Vaping and eating disorders association: A systematic review

Electronic cigarette (e-cigarette) use has risen rapidly, particularly among adolescents and young adults. Concurrently, the prevalence of eating disorders has increased in these populations. Given the shared demographic and psychological risk factors, this systematic review aims to explore the association between e-cigarette use and eating disorders, examining potential links.

The review was carried out following the PRISMA guidelines. A comprehensive search strategy was applied across PubMed, Web of Science, and Embase up to September 5, 2024, to locate studies investigating the link between eating disorders and e-cigarette use. Studies were included if they focused on adolescents, young adults, or the general adult population, with outcomes relating to diagnosed eating disorders or self-reported disordered eating behaviors. Data were collected and synthesized in a narrative format, and quality evaluations were conducted using the Newcastle-Ottawa Scale.

Out of 903 records identified, 13 studies met the inclusion criteria. Most studies were cross-sectional and predominantly conducted in the USA. Findings consistently indicated a positive association between e-cigarette use and different disorders of eating, including, binge eating disorder, bulimia nervosa, and anorexia nervosa. E-cigarette use was also linked to eating disorders such as purging and fasting. Gender-specific differences were observed, with female users at higher risk. However, mixed or non-significant results were reported in some studies, indicating potential variations due to cultural or demographic factors.

Then current evidence points towards a significant association between e-cigarette use and eating disorder behaviors, including binge eating, bulimia nervosa, anorexia nervosa, and unhealthy weight control behaviors such as purging and fasting. However, as most included studies were cross-sectional, the direction of this relationship remains unclear. E-cigarette use may be linked to eating disorders, but further longitudinal studies are necessary to establish causality and understand the dynamics of this relationship. These findings indicate the need for targeted public health interventions to address these co-occurring behaviors.