Electronic nicotine delivery systems: prevalence and perception of risk/harm in individuals with mental illness.

Introduction:
This text provides an analysis of the prevalence and perception of electronic nicotine delivery systems (ENDS) in individuals with mental illness (MI). The study aimed to understand the use patterns and perception of risk/harm towards these products in a sample of psychiatric patients in Singapore. The summary will cover the study design, key findings, and the main message of the text.

Key Points:

* The study used a cross-sectional design to recruit 380 participants with depressive or schizophrenia spectrum and other psychotic disorders from a tertiary psychiatric care institution.
* The study found that 30.4% of ever smokers reported lifetime use of ENDS, with 83.9% of them using it locally, 37.5% using it overseas, and 21.4% using it both locally and overseas.
* The most common ENDS used were e-vaporizers (n = 26), followed by e-cigarettes (n = 24) and e-pipes (n = 2).
* Only 3.6% of the ever smokers reported current daily use, 10.7% indicated using the products rarely, and the majority (85.7%) had stopped using it at the time of the interview.
* The top reasons for trying ENDS were curiosity (83.9%), availability of ENDS in different flavors (55.4), and their use as a substitute in the participant's attempt to quit smoking cigarettes (32.1%).
* Among non-smokers, 19.3% had never heard of ENDS before, 40.3% refrained from using them as they were unavailable locally, 26.1% felt that they were expensive, and 21% cited health concerns.
* Participants who were aware of ENDS (n = 165) had varying perceptions of harms associated with ENDS. Only 27.3% felt that ENDS were more harmful than regular cigarettes, while 21.2% reported that they were more addictive than regular cigarettes.
* Around 43.6% of participants were concerned about the long-term safety of ENDS, 27.3% felt that ENDS could act as a gateway for non-smokers and children to start tobacco use, and 22.4% reported that they did not know how harmful ENDS were as compared to regular cigarettes.

Main Message:
The study highlights the prevalence of ENDS use in individuals with MI and their varying perceptions of risk/harm associated with ENDS. The findings suggest that there is a need for increased awareness and education about the potential harms of ENDS use, particularly among individuals with MI who are at a higher risk of smoking-related harms. The study also emphasizes the importance of continued monitoring of ENDS use and health behaviors to avoid adverse health outcomes. Overall, the text underscores the need for regulatory measures to address the use and promotion of ENDS, particularly in vulnerable populations.

Asharani PV, Seet V, Devi F, Wang P, Roystonn K, Subramaniam M. Electronic nicotine delivery systems: prevalence and perception of risk/harm in individuals with mental illness. Singapore medical journal. Published online July 19, 2022. doi:10.11622/smedj.2022091