{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T15:56:12Z","timestamp":1772553372064,"version":"3.50.1"},"reference-count":36,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute on Minority Health and Health Disparities","award":["U54MD013376"],"award-info":[{"award-number":["U54MD013376"]}]},{"name":"National Institute on Minority Health and Health Disparities","award":["R24MD000217"],"award-info":[{"award-number":["R24MD000217"]}]},{"name":"National Institute on Minority Health and Health Disparities","award":["R24MD002803"],"award-info":[{"award-number":["R24MD002803"]}]},{"name":"National Institute on Minority Health and Health Disparities","award":["DA012390"],"award-info":[{"award-number":["DA012390"]}]},{"name":"National Institute on Minority Health and Health Disparities","award":["DA019805"],"award-info":[{"award-number":["DA019805"]}]},{"name":"National Institute on Minority Health and Health Disparities","award":["T32IR5355"],"award-info":[{"award-number":["T32IR5355"]}]},{"name":"National Institute on Drug Abuse","award":["U54MD013376"],"award-info":[{"award-number":["U54MD013376"]}]},{"name":"National Institute on Drug Abuse","award":["R24MD000217"],"award-info":[{"award-number":["R24MD000217"]}]},{"name":"National Institute on Drug Abuse","award":["R24MD002803"],"award-info":[{"award-number":["R24MD002803"]}]},{"name":"National Institute on Drug Abuse","award":["DA012390"],"award-info":[{"award-number":["DA012390"]}]},{"name":"National Institute on Drug Abuse","award":["DA019805"],"award-info":[{"award-number":["DA019805"]}]},{"name":"National Institute on Drug Abuse","award":["T32IR5355"],"award-info":[{"award-number":["T32IR5355"]}]},{"name":"Pfizer Inc. In addition","award":["U54MD013376"],"award-info":[{"award-number":["U54MD013376"]}]},{"name":"Pfizer Inc. In addition","award":["R24MD000217"],"award-info":[{"award-number":["R24MD000217"]}]},{"name":"Pfizer Inc. In addition","award":["R24MD002803"],"award-info":[{"award-number":["R24MD002803"]}]},{"name":"Pfizer Inc. In addition","award":["DA012390"],"award-info":[{"award-number":["DA012390"]}]},{"name":"Pfizer Inc. In addition","award":["DA019805"],"award-info":[{"award-number":["DA019805"]}]},{"name":"Pfizer Inc. In addition","award":["T32IR5355"],"award-info":[{"award-number":["T32IR5355"]}]},{"name":"California Tobacco-Related Disease Research Program (TRDRP)","award":["U54MD013376"],"award-info":[{"award-number":["U54MD013376"]}]},{"name":"California Tobacco-Related Disease Research Program (TRDRP)","award":["R24MD000217"],"award-info":[{"award-number":["R24MD000217"]}]},{"name":"California Tobacco-Related Disease Research Program (TRDRP)","award":["R24MD002803"],"award-info":[{"award-number":["R24MD002803"]}]},{"name":"California Tobacco-Related Disease Research Program (TRDRP)","award":["DA012390"],"award-info":[{"award-number":["DA012390"]}]},{"name":"California Tobacco-Related Disease Research Program (TRDRP)","award":["DA019805"],"award-info":[{"award-number":["DA019805"]}]},{"name":"California Tobacco-Related Disease Research Program (TRDRP)","award":["T32IR5355"],"award-info":[{"award-number":["T32IR5355"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Youth tobacco use remains a significant public health concern, particularly in urban communities disproportionately burdened by health disparities. In Baltimore City, where tobacco-related harms are elevated, understanding the relationship between tobacco use\u2014including e-cigarettes\u2014and mental health among high school students is essential for guiding equitable prevention and cessation strategies. The CEASE (Communities Engaged and Advocating for a Smoke-free Environment) program, in collaboration with the American Lung Association\u2019s Not On Tobacco (N-O-T) initiative, developed an online school-based survey to inform community-responsive interventions. Aims: This study aimed to examine the associations between cigarette use, including conventional cigarette use, and self-rated mental health among high school students in Baltimore City. Methods: High school students in Baltimore City completed an anonymous online survey that assessed demographic characteristics, tobacco knowledge and use, mental health, and related behaviors. Self-rated mental health was dichotomized as poor versus fair\/good. Tobacco use categories included current use of e-cigarettes and conventional cigarettes. Logistic regression models were used to examine associations between tobacco use and self-rated mental health, adjusting for age, gender, race, and parental education. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Results: No statistically significant associations were found between self-rated mental health and e-cigarette use and conventional tobacco use after adjusting for covariates. Conclusions: The absence of a significant association may reflect unique aspects of the social context in Baltimore City, where youth may not use tobacco products as a coping mechanism for mental health challenges. Alternatively, it may be due to limitations in measurement, particularly the use of a single-item mental health assessment. These findings should be considered preliminary. Future research using more comprehensive mental health measures and larger samples is warranted to further explore these complex relationships.<\/jats:p>","DOI":"10.3390\/children12070902","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T11:58:07Z","timestamp":1751975887000},"page":"902","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Use of Electronic and Conventional Cigarettes and Self-Rated Mental Health in High School Students"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0256-880X","authenticated-orcid":false,"given":"Payam","family":"Sheikhattari","sequence":"first","affiliation":[{"name":"School of Community Health and Policy, Morgan State University, Baltimore, MD 21251, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rifath Ara Alam","family":"Barsha","sequence":"additional","affiliation":[{"name":"John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS 39216, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6592-7698","authenticated-orcid":false,"given":"Chidubem","family":"Egboluche","sequence":"additional","affiliation":[{"name":"School of Community Health and Policy, Morgan State University, Baltimore, MD 21251, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5054-6250","authenticated-orcid":false,"given":"Shervin","family":"Assari","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1093\/ntr\/nty237","article-title":"Use of JUUL e-cigarettes among youth in the United States","volume":"22","author":"Hammond","year":"2020","journal-title":"Nicotine Tob. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1001\/jama.2019.18387","article-title":"E-cigarette use among youth in the United States, 2019","volume":"322","author":"Cullen","year":"2019","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1001\/jama.2014.7883","article-title":"E-cigarettes, vaping, and youth","volume":"312","author":"Gostin","year":"2014","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e1921513","DOI":"10.1001\/jamanetworkopen.2019.21513","article-title":"Prevalence of electronic cigarette dependence among youth and its association with future use","volume":"3","author":"Vogel","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Jenssen, B.P., and Boykan, R. (2019). Electronic cigarettes and youth in the United States: A call to action (at the local, national and global levels). Children, 6.","DOI":"10.3390\/children6020030"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e2020020651","DOI":"10.1542\/peds.2020-020651","article-title":"Rural-urban differences in changes and effects of Tobacco 21 in youth e-cigarette use","volume":"147","author":"Dai","year":"2021","journal-title":"Pediatrics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1177\/0890117117719621","article-title":"Current use of e-cigarettes and conventional cigarettes among US high school students in urban and rural locations: 2014 National Youth Tobacco Survey","volume":"32","author":"Noland","year":"2018","journal-title":"Am. J. Health Promot."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"101657","DOI":"10.1016\/j.copsyc.2023.101657","article-title":"Uncertainty as a driver of the youth mental health crisis","volume":"53","author":"Schweizer","year":"2023","journal-title":"Curr. Opin. Psychol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"McGorry, P., Gunasiri, H., Mei, C., Rice, S., and Gao, C.X. (2025). The youth mental health crisis: Analysis and solutions. Front. Psychiatry, 15.","DOI":"10.3389\/fpsyt.2024.1517533"},{"key":"ref_10","unstructured":"Haidt, J. (2024). The Anxious Generation: How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness, Penguin."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1080\/01612840.2024.2404806","article-title":"The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness: Haidt, J.; Penguin Press:, 2024; 400 pp., $30 (hardcover), ISBN 978-0593655030","volume":"46","author":"Long","year":"2024","journal-title":"Issues Ment. Health Nurs."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1080\/14622200802443569","article-title":"Tobacco use and cessation in psychiatric disorders: National Institute of Mental Health report","volume":"10","author":"Ziedonis","year":"2008","journal-title":"Nicotine Tob. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1080\/09595230600944461","article-title":"Mental health and alcohol, drugs and tobacco: A review of the comorbidity between mental disorders and the use of alcohol, tobacco and illicit drugs","volume":"25","author":"Matytsina","year":"2006","journal-title":"Drug Alcohol Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/j.jaac.2018.06.029","article-title":"Mental health problems and onset of tobacco use among 12-to 24-year-olds in the PATH study","volume":"57","author":"Green","year":"2018","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1017\/S0033291711002261","article-title":"A longitudinal study of the bi-directional relationship between tobacco smoking and psychological distress in a community sample of young Australian women","volume":"42","author":"Leung","year":"2012","journal-title":"Psychol. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1093\/ntr\/ntx270","article-title":"Characterizing polytobacco use trajectories and their associations with substance use and mental health across mid-adolescence","volume":"20","author":"Cho","year":"2018","journal-title":"Nicotine Tob. Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Hong, S.W., Teesdale-Spittle, P., Page, R., Ellenbroek, B., and Truman, P. (2022). Biologically active compounds present in tobacco smoke: Potential interactions between smoking and mental health. Front. Neurosci., 16.","DOI":"10.3389\/fnins.2022.885489"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.pedn.2022.01.006","article-title":"Physical and mental health outcomes associated with adolescent E-cigarette use","volume":"64","author":"Livingston","year":"2022","journal-title":"J. Pediatr. Nurs."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e20182935","DOI":"10.1542\/peds.2018-2935","article-title":"Mental health problems and initiation of e-cigarette and combustible cigarette use","volume":"144","author":"Riehm","year":"2019","journal-title":"Pediatrics"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Farrell, K.R., Weitzman, M., Karey, E., Lai, T.K., Gordon, T., and Xu, S. (2022). Passive exposure to e-cigarette emissions is associated with worsened mental health. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-13470-9"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.addbeh.2018.08.033","article-title":"Rates of electronic cigarette use among adults with a chronic mental illness","volume":"89","author":"Bianco","year":"2019","journal-title":"Addict. Behav."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1111\/ajad.13110","article-title":"A comparison of mental and behavioral health risks factors associated with current dual use of electronic cigarette and conventional tobacco cigarettes with exclusive tobacco cigarette use and nonuse among adults in the United States","volume":"30","author":"Okunna","year":"2021","journal-title":"Am. J. Addict."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.jpsychires.2015.11.008","article-title":"Psychiatric comorbidity in adolescent electronic and conventional cigarette use","volume":"73","author":"Leventhal","year":"2016","journal-title":"J. Psychiatr. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1001\/jamapediatrics.2013.5488","article-title":"Electronic cigarettes and conventional cigarette use among US adolescents: A cross-sectional study","volume":"168","author":"Dutra","year":"2014","journal-title":"JAMA Pediatr."},{"key":"ref_25","first-page":"1","article-title":"E-Cigarette, Conventional Cigarette, and Depression: Role of Race\/Ethnicity in the Health Information National Trends Survey (HINTS) 2022","volume":"7","author":"Assari","year":"2023","journal-title":"J. Lung Health Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15171\/ijhpm.2017.90","article-title":"Unequal Gain of Equal Resources across Racial Groups","volume":"7","author":"Assari","year":"2018","journal-title":"Int. J. Health Policy Manag."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1093\/ntr\/ntab059","article-title":"Naming Racism, not Race, as a Determinant of Tobacco-Related Health Disparities","volume":"23","author":"Pearson","year":"2021","journal-title":"Nicotine Tob. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e20161254","DOI":"10.1542\/peds.2016-1254","article-title":"Trends in Susceptibility to Smoking by Race and Ethnicity","volume":"138","author":"Sabado","year":"2016","journal-title":"Pediatrics"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"33","DOI":"10.29245\/2578-2959\/2024\/1.1300","article-title":"What is Common Becomes Normal; Black-White Variation in the Effects of Adversities on Subsequent Initiation of Tobacco and Marijuana During Transitioning into Adolescence","volume":"8","author":"Assari","year":"2024","journal-title":"J. Ment. Health Clin. Psychol."},{"key":"ref_30","first-page":"1121","article-title":"When Common Becomes Normal: Weaker Association Between Neighborhood Stress and Body Mass Index Among Black Adolescents Compared to White Adolescents","volume":"3","author":"Assari","year":"2024","journal-title":"Glob. J. Cardiovasc. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1177\/0190272516628298","article-title":"Lies, Damned Lies, and Survey Self-Reports? Identity as a Cause of Measurement Bias","volume":"79","author":"Brenner","year":"2016","journal-title":"Soc. Psychol. Q."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"35630","DOI":"10.52965\/001c.35630","article-title":"The Stigma and Self-Stigma Scales for attitudes to mental health problems: Psychometric properties and its relationship to mental health problems and absenteeism","volume":"10","author":"Docksey","year":"2022","journal-title":"Health Psychol. Res."},{"key":"ref_33","unstructured":"Centers for Disease Control and Prevention (2024, October 31). Youth Risk Behavior Surveillance System (YRBSS), Available online: https:\/\/www.cdc.gov\/yrbs\/results\/index.html."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.su6901a1","article-title":"Overview and Methods for the Youth Risk Behavior Surveillance System\u2014United States, 2019","volume":"69","author":"Underwood","year":"2020","journal-title":"MMWR Suppl."},{"key":"ref_35","first-page":"1","article-title":"Youth risk behavior surveillance\u2014United States, 2011","volume":"61","author":"Wechsler","year":"2012","journal-title":"MMWR Surveillence Summ."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Miech, R., Leventhal, A., Patrick, M., and Rodriguez, N. (2025). Trends in use of cigarettes and e-cigarettes among young adults who had smoked in adolescence: 2017\u20132022. Tob. Control.","DOI":"10.1136\/tc-2024-059018"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/7\/902\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:06:47Z","timestamp":1760033207000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/7\/902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,8]]},"references-count":36,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["children12070902"],"URL":"https:\/\/doi.org\/10.3390\/children12070902","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,8]]}}}