Individuals with eating disorders (ED) report higher rates of smoking than individuals without eating disorders. Nicotine is an appetite suppression which may lead some individuals to use it to control eating behaviors. In addition, many ED symptoms, including binge eating, purging, and fear of gaining weight, are more strongly associated with nicotine dependence. Both ED and smoking are associated with a variety of adverse health outcomes making these conditions major public health concerns. This study examines the association between ED symptoms and cigarette and e-cigarette use among college students.
The study’s sample consisted of 716 college students who completed an online survey. The survey assessed lifetime and past month smoking/vaping history and smoking/vaping motives. ED symptoms were evaluated using the Eating Pathology Symptoms Inventory (EPSI). This questionnaire assesses symptoms of body dissatisfaction, binge eating, cognitive restraint, purging, restricting, excessive exercise, negative attitudes toward obesity, and muscle building. Data was analyzed using independent samples t-tests, Pearson correlations, and linear regressions.
Results of the data analysis showed 30.35% of individuals reported lifetime smoking and 23.08% reported lifetime vaping. Students who reported lifetime smoking expressed higher mean scores of negative attitudes towards obesity and muscle building than those who did not report smoking. Participants that reported lifetime vaping noted higher muscle building mean scores compared to those who did not vape. The associations between vaping/smoking and muscle building were not significant after adjusting for sex. Body dissatisfaction and purging were positively correlated with smoking as a coping mechanism. No significant correlations between ED symptoms and vaping motives were noted.
Takeaway: The presence of eating disorder symptoms may not provide predictive value when assessing smoking/vaping use motives and smoking/vaping status.