Young adults, aged 18-25 years old, have the highest prevalence of lifetime and past 30 day electronic nicotine delivery systems (ENDS) use compared to any other age group. Additionally, rates of depression peak during young adulthood, and depression symptoms have been associated with lifetime ENDS use and ENDS use frequency. One potential explanation for this relationship is the self-medication hypothesis which theorizes that ENDS may be used for negative mood management or stress reduction. Social enhancement outcome expectancies may also explain the relationship between depressive symptoms and ENDS use. This study examines the mediating effect of positive affect reinforcement and social enhancement outcome expectancies on the relationship between depressive symptoms and ENDS use among young adults.
The study’s sample consisted of 1,567 young adults who reported ever using ENDS. Participants completed a scale that assessed for frequency of past week depressive symptoms during Wave 1. During Wave 2 (six months later), information was collected regarding ENDS outcome expectancies. Frequency of past 30 day ENDS use was recorded during Wave 3 (1 year after Wave 1). Lastly, demographic information was recording including age, sex, college type, and race/ethnicity. Data was analyzed using a mediation model to examine the influence of positive affect reinforcement and social enhancement on the relationship between depressive symptoms and ENDS use.
Results of the data analysis showed elevated depressive symptoms reported during Wave 1 were not associated with frequency of past 30 day ENDS use at Wave 3. However, elevated depression symptoms were significantly correlated with ENDS positive affect reinforcement and social enhancement outcome expectancies. Greater positive affect reinforcement expectancies, but not social enhancement expectancies, were correlated with greater frequency of ENDS use reported during Wave 3.
Takeaway: Positive affect reinforcement expectancies may mediate the relationship between elevated depression symptoms and electronic nicotine delivery systems (ENDS) use among young adults.