Pandemic Stress Boosted Teen Vaping Susceptibility, Study Finds

New research reveals that stress associated with the COVID-19 pandemic did not directly lead adolescents to vaping. Instead, it increased their susceptibility to trying e-cigarettes and cannabis long after schools reopened. The study, published in the journal PLoS One, involved researchers from the University of Southern California who assessed how pandemic-related stress during remote learning influenced vaping behaviors among high school students.

The investigation tracked the vaping patterns of 1,316 public school students in Los Angeles County over three years, beginning with the onset of the pandemic. The first survey took place during the 2020-2021 academic year, when schools were closed. Subsequent surveys were conducted during the 2021-2022 and 2022-2023 academic years, respectively.

Study Design and Methodology

Researchers measured COVID-related stress using a multi-item checklist assessing various life factors, including family dynamics and social pressures. They also evaluated the students’ susceptibility to using e-cigarettes and cannabis, which was marked by a shift from a firm “no” to a “maybe.” Current usage was recorded at the beginning and end of the study using questions from the Youth Risk Behavior Surveillance System (YRBSS).

The longitudinal nature of the study allowed researchers to analyze the effect of stress on later vaping behaviors. They employed regression-based path models to explore direct and indirect effects, providing a comprehensive analysis of how early pandemic stress impacted subsequent vaping risks.

Key Findings of the Research

The findings showed that early pandemic stress was linked to increased susceptibility to vaping. At the beginning of the study, only 3.6% of participants reported using e-cigarettes in the past 30 days, which rose to 6.4% by the study’s end. Cannabis vaping also saw an increase from 2.9% to 7.4% during the same period.

The average COVID-related stress score among students was 18.99, with a standard deviation of 4.93. Notably, susceptibility to nicotine vaping was observed in 38.4% of respondents by the second survey, while 19.9% showed susceptibility to cannabis vaping.

The study demonstrated that each standard deviation increase in stress correlated with a 24% increase in the odds of e-cigarette use and a 30% increase for cannabis use at the end of the study. Furthermore, the analysis indicated that heightened stress levels led to increased susceptibility, which in turn raised the likelihood of later vaping.

The authors highlighted that the shift in perception—from “definitely not” to “maybe”—was crucial in understanding the connection between pandemic stress and later vaping behaviors. This change was particularly pronounced among cannabis users, suggesting that societal norms surrounding cannabis may play a role in the increased likelihood of experimentation.

The study’s limitations include potential biases related to the demographics of participants and the specific context of Southern California, which may not be representative of broader trends. Additionally, factors such as peer influence and mental health history were noted as possible unmeasured variables that could affect the results.

In conclusion, the study underscores the importance of addressing adolescent stress and its long-term implications for health. Families and educators are encouraged to foster coping mechanisms and open dialogues about vaping. Preventive measures should focus on reducing susceptibility among teens, utilizing both in-person and digital strategies to engage them effectively.

For policymakers and healthcare providers, the findings serve as a reminder of the need for robust support systems during crises, particularly to safeguard the health and well-being of young people.

Lee et al. (2025) conducted this pivotal research, which offers critical insights into the relationship between stress and adolescent substance use during a tumultuous period in their lives.