Passive exposure to e-cigarette emissions is associated with worsened mental health.

Introduction:
This text provides an analysis of the Population assessment of Tobacco and health (PaTh) Study data to investigate potential adverse mental health outcomes associated with different tobacco exposures, with a particular focus on secondhand exposure to e-cigarette emissions. The study hypothesized that passive exposure to e-cigarette emissions, as well as e-cigarette consumption, is associated with an increased risk of internalizing mental health disorders.

Key Points:

* The study used data from Wave 4 of the PaTh study, which included 16,173 adults.
* Two types of tobacco product exposure were evaluated: direct tobacco product consumption and passive exposure to tobacco product emissions.
* Nine categories of tobacco use/exposure status were identified, including exclusive cigarette smokers, exclusive e-cigarette users, dual users, exclusive noncombustible tobacco users, non-users exposed to passive ShS, non-users exposed to passive e-cigarette emissions, and non-users with no passive exposure to tobacco product emissions.
* Internalizing mental health problems were assessed using the Global appraisal of Individual Needs-Short Screener (GaIN-SS).
* after adjusting for covariates, dual tobacco product users had the highest odds of moderate to severe internalizing problems (aOR = 3.37, 95% CI: 2.85, 4.00).
* Exclusive e-cigarette users with no history of smoking were at greater risk for moderate to severe internalizing problems than exclusive cigarette smokers (aOR = 3.14; 95% CI: 2.41, 4.09 and aOR = 2.53; 95% CI: 2.19, 2.93, respectively).
* among non-users, the odds of moderate to severe internalizing problems were higher for those passively exposed to tobacco product emissions, regardless of the tobacco product source (ShS exposure aOR = 1.63, 95% CI: 1.37, 1.94; e-cigarette aerosol exposure aOR = 1.43, 95% CI: 1.03, 1.99).

Main Message:
The study found that passive exposure to e-cigarette emissions is associated with an increased risk of internalizing mental health disorders, comparable to the risk of secondhand smoke exposure. The results suggest that further investigation of the safety profile of e-cigarette emission exposure is needed, and smoking ban policies may need to be extended to cover e-cigarettes, particularly in environments where vulnerable populations are likely to be exposed.

Farrell KR, Weitzman M, Karey E, Lai TKY, Gordon T, Xu S. Passive exposure to e-cigarette emissions is associated with worsened mental health. BMC public health. 2022;22(1):1138. doi:10.1186/s12889-022-13470-9