Study: E cigarettes and Mental Health

The smoking rate in the general UK population is now at an all-time low thanks to vaping, dropping to 14.5%, but problems persist in discrete sections of society. The rate in one group, those suffering from mental health problems, remains stubbornly high, yet research from academics at the American Geisel School of Medicine at Dartmouth has shown that electronic cigarettes can help.

The UK Health Security Agency (formerly Public Health England) says: “While a decrease in smoking rates has also been seen among adults with a long-term mental health condition – falling from 35.3% in 2013/14 to 26.8% in 2018/19 – prevalence remains substantially higher, despite the same levels of motivation to quit.”
Drilling down, the more severe the mental health condition, the more likely someone is to be a smoker. The rate in those with anxiety or depression was 28%, 34% in patients with a long-term mental health condition, and 40.5% in those with a serious mental illness.

What does this mean in real terms? The research team explain: “High cigarette smoking prevalence and low quit rates in people with serious mental illness contribute to disparate rates of chronic disease and premature death.”

The trial tested the impact of using electronic cigarettes to encourage people with a serious mental illness to switch away from smoking, therefore lowering their harm exposure.
The team recruited two hundred and forty subjects who all had a serious mental illness. All of them had previously tried to quit smoking, failed, and were currently unwilling to make another attempt to give up smoking.
They were split into groups, with one group receiving disposable electronic cigarettes for a period of eight weeks. They were assessed at the start, and after two, four, six, eight, thirteen, and twenty-six weeks.

They were tested and questioned each time. The research team recorded what their thoughts were about electronic cigarettes, the number of cigarettes they smoked per day, a measure of the volume of carbon monoxide in their breath (indicating the volume of smoking taking place), a measurement of how dependent they felt on nicotine, and if they had experienced any side effects from switching to vaping or smoking less.

The groups self-reported the same rate of smoking at the start of the trial. By the second week, 79% of the group who had received disposable vapes were using their electronic cigarettes every day.
During weeks 2-8, the number of cigarettes being smoked per day and the volumes of measured carbon monoxide continued to fall in the disposable vapes group. Almost a quarter of the group reported completely stopping smoking at this point. This difference between the groups was maintained over the rest of the research period. There were no serious side effects reported throughout the trial.
The team concluded: “Providing e-cigarettes for 8 weeks to smokers with SMI resulted in substantial reductions in [cigarettes per day] and [carbon monoxide]. Enhancing and maintaining switching from cigarettes to e-cigarettes warrant further study.”
In addition, they commented: “The finding that e-cigarette provision led to significant reductions in smoking and carbon monoxide without increasing nicotine dependence has implications for reducing harm not only among the millions of smokers with serious mental illness who struggle to quit, but also for other vulnerable smokers who cannot achieve cessation.”

This study supports findings from work done in the United Kingdom but is important as it is from an American team where research tends to have a very negative bias.