Two recent studies both show marked improvement in stress related symptoms and violence with consistent e-cigarette use.
Mental illness is a complicated and broad issue that we must work on being better at understanding. Almost 70% of the world’s bipolar population still smoke traditional cigarettes, even while smoking rates drop worldwide. Stress is a chronic condition for the nearly 51 million people living with bipolar disorder, so smoking is usually first leveraged to help alleviate some of this stress. But once addicted to cigarettes, the problems only multiply. Many manifestations of mental illness are exacerbated by attempting to quit, so for many years doctors of bipolar patients have weighed the options. Smoking long term is obviously extremely detrimental to your overall well being, but quitting could prove to be much more disastrous in the short term for these people. E-cigarettes were doctors and patients first real chance to have their cake and eat it too. Smokers finally able to get what they crave without seriously jeopardizing their long term health.
This possible third path has only just started to be properly studied. Two articles published this year indicate that e-cigarettes are just as useful for people with mental illness as they are in the general population. This first study was published in Sage Journals and conducted by Ratika Sharma, David J Castle, Coral E Gartner, and Colin P Mendelsohn. They set out to understand and address the persistently high smoking rates in people with severe mental illness. (SMI) Specifically they were interested with how a switch to harm reduction products could potentially reduce the immense health, financial, and social equity gaps that exist for this tremendously marginalized group. Building on the UK Royal College of Physicians’ study that indicated vaping is at least 95% safer than combustible cigarettes, the researchers concluded that e-cigarettes potentially provide a tenable quitting solution for smokers with SMI. To really drive their point home they compared this type of harm reduction to opiate substitution or clean needle exchanges. These programs, which are generally very popular, actively replace a large known risk with a much smaller one; The lesser of two evils.
The second study was published in the Lancet Psychiatry Journal and headed up by Dr. Debbie Robson. Researchers were interested in seeing if the implementation of a smoke free policy in a psychiatric hospital environment would cause an increase in the frequency of violent incidents. An increase in incidents like this is one of the biggest fears, and therefore barriers, keeping policy change from happening in these sorts of institutions. Patients at the South London and Maudsley NHS Foundation Trust (SLaM) were no longer allowed to smoke cigarettes, but were given plenty of access to nicotine replacement therapies, including e-cigarettes. Researchers compared the frequency of violent incidents from 30 months before and 12 months after the smoke free policy went into effect. Over the span there were 4,550 physical assaults reported, mainly toward staff. (2,916 on staff vs. 1,634 between patients) The researchers found, after accounting for a range of factors, there was a 39% decrease in the amount of physical assaults per month after the smoke free policy was implemented.
Parallels With General Population
This situation parallels what we already know about the perception of vaping. Most of the general population thinks that vaping is basically as dangerous as traditional cigarettes. Because of this people don’t really see a reason to switch to e-cigarettes. Figuring even if they do quit they’d only be replacing one bad habit for another. Therefore, we won’t get smokers to adopt vaping until we can convince enough of the smoking public that vaping is in fact 95% safer than than combustible cigarettes. This dilemma highlights what has prevented other psychiatric hospitals from implementing similar harm reduction strategies. They’re steadfast in their beliefs even when science is clearly telling them something entirely different. This makes it extremely important to uphold science and truth, because if we do not then policy makers will just do what is easiest for them. They will continue to make choices based on what feels right to their collective gut and not what has been repeatedly backed by peer reviewed research.
Do you think we should implement smoke free policies in psychiatric hospitals? Do you think that vaping actually helped reduce the amount of violent incidents? What else could we do to get the truth out into the public eye? Let us know in the comments