Depressed teenagers are at double the risk of using e-cigarettes, according to new research.

A study of 5,000 youth ages 12-13 in Australia found that vaping was higher among those with severe depression, stress and a low sense of well-being. The findings correspond with links that U.S. researchers have found between e-cigarette use and mental health issues in young people, and come amidst a global mental health crisis that has been ongoing since the COVID-19 pandemic. 

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In the Australian study, adolescents who reported moderate levels of stress were 74% more likely to vape, and those with high levels of stress 64% more likely to vape. Those who reported a low sense of wellbeing were 105% more likely to vape than those who had a strong sense of wellbeing. More than 8% of the youth surveyed reported having used e-cigarettes before.

“These findings highlight the urgent need for prevention and early intervention approaches, backed by evidence, to support both the short- and long-term health and wellbeing of young people,” Dr. Lauren Gardner, one of the lead researchers of the study from the University of Sydney, said in a release. 

A 2023 American Heart Association study found that more than half of 13- to 24-year-olds who vaped nicotine, THC, which is the active component in marijuana, or both reported experiencing depression in the past week compared to non-vapers. More than 50% of all vapers reported having suicidal thoughts in the past month compared to 25% of non-vapers.

The research follows U.S. Surgeon General Vivek Murthy’s warnings in recent years about the growing mental health crisis among American youth. In 2021, Murthy noted that 24% of young people around the world were experiencing higher levels of depression and 20% were experiencing heightened rates of anxiety. He called for the expansion of mental health services for youth, among other recommendations. 

In 2023, Murthy warned about the nearly universal use of social media among youth and its “profound risk of harm to the mental health and wellbeing” of children and adolescents.

Researchers in Sydney found that adolescents start vaping around age 14 on average. A 2023 survey in the U.S. found that 10% of high school students in the U.S. used e-cigarettes.

The American Heart Association offers the following recommendations to parents for steering children and adolescents away from tobacco use:

• Begin talking with your kids about smoking and vaping in kindergarten. Be honest and open to seeing things from your child’s point of view. And don’t stop. Keep the conversation going as kids get older.

• Explain that smokeless tobacco, hookah and e-cigarettes all have dangers, including nicotine addiction.

• Discuss what they might say if a friend offers a cigarette or e-cigarette.

• If you smoke or vape, the best thing you can do is quit. At least don’t smoke around your children.

• Don’t allow family members or friends to smoke in your home or car. Make sure the places where your child spends a lot of time are tobacco-free.