt. Multivariable logistic regression models examined associations between electronic vapor product use and each outcome, adjusting for sex, ethnicity, race, and grade.

RESULTS: Current electronic vapor product use was associated with higher odds of all four outcomes compared to no use (aORs = 3.15-5.13). Frequent use was associated with higher odds of sadness/hopelessness (aOR = 1.68, 95% CI: 1.29-2.19), suicidal ideation (aOR = 1.60, 95% CI: 1.27-2.02), and suicide plan (aOR = 1.48, 95% CI: 1.06-2.05) compared to infrequent use. Daily use was associated with higher odds of all four outcomes compared to non-daily use (aORs = 1.51-1.83).

CONCLUSION: Findings suggest that frequent electronic vapor product use is associated with mental health and suicide-related outcomes among adolescents, although temporal ordering could not be determined. Results support continued efforts to prevent electronic vapor product use initiation among adolescents.

PMID:42950699 | DOI:10.1016/j.addbeh.2026.108882

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