Psychosis is a frequently stigmatized though relatively prevalent psychiatric pathology that can present in individuals due to several different factors.  Among these are genetic predispositions, adverse effects of certain medications, substance use, and intense traumatic experiences.  Psychosis has been studied in association with dangerous alcohol use, cannabis use, and other recreational substances, but little literature exists exploring the relationship between this symptomatology and the use of electronic delivery systems, or “vaping” (for the purposes of this article, vaping will refer to nicotine-only products).  This study investigates potential associations between the use of vaporized nicotine products and psychosis in a population of college students.   

The sample is pulled from a nationwide mental health project completed in 2020 called the Healthy Minds Study, which used survey data from 36 universities throughout the United States.  A total of 29,232 student responses from “Healthy Minds” were used for the analysis within this study, measuring the following variables: demographics, psychotic experiences (via World Health Organization Composite International Diagnostic Interview Psychosis Screen), prior month use of vaping products, substance use (limited to traditional cigarettes and cannabis), depression (via Patient Health Questionnaire), and anxiety (via Generalized Anxiety Disorder-7).  The data was analyzed primarily using multiple logistic regressions.   

Results of the analysis found prevalence of past-year psychosis to be about 14% in the population.  About 1 in 6 students reported the use of vaping products in the past month, which was found to be associated with roughly double (1.88x) the likelihood of experiencing psychosis in the past year.  This finding was found to be of similar significance after controlling for all other mental health and substance use measures.  The research team discussed possible explanations including different harmful chemical exposures and induction of central nervous system inflammation. 

Takeaway: the use of electronic nicotine delivery systems may be associated with increased likelihood of psychosis in college students.  Additional research is necessary to support these findings as well as to establish potential mechanisms.

Oh H, Banawa R, Lee JO, Zhou S, Huh J. Vaping and psychotic experiences among college students in the United States. Drug and Alcohol Dependence. 2021;227:108987. doi:10.1016/j.drugalcdep.2021.108987