Title

Bidirectional associations between depressive symptoms and cigarette, e-cigarette, cannabis, and alcohol use: Cross-lagged panel analyses among young adults before and during COVID-19

Authors

Yan Wang, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Zongshuan Duan, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Katelyn F. Romm, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Yan Ma, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University.
W Douglas Evans, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA; Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA; George Washington Cancer Center, George Washington University, Washington, DC, USA.
Breesa Bennett, Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Caroline Fuss, Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Katharina E. Klinkhammer, Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Christina N. Wysota, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Carla J. Berg, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA; Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA; George Washington Cancer Center, George Washington University, Washington, DC, USA; Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA. Electronic address: carlaberg@gwu.edu.

Document Type

Journal Article

Publication Date

7-7-2022

Journal

Addictive behaviors

Volume

134

DOI

10.1016/j.addbeh.2022.107422

Keywords

Alcohol use; Cannabis use; Cross-lagged panel modeling; Depression; Tobacco use; Young adults

Abstract

BACKGROUND: The literature regarding bidirectional relationships of depressive symptoms to cigarette and alcohol use is mixed, and limited regarding e-cigarette and cannabis use. Moreover, COVID-19 has significantly impacted mental health and substance use, especially among young adults. Thus, this is a critical period for focused research on these relationships among young adults. METHODS: We analyzed longitudinal data (assessments in Fall 2018, 2019, and 2020) from 3,006 young adults (M = 24.56 [SD = 4.72], 54.8% female, 31.6% sexual minority, 71.6% White, 5.3% Black, 12.2% Asian, 11.4% Hispanic) from 6 US metropolitan statistical areas. Cross-lagged panel models were conducted to examine bidirectional associations between depressive symptoms and past 30-day use of cigarettes, e-cigarettes, cannabis, and alcohol (respectively), controlling for sociodemographics. RESULTS: During the study period, depressive symptoms decreased before the pandemic but increased during, cigarette and e-cigarette use decreased in both periods, alcohol use showed no change before but increases during the pandemic, and cannabis use increased in both periods. Additionally, each outcome demonstrated greater stability before versus during COVID-19. Finally, greater antecedent depressive symptoms correlated with more days of subsequent cigarette (β = 0.03, SE = 0.01, p =.011) and e-cigarette use (β = 0.03, SE = 0.01, p =.021), but fewer days of alcohol use (β = -0.02, SE = 0.01, p =.035). W2 cannabis use and alcohol use, respectively, were related to W3 depressive symptoms (cannabis: β = 0.09, SE = 0.02, p <.001; alcohol: β = 0.06, SE = 0.02, p =.002). No other cross-lagged associations were significant. CONCLUSIONS: Intervention efforts targeting depression and substance use should explicitly address the potential for onset and escalation of substance use and depressive symptoms, respectively, especially during societal stressors.

Department

Prevention and Community Health

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