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Significant association found between e-cigarette use and eating disorders in young adult populations

The study found that there were statistically significant differences between the vaping and non-vaping groups for all categories, including for participants who were at an elevated risk for an eating disorder (e-cigarette use: 29.6% vs. non-use: 23.9%) and participants who self-reported any lifetime eating disorder diagnosis (e-cigarette use: 5.8% vs. non-use: 3.2%).

Although research studies have previously identified a correlation between vaping and eating disorders, these studies were not conducted on college-aged populations— the age group (20-24) which has the highest prevalence of e-cigarette use. Vaping has become increasingly common among college-aged adults within the last decade, yet there has yet to be a conclusion drawn on whether this may lead to the development of lifelong eating disorders such as anorexia, bulimia or binge-eating disorder.

In a recently published study, a group of researchers from the University of Toronto assessed a large population of college students (mean age of 23.4) and found a substantial correlation between e-cigarette use and eating disorders. 

The researchers concluded that out of the total sample population (n= 52,231), 19% of students reported vaping/e-cigarette use within the last 30 days. Additionally, 3.7% reported that they had been diagnosed with an eating disorder, while 25% were at an elevated risk for one.

The paper results indicated that, “there were significant differences (all p < 0.001) between all dependent, independent, demographic, and confounding variables based on vaping or e-cigarette use. This included participants who were at elevated risk for an eating disorder (vaping or e-cigarette use: 29.6% vs. non-use: 23.9%), self-reported any lifetime eating disorder diagnosis (vaping or e-cigarette use: 5.8% vs. non-use: 3.2%), self-reported a lifetime anorexia nervosa diagnosis (vaping or e-cigarette use: 2.9% vs. non-use: 1.6%), self-reported a lifetime bulimia nervosa diagnosis (vaping or e-cigarette use: 1.7% vs. non-use: 0.9%), and self-reported a lifetime binge-eating disorder diagnosis (vaping or e-cigarette use: 1.4% vs. non-use: 0.7%).”

Lead author and assistant professor at the University of Toronto, Dr. Kyle T. Ganson, stated “The higher prevalence of vaping among those with eating disorder symptoms is concerning given that the co-occurrence of these behaviors can exacerbate physical health complications such as cardiovascular, pulmonary, and neurological problems….Nicotine vaping may be used by individuals to support eating disorder behaviors and goals, such as suppressing appetite and catalyzing weight loss. [This] can lead to dependence and future polysubstance use.”

According to a 2019 study conducted by the Center for Disease Control and Prevention (CDC), it reported that 22% of college-aged students and 25% of 12th grade students had self-reported nicotine-vaping use in the last 30 days. One of the major concerns of researchers in these fields is that full-syndrome eating disorders typically start before the age of 25, suggesting that the young adult population is already predisposed to having eating disorders, a problem that vaping may exacerbate.

The researchers analyzed the data produced in the 2018-2019 Healthy Minds Study. This study is a survey performed each year measuring college students’ physical, mental, and social health. 78 colleges and universities from the U.S. Institutes of higher education were voluntarily selected to participate. The study surveyed an approximately combined total of 62,000 students who were asked questions on whether they have vaped within the past 30 days, whether they have ever been diagnosed with an eating disorder, and whether they may be at risk of developing an eating disorder— a metric that was assessed using the SCOFF questionnaire

As the combination of the significant increase in the purchase and use of e-cigarettes and vape pens throughout the last decade and the increase in the prevalence of eating disorders among young adults persists, this new research assists in highlighting the correlation which exists between them. 

The paper’s authors conclude the paper by suggesting that their hopes are that the findings help in both identifying as well as treating the previously unknown health risks posed by the use of e-cigarettes, and that the findings be used and built upon by federal, and state policymakers to devise regulations and procedures which ensure the health of young adults. 


The study was published in Eating Disorders, on September 11th, 2021.

Abstract. Vaping is common among college-age young adults. Preliminary research has shown associations between vaping and eating disorder symptoms, however, there remain gaps in this knowledge among college students. The aim of this study was to determine the associations between vaping and a self-reported lifetime eating disorder diagnosis and eating disorder risk among a large sample of college students. Cross-sectional data from the 2018-2019 national (U.S.) Healthy Minds Study (n = 51,231) were analyzed. Multiple logistic regression analyses were conducted to determine the unadjusted and adjusted associations between vaping or e-cigarette use in the past 30 days and a self-reported lifetime eating disorder diagnosis (any diagnosis, anorexia nervosa, bulimia nervosa, binge-eating disorder) and eating disorder risk (SCOFF). Among the sample, 19.0% of participants reported vaping or e-cigarette use in the past 30 days, 3.7% self-reported any lifetime eating disorder diagnosis, and 25.0% were at elevated risk for an eating disorder. Vaping or e-cigarette use was associated with higher odds of all eating disorder measures, including the self-reported lifetime eating disorder diagnosis items (any diagnosis, anorexia nervosa, bulimia nervosa, binge-eating disorder) and elevated eating disorder risk, while adjusting for demographic and confounding variables. Among a large sample of college students, vaping or e-cigarette use was associated with a self-reported lifetime eating disorder diagnosis and elevated eating disorder risk, which may exacerbate the many medical complications associated with eating disorder behaviors. Clinical professionals should screen for eating disorder behaviors among college students who report vaping or e-cigarette use to monitor symptoms and medical complications.

Ganson, Kyle T., and Jason M. Nagata. “Associations between Vaping and Eating Disorder Diagnosis and Risk among College Students.” Eating Behaviors, vol. 43, 2021, p. 101566., doi:10.1016/j.eatbeh.2021.101566.

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