Silver linings and improvement of our resources for smoking cessation interventions.
The article of Cummins et al. (1) is based on a survey which according to the authors considers electronic cigarette a risk for populations with mental health conditions. First of all, in our opinion it is not correct to agglomerate and treat all mental health conditions in the same way. It would be like considering all physical illness the same way. Fever is like a cancer? A specific phobia is like schizophrenia? It 'is true that there is a high level of smoking prevalence in individuals with mental health conditions but it varies according to mental health conditions e.g. schizophrenia, major depression, bipolar disorder. In two studies we have shown for the first time that regular use of E- cigarettes substantially decreased consumption of conventional cigarettes without causing significant side effects in chronic schizophrenic patients and in depressed patients who smoke (2,3). Large prospective randomized controlled are now required to confirm these initial observations (4,5). If these studies further confirm the potential use of the ecig as a tool in the fight against smoking, we could see the resources of this instrument rather than just the limits. Millions of lives could be saved and the smoking cessation centers, in real life settings, could boast a range of proposed therapies able to increase their level of clinical efficacy and improve their level of attractiveness for the smoker who thinks to improve their health and quality of life. Although not formally regulated, the e-cigarette may help smokers with mental health conditions to reduce their cigarette consumption or remain abstinent and reduce the burden of smoking-related morbidity and mortality. The ultimate goal is to propose an effective intervention to reduce the harm of tobacco smoking for this challenging population.
1. Cummins SE, Zhu S, Tedeschi GJ, Gamst AC, Myers MG. Use of e- cigarettes by individuals with mental health conditions. Tob Control doi:10.1136/tobaccocontrol-2013-051511 2. Caponnetto P, Auditore R, Russo C, Cappello G C, Polosa R: Impact of an Electronic Cigarette on Smoking Reduction and Cessation in Schizophrenic Smokers: A Prospective 12-Month Pilot Study. Int. J. Environ. Res. Public Health 2013, 10: 446-461. 3. P Caponnetto, R Polosa, R Auditore, C Russo, D Campagna: Smoking Cessation with E-Cigarettes in Smokers with a Documented History of Depression and Recurring Relapses. International Journal of Clinical Medicine 2(3), Vol.2 No.3, July 2011. 4. Caponnetto P, Polosa R, Auditore R, Minutolo G, Signorelli M, Maglia M, Alamo A, Palermo F, Aguglia E. Smoking cessation and reduction in schizophrenia (SCARIS) with e-cigarette: study protocol for a randomized control trial. Trials. 2014 Mar 22;15:88 5. http://clinicaltrials.gov/ct2/show/NCT02124187
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