Electronic cigarettes and mental illness: Reviewing the evidence for help and harm among those with psychiatric and substance use disorders.
OBJECTIVE
Adults with mental illness (MI) use combustible tobacco at increased rates and have greater difficulty quitting smoking. Given the increasing popularity of electronic cigarettes (e-cigarettes), their use by those with MI has important health implications. While preliminary evidence suggests potential benefits of e-cigarette use for those with MI, well-controlled, systematic research examining appeal, correlates, and consequences of e-cigarette use in this vulnerable population is lacking. This review evaluated current knowledge of e-cigarette use and potential for help and/or harm among adults with MI.


METHODS
The search strategy resulted in k = 88 reports, of which k = 9 were deemed relevant.


RESULTS
E-cigarette use is prevalent among those with MI, as is concurrent use of e-cigarettes and combustibles. E-cigarettes appeal to those with MI as a viable alternative to combustible tobacco, and their use does not appear to exacerbate nicotine addiction or psychiatric symptoms. However, the long-term impact of e-cigarette use on combustible tobacco use and other health indices is largely unknown.


CONCLUSIONS
Rigorous research and improved knowledge regarding risks and benefits of e-cigarette use within this vulnerable population are needed to inform whether special consideration is warranted towards those with MI in developing tobacco control policies and health communications. Recommendations for future e-cigarette research include improved assessment of the following: 1) psychodiagnostic variability, 2) flavor preferences, 3) the longitudinal impact on combustible tobacco use, and 4) impact of tobacco product communications.


CONCLUSIONS
As with combustible cigarettes, individuals with MI may display unique e-cigarette use patterns from that of the general population. (Am J Addict 2017;26:306-315).
Veterans Health Administration Mental Illness Research, Education and Clinical Center (MIRECC), West Haven, Connecticut.|Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
Kathryn
K
Hefner
Veterans Health Administration Mental Illness Research, Education and Clinical Center (MIRECC), West Haven, Connecticut.|Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
Gerald
G
Valentine
Veterans Health Administration Mental Illness Research, Education and Clinical Center (MIRECC), West Haven, Connecticut.|Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
Mehmet
M
Sofuoglu
D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D006801:Humans; D001523:Mental Disorders / Q000523:psychology*; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*