Vaping Linked to Increased Eating Disorder Risk Among U.S. College Students

Vaping might be a less harmful alternative to smoking, but that still doesn’t make it safe.

There are still a lot of unknowns about vaping, including the chemicals that make up the vapor and how they affect a person’s physical health over the long haul. E-cigarettes contain nicotine, which is a highly addictive substance even in lesser amounts.

Evidence points to an association between vaping and chronic lung disease and asthma and links the dual use of e-cigarettes and smoking with cardiovascular disease.

E-cigarettes are more popular among young people than traditional cigarettes, and their use is rising at unprecedented levels. A 2019 survey conducted by the University of Michigan’s Institute for Social Research found that 22% of college students said that they had vaped nicotine in the previous month — a 15.9% increase over 2017 that was among the largest rise in use for any substance in the study’s 45-year history.

But as more and more young people are vaping, there’s another risk factor that has seen a recent uptick: eating disorders.

Nicotine the common link?

 A new University of Toronto study published in the journal Eating Behaviors collected samples from 50,000 higher education students and found that vaping or e-cigarette use has been linked to an elevated risk for developing an eating disorder among college students in the United States. Given the aforementioned spike in vaping use among undergrads, that’s a trend that warrants some concern.

The combination of vaping and an eating disorder can lead to other health complications, such as neurological concerns and heart and lung problems. Study author Kyle Ganson, an assistant professor at the University of Toronto, says that nicotine could be the common denominator between an eating disorder and vaping.

“Nicotine vaping may be used by individuals to support eating disorder behaviors and goals, such as suppressing appetite and catalyzing weight loss,” Ganson said in a news release. “Nicotine vaping can lead to dependence and future polysubstance use.”

People who have eating disorders often use e-cigarettes to suppress their appetites. Another study, published in 2018 in the International Journal of Eating Disorders, found that many participants who struggled with eating disorders were vaping with higher levels of nicotine than those who did not have an eating disorder.

Results of the University of Toronto survey, which collected data from students across 78 colleges and universities, indicated that 25% of respondents were at an increased risk for an eating disorder and nearly 4% self-reported an eating disorder diagnosis.

These findings are particularly notable for women, considering that, as the study authors noted, up to 29% of female college students report symptoms of eating disorders, much higher than male (16%) and transgender/gender-nonconforming students (14%).

How to help those at highest risk for eating disorders and vaping

What can be done to help those who are most at risk for the health problems often associated with eating disorders and the potential long-term risks of vaping?

The study’s authors believe that clinicians need to take more steps to screen for any eating disorder symptoms among college students who report e-cigarette use, discourage those students from using, and monitor them for possible medical red flags.

The Food and Drug Administration (FDA) recently issued marketing denial orders for nearly a million flavored vaping products, but it delayed a decision on whether top vaping brand Juul — which accounts for 40% of the e-cigarette market — can remain. Critics have pushed for tighter federal controls on vaping for years to combat the surge of use by high school and college students.

More stringent restrictions there would certainly help with the vaping side of this conversation, but there are still obstacles from the eating disorder piece of the puzzle.

For now, it’s time to add a goal to eating disorder recovery for those it applies to: putting down the e-cigarettes for good.