Uso de cigarrillo electrónico entre estudiantes de medicina: relación con depresión y estrés percibido
DOI:
https://doi.org/10.11606/issn.1806-6976.smad.2025.229954Palabras clave:
Vapeo, Sistemas Electrónicos de Liberación de Nicotina, Depresión, Estrés PsicológicoResumen
Objetivo: identificar la prevalencia del uso de cigarrillos electrónicos entre estudiantes de medicina y su asociación con síntomas de depresión y niveles de estrés percibido. Metodología: estudio transversal cuantitativo, realizado con 234 estudiantes de medicina. La recolección de datos incluyó información sociodemográfica, estilo de vida, uso de cigarrillos electrónicos y evaluación de síntomas depresivos y estrés percibido, utilizando el Patient Health Questionnaire-9 y la Perceived Stress Scale-10, respectivamente. Se realizaron análisis de regresión logística multivariada, pruebas de diferencias entre medias y correlación de Spearman para explorar las asociaciones entre las variables. Resultados: la prevalencia de uso de cigarrillos electrónicos fue del 65,4%. Los estudiantes que usaban cigarrillos electrónicos presentaron niveles significativamente más altos de estrés percibido (p < 0,001), pero no hubo diferencia significativa en los síntomas depresivos (p = 0,296). El análisis de regresión mostró que un aumento de un punto en el estrés percibido incrementó en 1,12 veces la probabilidad de uso de cigarrillos electrónicos (Odds ratio ajustado = 1,12; IC95% 1,07 – 1,18; p < 0,001). Conclusión: la alta prevalencia de uso de cigarrillos electrónicos resalta la necesidad de implementar intervenciones educativas y políticas de apoyo a la salud mental para mitigar el uso entre estudiantes de medicina.
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Referencias
1. World Health Organization. WHO global report on trends in prevalence of tobacco use 2000-2025, 40ª edition [Internet]. Geneva: WHO; 2021 [cited 2024 Sep 18]. Available from: https://www.who.int/publications/i/item/9789240039322
2. Reitsma MB, Kendrick PJ, Ababneh E, Abbafati C, Abbasi-Kangevari M, Abdoli A, et al. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet. 2021;397(10292):2337-60. https://doi.org/10.1016/S0140-6736(21)01169-7
3. Fundação Oswaldo Cruz. Painel de Indicadores da Saúde – Pesquisa Nacional de Saúde [Homepage]. Rio de Janeiro: FIOCRUZ; 2019 [cited 2024 Sep 18]. Available from: https://www.pns.icict.fiocruz.br/painel-de-indicadores-mobile-desktop/
4. Wang L, Wang Y, Chen J, Yang XM, Jiang XT, Liu P, et al. Comparison of biological and transcriptomic effects of conventional cigarette and electronic cigarette smoke exposure at toxicological dose in BEAS-2B cells. Ecotoxicol Environ Saf. 2021;222:112472. https://doi.org/10.1016/j.ecoenv.2021.112472
5. Bertoni N, Szklo AS. Electronic nicotine delivery systems in Brazilian state capitals: prevalence, profile of use, and implications for the National Tobacco Control Policy. Cad Saude Publica. 2021;37:e00261920. https://doi.org/10.1590/0102-311X00261920
6. Marques P, Piqueras L, Sanz MJ. An updated overview of e-cigarette impact on human health. Respir Res. 2021;22(1):151. https://doi.org/10.1186/s12931-021-01737-5
7. Turkistani YA, Dahlawi M, Bukhari RI, Aldabbagh M, Turkistani YA, Malosh A. Electronic Cigarette Prevalence and Knowledge Among Medical Students in Saudi Arabia and Bahrain: A Cross-National Study. Cureus. 2023;15(9):e45583. https://doi.org/10.7759/cureus.45583
8. Camargo EB Júnior, Noivo IS, Gouvea TCC, Fernandes MNF, Gherardi-Donato ECS. Depression and Substance Use Among Brazilian University Students During the COVID-19 Pandemic. J Psychoactive Drugs. 2023;56(4):1-10. https://doi.org/10.1080/02791072.2023.2244499
9. Chaiton M, Fan J, Bondy SJ, Cohen JE, Dubray J, Eissenberg T, et al. E-Cigarette Dependence and Depressive Symptoms Among Youth. Am J Prev Med. 2024;66(1):104-11. https://doi.org/10.1016/j.amepre.2023.09.020
10. Bautista M, Mogul AS, Fowler CD. Beyond the label: current evidence and future directions for the interrelationship between electronic cigarettes and mental health. Front Psychiatry. 2023;14:1134079. https://doi.org/10.3389/fpsyt.2023.1134079
11. Tehrani H, Rajabi A, Ghelichi-Ghojogh M, Nejatian M, Jafari A. The prevalence of electronic cigarettes vaping globally: a systematic review and meta-analysis. Arch Public Health. 2022;80(1):240. https://doi.org/10.1186/s13690-022-00998-w
12. Santos IS, Tavares BF, Munhoz TN, Almeida LSP, Silva NTB, Tams BD, et al. Sensitivity and specificity of the Patient Health Questionnaire-9 (PHQ-9) among adults from the general population. Cad Saude Publica. 2013;29:1533-43. https://doi.org/10.1590/0102-311X00144612
13. Faro A. Confirmatory factor analysis of three versions of the Perceived Stress Scale (PSS): a population-based study. Psicol Reflex Crit. 2015;28(1):21-30. https://doi.org/10.1590/1678-7153.201528103
14. Field A. Discovering Statistics Using IBM SPSS Statistics. Thousand Oaks, CA: SAGE Publications; 2018. 816 p.
15. Alshanberi AM, Baljoon T, Bokhari A, Alarif S, Madani A, Hafiz H, et al. The prevalence of E-cigarette uses among medical students at Umm Al-Qura University; a cross-sectional study 2020. J Fam Med Prim Care. 2021;10(9):3429. https://doi.org/10.4103/jfmpc.jfmpc_1496_20
16. Benjakul S, Nakju S, Termsirikulchai L. Use of e-cigarettes among public health students in Thailand: Embedded mixed-methods design. Tob Induc Dis. 2022;7;20:78. https://doi.org/10.18332/tid/152256
17. Degani-Costa LH, Bruno FP, Gushken F, Szlejf C, Tokeshi AB, Tehrani YF, et al. Vaping and Hookah Use Among Medical Trainees: A Multinational Survey Study. Am J Prev Med. 2023;65(5):940-9. https://doi.org/10.1016/j.amepre.2023.05.009
18. Babjaková J, Rimárová K, Weitzman M, Bušová M, Jurkovičová J, Dorko E, et al. E-cigarette use, opinion about harmfulness and addiction among university students in Bratislava, Slovakia. Cent Eur J Public Health. 2022;30:S50-6. https://doi.org/10.21101/cejph.a7240
19. Martins SR, Araújo AJ, Wehrmeister FC, Freitas BM, Basso RG, Santana ANC, et al. Prevalence and associated factors of experimentation with and current use of water pipes and electronic cigarettes among medical students: a multicentric study in Brazil. J Bras Pneumol. 2023;49:e20210467. https://doi.org/10.36416/1806-3756/e20210467
20. Albgami MH, Alzahrani AS, Alghamdi AM, Alamri NS, Alghamdi AH, Alsuwat RA. Prevalence and Determinants Influencing the Use of Electronic Cigarette Smoking in Male Students of Taif University. Cureus. 2023;15(6):e40885. https://doi.org/10.7759/cureus.40885
21. Garcia PLB, Sielski JDS, Oliveira LVP, Duarte MES, Miranda IG, Ramos PRG, et al. Prevalence and usage profile of electronic cigarettes in medical students from a capital in southern Brazil. Rev Med. 2024;103(2):e-219219. https://doi.org/10.11606/issn.1679-9836.v103i2e-219219
22. Maximino GS, Andrade ALM, Andrade AG, Oliveira LG. Profile of Brazilian Undergraduates Who Use Electronic Cigarettes: a Cross-Sectional Study on Forbidden Use. Int J Ment Health Addict. 2025;23:193-206. https://doi.org/10.1007/s11469-023-01074-2
23. Alzahrani T, Alhazmi MF, Alharbi AN, AlAhmadi FT, Alhubayshi AN, Alzahrani BA. The Prevalence of Electronic Cigarette Use Among College Students of Taibah University and Symptoms of Cardiovascular Disease. J Saudi Heart Assoc. 2023;35(2):163-8. https://doi.org/10.37616/2212-5043.1338
24. Perkins KA, Karelitz JL. Sex Differences in Acute Relief of Abstinence-Induced Withdrawal and Negative Affect due to Nicotine Content in Cigarettes. Nicotine Tob Res. 2015;17(4):443-8. https://doi.org/10.1093/ntr/ntu150
25. Sofuoglu M, Mooney M. Subjective responses to intravenous nicotine: Greater sensitivity in women than in men. Exp Clin Psychopharmacol. 2009;17(2):63-9. https://doi.org/10.1037/a0015297
26. Ali FR, Agaku IT, Sharapova SR, Reimels EA, Homa DM. Onset of Regular Smoking Before Age 21 and Subsequent Nicotine Dependence and Cessation Behavior Among US Adult Smokers. Prev Chronic Dis. 2020;17:E06. https://doi.org/10.5888/pcd17.190176
27. al’Absi M, Nakajima M, Allen S, Lemieux A, Hatsukami D. Sex Differences in Hormonal Responses to Stress and Smoking Relapse: A Prospective Examination. Nicotine Tob Res. 2015;17(4):382-9. https://doi.org/10.1093/ntr/ntu340
28. Ratcliff BR, Burrow-Sánchez J, Steele TA. Adolescent Protective Factors for Preventing Electronic Cigarette Use. J Drug Issues. 2023;55(1):50-63. https://doi.org/10.1177/00220426231189737
29. Idrees B, Sampasa-Kanyinga H, Hamilton HA, Chaput JP. Associations between problem technology use, life stress, and self-esteem among high school students. BMC Public Health. 2024;24(1):492. https://doi.org/10.1186/s12889-024-17963-7
30. Pokhrel P, Schmid S, Pagano I. Physical Activity and Use of Cigarettes and E-Cigarettes Among Young Adults. Am J Prev Med. 2020;58(4):580-3. https://doi.org/10.1016/j.amepre.2019.10.015
31. Tiralla G, Tamulevicius N, Martinasek MP, Leung W. Examining the Relationship Between E-Cigarette Status and Wearable Device Use on Physical Activity Levels in U.S. Adults. Am J Health Promot. 2024;38(8):1140-6. https://doi.org/10.1177/08901171241256712
32. Hefner KR, Sollazzo A, Mullaney S, Coker KL, Sofuoglu M. E-cigarettes, alcohol use, and mental health: Use and perceptions of e-cigarettes among college students, by alcohol use and mental health status. Addict Behav. 2019;91:12-20. https://doi.org/10.1016/j.addbeh.2018.10.040
33. Jackson SE, Cox S, Shahab L, Brown J. Trends and patterns of dual use of combustible tobacco and e-cigarettes among adults in England: a population study, 2016-2024. MedRxiv. [Preprint]. 2024 [cited 2024 Sep 18];2024.07.17.24310557. Available from: https://doi.org/10.1101/2024.07.17.24310557
34. O’Brien D, Long J, Quigley J, Lee C, McCarthy A, Kavanagh P. Association between electronic cigarette use and tobacco cigarette smoking initiation in adolescents: a systematic review and meta-analysis. BMC Public Health. 2021;21:954. https://doi.org/10.1186/s12889-021-10935-1
35. Martinelli T, Candel MJ, de Vries H, Talhout R, Knapen V, van Schayck CP, et al. Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders. Tob Control. 2023;32(2):170-8. https://doi.org/10.1136/tobaccocontrol-2021-056528
36. Biggs A, Brough P, Drummond S. Lazarus and Folkman’s Psychological Stress and Coping Theory [Internet]. In: Cooper CL, Quick JC, editors. The Handbook of Stress and Health. Chichester: John Wiley & Sons, Ltd; 2017 [cited 2024 Sep 26]. p. 349-64. Available from: https://doi.org/10.1002/9781118993811.ch21
37. Yu Y, Du M, Wang DB, Wu AMS, Chen JH, Li S, et al. School climate and school identification as determinants of smoking conventional cigarettes or vaping among adolescents in China: Stress-coping mediation mechanisms. Tob Induc Dis. 2024;22:39. https://doi.org/10.18332/tid/177171
38. Erhabor J, Boakye E, Osuji N, Obisesan O, Osei AD, Mirbolouk H, et al. Psychosocial stressors and current e-cigarette use in the youth risk behavior survey. BMC Public Health. 2023;23(1):1080. https://doi.org/10.1186/s12889-023-16031-w
39. Teah GE, Conner TS. Psychological and Demographic Predictors of Vaping and Vaping Susceptibility in Young Adults. Front Psychol. 2021;12:659206. https://doi.org/10.3389/fpsyg.2021.659206
40. Mantey DS, Clendennen SI, Sumbe A, Wilkinson AV, Harrell MB. Perceived stress and E-cigarette use during emerging adulthood: A longitudinal examination of initiation, progression, and continuation. Prev Med. 2022;160:107080. https://doi.org/10.1016/j.ypmed.2022.107080
41. Ou TS, Buu A, Yang JJ, Lin HC. E-cigarette use reasons and associated e-cigarette use dependence among college students: A longitudinal examination. Addict Behav. 2024;155:108039. https://doi.org/10.1016/j.addbeh.2024.108039
42. Bonner E, Chang Y, Christie E, Colvin V, Cunningham B, Elson D, et al. The chemistry and toxicology of vaping. Pharmacol Ther. 2021;225:107837. https://doi.org/10.1016/j.pharmthera.2021.107837
43. Rohleder N, Kirschbaum C. The hypothalamic–pituitary–adrenal (HPA) axis in habitual smokers. Int J Psychophysiol. 2006;59(3):236-43. https://doi.org/10.1016/j.ijpsycho.2005.10.012
44. Anyan F, Hjemdal O. Adolescent stress and symptoms of anxiety and depression: Resilience explains and differentiates the relationships. J Affect Disord. 2016;203:213-20. https://doi.org/10.1016/j.jad.2016.05.031
45. O’Connor DB, Thayer JF, Vedhara K. Stress and Health: A Review of Psychobiological Processes. Annu Rev Psychol. 2021;72:663-88. https://doi.org/10.1146/annurev-psych-062520-122331
46. Wang M, Li J, Yan G, Lei T, Rong W, Sun L. The relationship between psychological resilience, neuroticism, attentional bias, and depressive symptoms in college Chinese students. Front Psychol. 2022;13:884016. https://doi.org/10.3389/fpsyg.2022.884016
47. Gherardi-Donato EC, Díaz-Serrano KV, Barbosa MR, Fernandes MNF, Gonçalves-Ferri WA, Camargo EB Júnior, et al. The Impact of an Online Mindfulness-Based Practice Program on the Mental Health of Brazilian Nurses during the COVID-19 Pandemic. Int J Environ Res Public Health. 2023;20(4):3666. https://doi.org/10.3390/ijerph20043666
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