The Association Between E-cigarette Use and Sleep Duration Among Adolescents and Young Adults: A Structured Narrative...

E-cigarette use has become increasingly widespread among youth, raising concerns that nicotine exposure may contribute to sleep disruption. This structured narrative review synthesizes current evidence on the association between e-cigarette use and sleep duration among adolescents and young adults. Studies were evaluated using predefined inclusion criteria, and eligible studies examined e-cigarette use alongside sleep duration or related sleep disturbances in youth populations. Extracted data included study design, population characteristics, exposure definitions, sleep measures, and statistical associations, while study quality was assessed based on sample representativeness, outcome validity, and adjustment for confounding variables. Six empirical studies and one narrative review met the inclusion criteria. Across large national datasets, exclusive e-cigarette use was consistently associated with 30-80% higher odds of insufficient sleep among adolescents and young adults, while dual users demonstrated the strongest associations and were up to three times more likely to report inadequate sleep. Adolescents using both combustible and electronic cigarettes also showed increased sleep latency. Emerging evidence suggests a potential bidirectional relationship in which sleep problems may increase susceptibility to vaping initiation. Overall, current evidence indicates that e-cigarette use is repeatedly linked to inadequate sleep duration and other sleep difficulties in youth. Nicotine's neurobiological effects on arousal and withdrawal likely contribute to these outcomes, while sleep disturbances themselves may also increase vulnerability to nicotine use. Public health strategies aimed at reducing youth vaping may therefore improve sleep health, and interventions targeting sleep may help reduce nicotine use. Longitudinal and mechanistic studies are needed to clarify causal pathways and underlying processes.