Tob Control 23:iii48-iii53 doi:10.1136/tobaccocontrol-2013-051511
  • Original article

Use of e-cigarettes by individuals with mental health conditions

Open Access
  1. Mark G Myers3
  1. 1Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
  2. 2Cancer Center, University of California, San Diego, La Jolla, California, USA
  3. 3Psychology Service, Veteran Affairs San Diego Healthcare System, Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
  1. Correspondence to Dr Sharon Cummins, Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0905, La Jolla, CA 92093-0905, USA; scummins{at}
  • Received 19 December 2013
  • Revised 11 March 2014
  • Accepted 13 March 2014
  • Published Online First 12 May 2014


Background Individuals with mental health conditions (MHC) have disproportionately high tobacco-related morbidity and mortality due to high smoking prevalence rates. As high consumers of cigarettes, smokers with MHC may consider using e-cigarettes as an alternative form of nicotine delivery.

Objective Examination of the susceptibility to use e-cigarettes by individuals with MHC.

Methods A US population survey with a national probability sample (n=10 041) was used to assess ever use and current use of regular cigarettes, e-cigarettes, and US Food and Drug Administration-approved pharmacotherapy for smoking cessation. Survey respondents provided information about whether they had been diagnosed with an anxiety disorder, depression, or other MHC.

Results Individuals with MHC were more likely to have tried e-cigarettes (14.8%) and to be current users of e-cigarettes (3.1%) than those without MHC (6.6% and 1.1%, respectively; p<0.01). Ever smokers with MHC were also more likely to have tried approved pharmacotherapy (52.2% vs 31.1%, p<0.01) and to be currently using these products (9.9% vs 3.5%, p<0.01) than those without MHC. Additionally, current smokers with MHC were more susceptible to future use of e-cigarettes than smokers without MHC (60.5% vs 45.3%, respectively, p<0.01).

Conclusions Smokers with MHC are differentially affected by the rise in popularity of e-cigarettes. Clinical interventions and policies for tobacco control on e-cigarettes should take into account the possible outcomes and their implications for this priority population.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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