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 mental health and substance use challenges?

While individuals with mental health and substance use challenges 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 mental health and substance use challenges, 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 health and substance use challenges 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 health and substance use challenges 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, 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

Toolkits & Guides

Fact Sheets and Infographics


Research Articles & Reports

Additional Resources/Information

Youth & Vaping Resources 

Local Youth Tobacco Initiatives

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.


  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.

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