Korean J Fam Pract 2019; 9(5): 448-453  https://doi.org/10.21215/kjfp.2019.9.5.448
Association between E-Cigarette Smoking Experience and Depressive Symptoms Using the Korea National Health and Nutrition Examination Survey 2016
Gayoon Park, Hyejeong Yeo, Dongyeon Kang, Seungyong Lim, Junyong Lee, Nayeon Moon*
Department of Family Medicine, VHS Medical Center, Seoul, Korea
Nayeon Moon
Tel: +82-2-2225-1292, Fax: +82-504-042-0518
E-mail: utodise0210@naver.com
ORCID: http://orcid.org/0000-0003-1578-4947
Received: August 6, 2018; Accepted: September 2, 2019; Published online: October 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Although the prevalence of e-cigarette smoking is increasing worldwide, the harmfulness of e-cigarette is not obvious. A previous study reported that e-cigarette smoking is associated with depressive symptoms in college students irrespective of tobacco smoking. However, there has been no research that has addressed this issue in the general population to date. This study was conducted to clarify the association between e-cigarette smoking and depressive symptoms in Korean adults.
Methods: The cross-sectional study collected raw data from the 7th Korea National Health and Nutrition Examination Survey (2016) and included 5,742 adults, who were ≥19 years and responded to the survey of smoking and mental health section. Multivariate logistic regression analysis was used to determine the odds ratio of depressive symptoms by e-cigarette smoking experience and included sex, age, educational level, marital status, household income level, self-rated health, activity restriction, obesity, tobacco smoking experience, alcohol drinking experience, and stress perception level as covariates. Depressive symptoms were assessed using the patient health questionnaire-9, Korean edition.
Results: The rate of depressive symptoms in subjects was 5.6% (n=354) in total. Individuals with depressive symptoms were more likely to have used e-cigarettes (15.6%) than those without depressive symptoms (8.6%; P=0.001). The e-cigarette experienced group showed a higher risk of depressive symptoms (odds ratio, 1.71; 95% confidence interval, 1.004–2.924) than the e-cigarette unexperienced group. The result was adjusted based on the abovementioned covariates.
Conclusion: In Korean adults, a significant association between e-cigarette smoking experience and depressive symptoms was observed.
Keywords: Electronic Nicotine Delivery Systems; Depression; Patient Health Questionnaire; Smoking
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