• Kathryn Hefner, Gerald Valentine, and Mehmet Sofuoglu.
• Veterans Health Administration Mental Illness Research, Education and Clinical Center (MIRECC), West Haven, Connecticut.
• Am J Addict. 2017 Jun 1; 26 (4): 306-315.

Background And ObjectivesAdults 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.MethodsThe search strategy resulted in k = 88 reports, of which k = 9 were deemed relevant.ResultsE-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.Discussion And ConclusionsRigorous 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.Scientific SignificanceAs 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).Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

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