Appeal of electronic cigarettes in smokers with serious mental illness. (August 2016)

• Record Type: Journal Article
• Authors: Pratt, Sarah I.; Sargent, James; Daniels, Luke; Santos, Meghan M.; Brunette, Mary
• Is Part Of: Addictive behaviors. Volume 59(2016)
• Page Start: 30
• Page End: 34
• Publication Date: 2016-08
• Subjects: Smoking -- Electronic cigarettes -- Serious mental illness; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2016.03.009
• Languages: English
• ISSNs: 0306-4603

Abstract

Abstract: Introduction: Up to 75% of people with serious mental illness (SMI) smoke, and most are highly dependent on nicotine, consuming more cigarettes per day than smokers without mental illness. Even with evidence-based treatment, relapses are common, resulting in high morbidity and early mortality from tobacco-related diseases. Electronic cigarettes (e-cigarettes) are theoretically safer because they deliver no tar or carbon monoxide; however, their appeal is largely untested in people with SMI. Methods: We enrolled 21 chronic smokers with SMI who had failed a quit attempt and were not engaged in cessation treatment. Research staff provided e-cigarettes and instructions on how to use them, and assessed participants weekly for 4 weeks. Results: Of the enrolled participants, 19 completed weekly assessments. From baseline to the final study visit, mean self-reported use of combustible tobacco declined from 192 to 67 cigarettes/week (t = 3.62, df = 17, p = 0.005), confirmed by reduction in breath carbon monoxide from 27 ppm to 15 ppm (t = 3.246, df = 18, p = 0.004). Use of e-cigarettes did not escalate over the 4 weeks. Temporary and mild side effects, including dry/sore throat, nausea, dizziness, and cough, were reported by 58% of participants. End of trial ratings of enjoyment, satisfaction compared to regular cigarettes, and willingness to buy e-cigarettes were high (ranging from 3.82–4.51 on a 5-point scale). Conclusions: Results of this study suggest that people with SMI may find e-cigarettes an appealing substitute for combustible cigarettes. We found no evidence of increasing nicotine dependence. Further randomized studies are needed to better assess e-cigarette appeal and toxicity. Highlights: Electronic cigarettes may be appealing to chronic smokers with serious mental illness. Participants reduced use of combustible cigarettes when given e-cigarettes. Carbon monoxide levels decreased when people were given e-cigarettes for 4 weeks.