E-cigs, vapes, e-hookahs, vape pens, juuls and electronic nicotine delivery systems (ENDs) – electronic cigarettes go by many different names that are constantly evolving, and just like their names, the research, risks, and associated impact are evolving too. So, what exactly are the facts about e-cigarettes and vaping? And how can we better understand their potential risks, benefits, and other implications to better serve individuals with behavioral health conditions?
While individuals with behavioral health conditions account for almost 40% of all traditional cigarettes smoked by adults 1,2, they are also a significantly vulnerable group for high e-cigarette use.
- A study by the University of California has shown that people living with behavioral health conditions, like depression and anxiety, are twice as likely to have tried e-cigarettes and three times as likely to be users of battery-powered electronic nicotine delivery devices.
- Individuals with mental illness are more likely to believe that using e-cigarettes will help them quit smoking. Currently, the FDA does not recognize electronic nicotine devices as a smoking cessation aid.5
- In addition, studies have shown that individuals with mental illness often combine e-cigarettes with concurrent use of traditional combustible cigarettes which make them more at risk for nicotine addiction and susceptible to the effects of traditional tobacco.3,4 To complicate matters, recent outbreaks have also tied e-cigarette use with the concurrent use of illegal THC cannabis oils which have resulted in lung injuries and deaths in 24 states (and growing) across the nation. Although information on e-cigarette use and its side effects are still in development, below you’ll find a digest of available resources and information related to e-cigarettes and vaping.
General Resources/ Information
- E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General (2016)
- CDC OSH Electronic Facts About E-Cigarettes Information Page
- CDC Lung Injury Associated with the Use of E-Cigarette, or Vaping Products Landing Page
- Know the Risks: E-Cigarettes & Young People
- Public Health Consequences of E-Cigarettes by NASEM
- What Do We Know About E-cigarettes? by American Cancer Society
Toolkits & Guides
- Vaping, Juul and E-Cigarettes Presentation Toolkit by American Academy of Pediatrics
- Stanford Medicine Tobacco Prevention Toolkit
- Parents Against Vaping (PAVe) Parent Toolkit
- Know the Risks: A Youth Guide to E-cigarettes
- The Real Cost of Vaping: Understanding the dangers of teen e-cigarette use
Fact Sheets and Infographics
- Electronic Cigarettes: What’s the Bottom Line?
- E-cigarettes Shaped Like USB Flash Drives: Information for Parents, Educators and Health Care Providers
- Teachers and Parents: That USB Stick Might Be an E-cigarette
- FDA Youth Vaping Risks
- Catch My Breath: Youth E-Cigarette & Juul Prevention Program
- The Impact of E-Cigarettes in the Lung
- E-cigarettes, “Vapes”, and JUULs What parents Should Know
- FDA’s Center for Tobacco Products Exchange Lab Tobacco Education Social Media Content
- It’s Not Like You Can Buy A New Brain
- Know the Risks
- Out Proud and Vape Free
- STATE System E-Cigarette Fact Sheet
- CDC/OSH and Tobacco Control Network Youth E-Cigarette Microlearning
- FDA The Real Cost Magic
- Stop and Think
- Stop and Think 2
- Stop and Think 3
- Truth Initiative Sweet Clouds
- Truth Initiative Burn Through
- Don’t Get Hacked by Vaping
Research Articles & Reports
- Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students – United States, 2011-2018
- Flavored Tobacco Product Use Among Middle and High School Students, 2014 – 2018
- Tobacco Product Use Among Middle and High School Students – United States, 2011 – 2017
- Electronic Nicotine Delivery Systems
- Flavorings in Electronic Cigarettes An Unrecognized Respiratory Health Hazard?
- E-Cigarette Uptake Amongst UK Youth: Experimentation, but Little or No Regular Use in NonSmokers.
- Emerging nicotine delivery products. Implications for public health.
- Promise and peril of e-cigarettes: can disruptive technology make cigarettes obsolete?
- Electronic cigarettes: A report commissioned by Public Health England
- Intention to smoke cigarettes among never-smoking US middle and high school electronic cigarette users: National Youth Tobacco Survey, 2011- 2013.
- Beliefs and experimentation with electronic cigarettes: a prospective analysis among young adults
- Correlates of e-cigarette ad awareness and likeability in U.S. young adults
- Nicotine and the Developing Human: A Neglected Element in the Electronic Cigarette Debate
- Tobacco harm reduction: the need for new products that can compete with cigarettes.
- Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review
- Acute impact of active and passive electronic cigarette smoking on serum cotinine and lung function.
- Electronic Cigarettes Are a Source of Thirdhand Exposure to Nicotine
- E-cigarettes: a scientific review
- Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit.
- Electronic cigarettes for smoking cessation.
- Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence.
- Quantifying the effects of promoting smokeless tobacco as a harm reduction strategy in the USA.
- A systematic review of health effects of electronic cigarettes.
- Electronic cigarettes as a smoking-cessation: tool results from an online survey
- Longitudinal study of e-cigarette use and onset of cigarette smoking among high school students in Hawaii.
- Vaporizers, E-Cigarettes, and other Electronic Nicotine Delivery Systems (ENDS)
- BecomeAnEx Digital Quit-Smoking Plan and Online Community
- This is Quitting Youth Program
- INDEPTH: An Alternative to Teen Nicotine Suspension or Citation by the American Lung Association
- SmokeFree Teen: Quit Vaping by the National Cancer Institute
This resource digest will continue to be updated as resources are gathered so please keep checking back!
If you have resources/information on this topic that you’d like us to add to this list, please email us at BHtheChange@TheNationalCouncil.org.
- Lipari R, Van Horn S. Smoking and Mental Illness Among Adults in the United Statesexternal icon. The CBHSQ Report: March 30, 2017. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
- Centers for Disease Control and Prevention. Vital Signs: Current Cigarette Smoking Among Adults Aged ≥18 Years With Mental Illness—United States, 2009–2011. Morbidity and Mortality Weekly Report 2013;62(05):81-7.
- Hefner, K. Valentine, G., Sofuoglu, M. Electronic cigarettes and mental illness: Reviewing the evidence for help and harm among those with psychiatric and substance use disorders. Am J Addict. 2017 Jun;26(4):306-315. doi: 10.1111/ajad.12504.
- Centers for Disease Control and Prevention. Tobacco Use Among Adults with Mental Illness and Substance Use Disorders. Retrieved from https://www.cdc.gov/tobacco/disparities/mental-illness-substance-use/index.htm.
- Food and Drug Administration. Fact or Fiction: What to Know About Smoking Cessation and Medications. Retrieved from https://www.fda.gov/consumers/consumer-updates/fact-or-fiction-what-know-about-smoking-cessation-and-medications.