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The case for routine screening for e-cigarette use in psychiatry

Published online by Cambridge University Press:  30 November 2023

Astha Malik*
Affiliation:
Junior Medical Officer, Sydney Local Health District, Camperdown, New South Wales, Australia. Email: astham1@outlook.com
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Abstract

Type
Correspondence
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use and/or adaptation of the article.
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

Smoking e-cigarettes, also known as vaping, has become an increasingly common practice in the past decade, with recent estimates of lifetime prevalence of 23% globally.Reference Tehrani, Rajabi, Ghelichi- Ghojogh, Nejatian and Jafari1 Despite this, the incidence of documentation of e-cigarette use in medical records by clinicians remains relatively low,Reference Young-Wolff, Klebaner, Folck, Carter-Harris, Salloum and Prochaska2,Reference Winden, Chen, Wang, Sarkar, Carter and Melton3 perhaps indicating that e-cigarette use is not routinely screened for or that patients do not inform clinicians about their use.

As smoking e-cigarettes is a relatively new phenomenon, there remains a paucity of literature regarding its adverse effects. However, recent research has demonstrated a host of side-effects, including but not limited to cytotoxicity, oxidative stress and pulmonary injury.Reference Marques, Piqueras and Sanz4 Although the impacts on mental health remain largely unknown, a recent cross-sectional study by Oh et al found a positive correlation between vaping and psychotic experiences in college students in the USA, even after adjusting for marijuana use and the presence of depression or anxiety.Reference Oh, Banawa, Lee, Zhou and Huh5 Similarly, a recent scoping review found positive associations between e-cigarette use and depression, suicidal ideation and suicide attempts.Reference Javed, Usmani, Sarfraz, Sarfraz, Hanif and Firoz6 Although these findings do not necessarily suggest a causative relationship, especially acknowledging the significant heterogeneity among e-cigarette devices, these studies do indicate a potential link between e-cigarette use and mental illness.

As such, there may be benefit to routinely screening for e-cigarette use in a standard mental health history. Data derived from health services, as well as individual clinician experiences, can assist in determining the potential risks of this increasingly popular practice moving forward.

Declaration of interest

None

References

Tehrani, H, Rajabi, A, Ghelichi- Ghojogh, M, Nejatian, M, Jafari, A. The prevalence of electronic cigarettes vaping globally: a systematic review and meta-analysis. Arch Public Health 2022; 80(1): 240.CrossRefGoogle ScholarPubMed
Young-Wolff, KC, Klebaner, D, Folck, B, Carter-Harris, L, Salloum, RG, Prochaska, JJ, et al. Do you vape? Leveraging electronic health records to assess clinician documentation of electronic nicotine delivery system use among adolescents and adults. Prev Med 2017;105: 32–6.CrossRefGoogle Scholar
Winden, TJ, Chen, ES, Wang, Y, Sarkar, IN, Carter, EW, Melton, GB. Towards the standardized documentation of e-cigarette use in the electronic health record for population health surveillance and research. AMIA Jt Summits Transl Sci Proc 2015; 2015:199203.Google ScholarPubMed
Marques, P, Piqueras, L, Sanz, M-J. An updated overview of e-cigarette impact on human health. Respir Res 2021; 22(1): 151.CrossRefGoogle ScholarPubMed
Oh, H, Banawa, R, Lee, JO, Zhou, S, Huh, J. Vaping and psychotic experiences among college students in the United States. Drug Alcohol Depend 2021; 227: 108987.CrossRefGoogle ScholarPubMed
Javed, S, Usmani, S, Sarfraz, Z, Sarfraz, A, Hanif, A, Firoz, A, et al. A scoping review of vaping, e-cigarettes and mental health impact: depression and suicidality. J Community Hosp Intern Med Perspect 2022; 12(3): 33–9.CrossRefGoogle ScholarPubMed
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