{
  "abstract": "Background: Youth and young adult use of electronic nicotine delivery systems (ENDS) continues to rise. Early nicotine exposure is linked to long‑term neurobehavioral risks, and emerging evidence suggests that vaping may co‑occur with mental health and substance‑related disorders. However, limited clinical data exist on how ENDS use aligns with psychiatric and substance‑related diagnoses in young adults.\n\nMethods: This cross‑sectional study analyzed electronic health record (EHR) data from 41,270 patients aged 18-24 years within the University of Maryland Medical System (UMMS) who completed the E‑cigarette and Vaping Assessment Tool (EVAT) between August 2020 and June 2024. ENDS use (current/former vs. never) was examined in relation to International Classification of Diseases, 10th Revision (ICD‑10) diagnoses for depressive episode (F32), anxiety disorder (F41), cannabis‑related disorder (F12), and alcohol‑related disorder (F10). Associations were assessed using chi‑square tests and multivariable ordinal logistic regression adjusting for age, sex, and race/ethnicity.\n\nResults: Overall, 19.0% of young adults reported using ENDS. ENDS use increased with diagnostic burden, rising from 17.1% among those with no diagnoses to 58.3% among those with four diagnoses. Patients with anxiety, depression, cannabis‑related disorder, or alcohol‑related disorder consistently demonstrated higher ENDS use, with the highest prevalence (66.7%) observed among those with combined anxiety, cannabis, and alcohol‑related disorders. In adjusted models, having one or more diagnoses significantly increased the odds of ENDS use in both age groups, with the strongest effect among 18-20‑year‑olds with three diagnoses (OR ≈ 6.0).\n\nConclusions: ENDS use is strongly associated with psychiatric and substance‑related disorders among young adults, with risk increasing alongside the number of diagnoses. These findings underscore the need for integrated screening of vaping behaviors within mental health and substance‑use encounters, as well as concurrent assessment of behavioral health conditions among ENDS users. Embedding standardized vaping assessments into EHR workflows may support earlier identification of nicotine dependence and facilitate timely referral to cessation and addiction services.",
  "abstract_shown": true,
  "affiliations": [
    "Family and Community Medicine, University of Maryland School of Medicine, Baltimore, USA",
    "Family Medicine, University of Maryland School of Medicine, Baltimore, USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Colleen Kernan"
    },
    {
      "affs": [
        0
      ],
      "name": "Carissa S Kwan"
    },
    {
      "affs": [
        0
      ],
      "name": "Elena Klyushnenkova"
    },
    {
      "affs": [
        1
      ],
      "name": "Niharika Khanna"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dx3x1m5137wj9.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.117213",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13721598/?tool=EBI",
  "id": "dx3x1m5137wj9",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13721598",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Family/General Practice"
    ],
    [
      "heading",
      "Public Health"
    ],
    [
      "heading",
      "Substance Use and Addiction"
    ],
    [
      "openalex",
      "2737|Smoking Behavior and Cessation"
    ]
  ],
  "openalex": "W7214936849",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13721598/pdf/?tool=EBI",
  "pmcid": "PMC13721598",
  "pmid": "42965074",
  "published": "2026-09-30",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/dx3x1m5137wj9.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:36Z",
      "native_id": "PMC:PMC13721598",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13721598"
    },
    {
      "first_seen": "2026-11-03T12:22:16Z",
      "native_id": "PMC13721598",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.117213"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Public Health",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "The Age to Vape: Nicotine Use and Behavior Associations in Young Adults",
  "title_text": "The Age to Vape: Nicotine Use and Behavior Associations in Young Adults",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:16Z",
  "url": "https://research.draconitic.com/paper/dx3x1m5137wj9",
  "venue": "Cureus",
  "versions": []
}