Eating disorders (ED) prevalence has almost doubled since the early 2000s. EDs have been associated with high rates of substance use; more specifically, the rate of cigarette smoking among those with EDs is three times higher than the national average. Tobacco use is known to have effects on appetite suppression. With e-cigarette use on the rise, individuals who self-reported EDs, compared to those who did not report a history of EDs, reported that their e-cigarette appeal was due to weight loss and appetite control. The goal of this study was to characterize ED symptomatology and tobacco use patterns, including exclusive cigarette use, e-cigarette use, dual use, and nonuse.
Participants of this study were all between the ages of 18-24 and living in the United States. Data collection took place from July-August 2020. Participants’ demographics, such as age, gender, race, ethnicity, height, and weight, were collected. Body dissatisfaction, eating disorder diagnosis, binge eating, and self-induced vomiting frequency were all measured. The mean BMI of participants was 25.91 kg/m2. The mean ED psychopathology score using the EDEQ Global score indicated that most participants (72.7%) had no ED diagnosis.
The results of this study showed that young adults with Anorexia Nervosa (AN) were five times more likely to be dual users. At the same time, those with bulimia spectrum eating disorders or night eating syndrome were twice as likely to be exclusive e-cigarette users and three times as likely to be dual users (e-cigarettes and cigarettes). Body dissatisfaction and global ED psychopathology were higher among exclusive e-cigarette users and dual users and exhibited medium-large effects. Binge eating frequency and self-induced vomiting frequency were greater among all tobacco users compared to nonusers, although the effects were small-medium. As the prevalence of EDs and e-cigarette use increase, it is essential to assess how the associations between the two manifest over a longitudinal and clinical population.
Takeaway: Young adults with ED symptoms are more likely to be users of e-cigarettes or dual users (e-cigarettes and cigarettes) than their peers without ED symptoms.