Associations of dual use of tobacco cigarettes and e‐cigarettes, sleep duration, physical activity and depressive symptoms among middle‐aged and older Korean adults

Aim There is limited evidence of the association between dual tobacco–e‐cigarette use and health‐related variables in Korea. Thus, this study aimed to investigate the associations between types of cigarette smoking, sleep duration, physical activity and depressive symptoms among Korean adults. Design A cross‐sectional study design using the 2019 Korean Community Health Survey. Methods The study subjects consisted of 179,004 adults older than 40 years from a total of 229,099 individuals. Self‐reported general characteristics, smoking history, sleep duration, physical activity and depressive symptoms were analysed. Results In multinomial logistic regression, dual users of tobacco cigarettes and e‐cigarettes were more likely to have sleep duration of less than 7 h per day and to report both mild and moderate‐to‐severe depressive symptoms than non‐smokers. Single use of either cigarettes or e‐cigarettes increased the risk of short sleep duration and moderate‐to‐severe depressive symptoms.