Gender-moderated associations between adolescent mental health, conventional substance use, and vaping

Existing studies have overlooked the moderating effect of gender on the associations between mental health, conventional substance use, and electronic vapor product (EVP) use, colloquially called "vaping." Thus, this study examined whether mental health problems and conventional substance use have different effects on EVP use among female and male adolescents. Data were drawn from the CDC's 2019 Youth Risk Behavior System Survey. A multivariate hierarchical logistic regression was conducted using a national sample of high school students in the United States (N = 13,677). The results showed statistically significant associations between mental health problems and EVP use, as well as between conventional substance use and EVP use, among adolescents. Furthermore, gender was a significant moderator that influences both associations. Specifically, the impact of mental health problems on EVP use was greater among female adolescents than among their male counterparts. Conversely, the impacts of current cigarette and marijuana use on EVP use were greater among male adolescents than among their female counterparts. Effective prevention and intervention programs should consider and address these co-occurrences of mental health problems, substance use, and EVP use differently for male and female adolescents.