Associations of dual use of tobacco cigarettes and e-cigarettes, sleep duration, physical activity and depressive symptoms among middle-aged and older Korean adults.
Mi-Ae You, JiYeon Choi, Youn-Jung Son
PMID 36929137WHAT IT FOUND
Korean adults aged 40 to 88 who used both cigarettes and e-cigarettes reported sleeping less than 7 hours and moderate-to-severe depressive symptoms more often than non-smokers.
Nurses can ask about smoking type, sleep and mood when planning cessation support.
Key findings
01In adjusted analysis, dual users had higher odds than non-smokers of sleeping less than 7 hours per day (adjusted OR 1.31, 95% CI 1.11-1.54).
02In adjusted analysis, dual users had higher odds than non-smokers of mild depressive symptoms (adjusted OR 2.36, 95% CI 1.87-2.98) and moderate-to-severe depressive symptoms (adjusted OR 3.86, 95% CI 2.65-5.63).
03Single users had higher adjusted odds than non-smokers of being physically inactive (adjusted OR 1.31, 95% CI 1.24-1.38), while dual users did not differ significantly from non-smokers in physical activity.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is cross-sectional, so it cannot show that smoking type causes short sleep, inactivity or depressive symptoms. Sleep duration, physical activity, smoking and depressive symptoms were self-reported, and objective measures such as nicotine levels were not available. The correlation between self-reported sleep duration and actigraphy-measured sleep duration has not been strong. The e-cigarette-only group was too small for independent comparison with other groups. The data did not include details on smoking cessation history, antidepressant use or past mental health history. The sample was limited to adults aged 40 to 88, so it does not show what happens in younger adults. The analysed sample was 167,809, lower than the 179,004 adults older than 40 initially included, because some did not respond to key questions.
Declared interests
No external or intramural funding was received, and no conflicts of interest were declared.
The easy way to misread this
Do not read the higher odds as proof that dual use causes short sleep or depression. The survey measured smoking, sleep and depressive symptoms at one time, and all were self-reported.