Abstract Background The use of Electronic Nicotine Delivery Systems(ENDS) has increased significantly among adolescents, raising concern due to potential adverse effects on mental health and sleep. In Latin America, evidence regarding the association between ENDS use and symptoms of anxiety, depression, and sleep disturbances is still limited. These devices, often marketed as safer alternatives to traditional cigarettes, are highly attractive to youth due to flavored products, social influence, and targeted advertising, contributing to increased acceptability and risk perception gaps. The objective of this study was to evaluate the association between ENDS use and anxious/depressive symptoms and insufficient sleep among school-aged adolescents in Valledupar, Colombia. Methods A cross-sectional analytical study was conducted among adolescents aged 10 to 18 years enrolled in public and private schools in urban and rural areas of Valledupar. Cluster probability sampling was applied. Sample size was calculated based on estimated ENDS prevalence, with a 1% margin of error and 95% confidence level. A structured questionnaire collected sociodemographic and sleep variables, and mental health was assessed using the Goldberg Anxiety and Depression Scale. Data were entered into a study-designed database. Normality was evaluated using the Anderson-Darling test. Descriptive statistics, Chi-square and Kruskal-Wallis tests, and Poisson regression adjusted for age, sex, school type, and vamping were performed. Linear regression was used to explore the relationship between ENDS use and hours of sleep. Institutional ethics approval was obtained. Results A total of 9,069 adolescents participated, with a mean age of 13.9 years (SD: 1.9); 49.8% were female. Overall ENDS use was 24.6%, with 10.6% reporting occasional use and 14% regular use. Adolescents who used ENDS showed a higher prevalence of anxious and depressive symptoms and insufficient sleep compared with non-users. Multivariate analysis revealed a significantly higher likelihood of anxiety and depression among occasional and regular ENDS users. Regarding sleep duration, a mean reduction of 0.11 hours was observed among occasional users (95% CI: −0.24 to 0.01) and 0.07 hours among regular users (95% CI: −0.19 to 0.04); however, these differences were not statistically significant (p 0.05). Conclusions ENDS use was significantly associated with anxiety and depression symptoms among adolescents in Valledupar. A trend toward reduced sleep duration was observed among ENDS users, although without statistical significance. These findings highlight the urgent need for comprehensive prevention programs, strengthened regulation, and public health strategies to reduce ENDS use and protect adolescent mental wellbeing. Longitudinal studies are recommended to evaluate long-term effects of ENDS in this population. This abstract is funded by: None
Orozco et al. (Fri,) studied this question.