Sleep Deprivation May Be Linked to E-Cigarette Use in Young Adults

Given the increase in recent years of e-cigarette use, researchers looked at whether this use is associated with sleep deprivation in a sample of young adults.

Study data published in Addictive Behaviors suggest that sleep deprivation in young adults may be linked to e-cigarette use. In a cross-sectional study of youth in the United States, the prevalence of sleep deprivation was elevated in current and former e-cigarette users compared to never users.

Investigators extracted data from the Behavioral Risk Factor Surveillance System (BRFSS), an annual, nationwide, telephone-based survey that captures health-related risk behaviors and health conditions in adults in the United States. The current study used data from the 2017 and 2018 BRFSS surveys. Young adults (18-24 years) who completed the optional e-cigarette survey section were included in the analyses.

The primary outcome was sleep deprivation, defined as achieving less than 7 hours of sleep per night. E-cigarette use was classified as never, former, sometimes, and every day. Poisson regression models were used to estimate the impact of e-cigarette use on sleep deprivation. Models were adjusted for various sociodemographic and health factors, including age, sex, race/ethnicity, employment status, tobacco and alcohol use, and self-reported mental health symptoms.

The pooled cohort comprised 18,945 participants, among whom 52% were men and 58% were White. In 2017, the weighed prevalence of ever having used e-cigarettes was 38.9% (95% CI, 37.9-40.0%). The weighted prevalence of current e-cigarette use was 10.0% (95% CI, 9.3-10.6%). In 2018, the weighted prevalence values of former and current e-cigarette use increased to 47.0% (95% CI, 45.6-48.4%) and 15.7% (95% CI, 14.7-1.67%), respectively. The weighed prevalence rates of sleep deprivation were 34.2% (95% CI, 31.9-36.5%) in 2017 and 34.3% (95% CI, 33.3-35.4%) in 2018.

In adjusted regression analyses, former e-cigarette use was associated with elevated prevalence of sleep deprivation compared to never use (prevalence ratio [PR], 1.17; 95% CI, 1.06-1.29). Sleep deprivation was also more prevalent among daily users (PR, 1.42; 95% CI, 1.23-1.65) compared to never users. Individuals who reported using e-cigarettes some days had numerically higher prevalence rates of sleep deprivation, though the difference was not statistically significant.

The primary study limitation was the cross-sectional design, which prevents the assertion of causality. Additionally, little data were available on e-cigarette habits beyond frequency of use. Nicotine dependence, intensity of use, and content of e-liquids were not captured.

In this large-scale study, young adults who reported prior or current e-cigarette use were more likely to experience sleep deprivation compared to never users. This relationship remained significant after adjustments for relevant covariates, such as health status, gender, and age. Future longitudinal studies are needed to confirm the potential association between e-cigarette use and sleep disturbances.


Kianersi S, Zhang Y, Rosenberg M, Macy JT. Association between e-cigarette use and sleep deprivation in U.S. young adults: Results from the 2017 and 2018 Behavioral Risk Factor Surveillance System [published online September 6, 2020]. Addict Behav. doi: 10.1016/j.addbeh.2020.106646