Depression and Substance Use (Including Vapor Products) in Hispanic Early Adolescent Girls: Patterns over Time

Introduction: Both depression and substance use in US youth are major public health concerns. Past research has shown associations between depression and alcohol use and depression and smoking cigarettes, but it is unclear whether these associations hold in early adolescents. In addition, recent popularity of vapor products and their promotion as a “safe” alternative to traditional cigarettes combined with use of flavoring ingredients raise questions about use of these products and their impact on smoking traditional cigarettes. This presentation attempts to address these gaps in the science using data from an efficacy trial of an intervention targeting early adolescent Hispanic females.

Methods: Hispanic 7^th grade girls (n=242), participating in the JUEGA pregnancy prevention intervention study conducted in Miami-Dade County Public Schools, completed self-report measures of demographics, substance use, depression, and psychosocial variables related to health risk behaviors at baseline, one month, and three months. Data were analyzed with frequencies, Fisher’s exact, and logistic regression. Analyses involving data collected at one and three months controlled for intervention effects.

Results: Approximately 25.8-28.6% of girls reported symptom severity consistent with major depressive disorder at any one time point. Use of substances increased across all 3 time points with use of vapor products (12.6-17.0%) reported more frequently than cigarettes (2.8-3.7%) and marijuana (.5-1.6%), but not more frequently than alcohol (35.0-44.3%). Baseline use of alcohol, and vapor products and traditional cigarettes were all strongly associated (p<.01). Baseline ever use of vapor products and cigarettes were each predictive of cigarette use at time 3 (p<.05), but not alcohol use (p=.99). Depression was significantly associated with smoking cigarettes, and ever use of vapor products at baseline only. Baseline depression was not predictive of substance use at time 3 when baseline use of the substance was included in the regression model (p>.30). Similarly, baseline substance use was not predictive of depression at time 3 when baseline depression was included in the model (p>.37).

Conclusion: Both depression and substance use co-occurred, but the presence of one was not predictive of the other, arguing against a causal association. Use of vapor products appeared to increase likelihood of cigarette use suggesting these products may function as a gateway to cigarette smoking for some youth. Increasing rates of substance use reported over a 3 month period, and the relatively high rates of depression underscore the importance of substance use and mental health prevention efforts in this age group.