Smoking Cessation and Improvement in Mental Health Outcomes: Do People Who Quit Smoking by Switching to Electronic Cigarettes Experience Improvement in Mental Health?

Introduction:
This text presents the results of a study examining the relationship between smoking cessation, the use of electronic cigarettes (e-cigarettes), and mental health outcomes, specifically depressive disorders. The study used data from the Canadian Community Health Survey (CCHS) 2015-2016 to investigate the association between smoking status, e-cigarette use, and depressive symptoms in the Canadian household population.

Key Points:

* The study found that former smokers who used e-cigarettes were more likely to have elevated depressive symptoms than those who did not use e-cigarettes.
* The study used cross-sectional data, which cannot assess the temporal relationships between study variables.
* Nicotine may cause or perpetuate depressive symptoms, but elevated depressive symptoms may also lead to self-medication with nicotine products.
* Mental health improves slowly and progressively with smoking cessation, and e-cigarette users may be more recent quitters, which may explain their higher prevalence of elevated depressive symptoms.
* E-cigarette users may be using them temporarily to get through the early stages of cessation, which may subsequently lead to long-term gains in mental health.
* The study did not determine whether the e-cigarettes contained nicotine, as the use of nicotine products in e-cigarettes was only legalized in 2018 in Canada.
* The study found no evidence of reduction in depressive symptoms after smoking cessation among those who report e-cigarette use, benefits that have been confirmed by systematic reviews.
* There is a need for longitudinal studies to clarify the risks and benefits of e-cigarette use, including those related to mental health, especially among people trying to quit smoking.

Main Message:
The main message of this study is that the use of e-cigarettes may not lead to the expected improvement in mental health outcomes following smoking cessation. Former smokers who use e-cigarettes may be more likely to have elevated depressive symptoms than those who do not use e-cigarettes. The study highlights the need for further research to clarify the risks and benefits of e-cigarette use, particularly in relation to mental health outcomes, to inform regulatory decisions and public health policies.

Dahal R, Adhikari K, Patten SB. Smoking Cessation and Improvement in Mental Health Outcomes: Do People Who Quit Smoking by Switching to Electronic Cigarettes Experience Improvement in Mental Health? Canadian journal of psychiatry Revue canadienne de psychiatrie. 2020;65(7):512-514. doi:10.1177/0706743720917775