Bidirectional Associations Between Vaping and Changing Eating to Manage Weight and Shape in Canadian Adolescents

Vaping among adolescents has surged in recent years, underscoring the need to identify intentions and motivating factors behind vaping. Although weight management behaviors have been associated with vaping, the largely cross-sectional evidence precludes understanding of how these behaviors may relate to and reinforce each other over time. This study explored the bidirectional associations between vaping and changed eating to manage weight and shape over 3 years of adolescence.

Adolescents from the Cannabis, Obesity, Mental Health, Physical Activity, Alcohol, Smoking, and Sedentary Behaviour (COMPASS) Study (N = 8,960, M age = 13.8 [SD = 1.1], 55.5% cisgender girls) completed self-report surveys annually for 3 years (Time 1 [T1] = 2020/2021, T2 = 2021/2022, T3 = 2022/2023). Data were analyzed using random-intercept cross-lagged panel models with full information maximum likelihood.

Increases in vaping were observed over time (20.9% at T1, 40.0% at T3), and 30% of adolescents changed their eating habits to manage their weight/shape each year. Weak but significant associations were generally observed, such that cisgender girls who changed their eating to manage weight/shape engaged in more vaping the following year (beta_T1-T2 = .05; beta_T2-T3 = .05). Conversely, cisgender girls and boys with a higher vaping frequency reported more days of changing eating to manage weight/shape 1 year later (beta_T1-T2 = .02 and .04, beta_T2-T3 = .05 and .06).

The bidirectional relationship between vaping and weight-related eating behaviors underscores the value of addressing these habits as interconnected behaviors, informing the development of targeted public health policies, preventative measures, and intervention strategies to support health and reduce the adoption of vaping among adolescents.