The Association of Global and Disease-Related Stress With Susceptibility to and Use of E-Cigarettes and Marijuana Among Adolescents With Congenital Heart Disease.

Objective Adolescents with congenital heart disease (CHD) are exposed to disease-related
stressors and have elevated risk for cardiovascular and cognitive complications that are exacerbated
by e-cigarettes and marijuana. The aims of this cross-sectional study are to: (1) identify the
association between perceived global and disease-related stress and susceptibility to e-cigarettes
and marijuana, (2) determine if the association between stress and susceptibility differs by gender,
and (3) explore the association between stress and ever use of e-cigarettes and marijuana among
adolescents with CHD; Methods Adolescents with CHD (N¼98; aged 12–18 years) completed
self-report measures of susceptibility to/ever use of e-cigarettes and marijuana and global and
disease-related stress; Results Susceptibility to e-cigarettes and marijuana was reported by
31.3% and 40.2% of adolescents, respectively. Ever use of e-cigarettes and marijuana was reported
by 15.3% and 14.3% of adolescents, respectively. Global stress was associated with susceptibility
to and ever use of e-cigarettes and marijuana. Disease-related stress was associated with susceptibility
to marijuana. Females reported more global and disease-related stress than males, but the
association of stress with susceptibility to e-cigarettes and marijuana did not differ by gender.
Conclusions Susceptibility to e-cigarettes and marijuana is common among adolescents with
CHD and is associated with stress. Future work to examine the longitudinal associations between
susceptibility, stress, and use of e-cigarettes and marijuana is warranted. Global stress may be an
important consideration in the development of strategies to prevent these risky health behaviors
among adolescents with CHD.

Fox KR, Ferketich AK, Groner JA, et al. The Association of Global and Disease-Related Stress With Susceptibility to and Use of E-Cigarettes and Marijuana Among Adolescents With Congenital Heart Disease. Journal of pediatric psychology. 2023;48(5):458-467. doi:10.1093/jpepsy/jsad005