Heated Tobacco Product Use and Mental Health: Korean National Health and Nutrition Examination Survey (2018-2020)

Abstract

The relationship between mental health and heated tobacco products’ (HTPs) use remains unclear. We obtained data from the Korea National Health and Nutrition Examination Survey (2018–2020) on 18,231 participants aged ≥ 19 years. We examined the association between participants’ type of tobacco use (non-tobacco, combustible cigarette (CC) only, or HTP use [with or without CCs]) and their mental health using logistic regression analysis. Among 18,231 participants, 18.41% was current tobacco users and 38.32% was lifetime tobacco users. Approximately 18.38% (18.14%) current (lifetime) tobacco users were current (lifetime) HTP users. Lifetime HTP users had higher odds of reporting perceived stress (adjusted odds ratio: 1.91, 95% confidence interval: [1.61–2.25]), depressive mood (1.79 [1.17–2.73]), suicidal ideation (2.09 [1.08–4.04]), Patient Health Questionnaire-9 (PHQ-9) ≥ 10 (3.68 [2.38–5.71]), and doctor-diagnosed depression (2.52 [1.75–3.62]) than non-tobacco users, and reporting perceived stress (1.18 [1.004–1.38]), depressive mood (1.53 [1.03–2.26], and PHQ-9 ≥ 10 (1.67 [1.12–2.49]) than lifetime CC only users. Finally, lifetime HTP only users had increased odds of doctor-diagnosed depression (4.30 [1.41–13.16]) than lifetime CC only users. Lifetime HTP users are more likely to experience poor mental status than non-tobacco and CC only users.