Hefner Kathryn, Rosenheck Robert, Merrel Jeremy, Coffman Marcedes, Valentine Gerry, Sofuoglu Mehmet
a Veterans Health Administration Mental Illness Research, Education and Clinical Center (MIRECC) , West Haven , Connecticut , USA.
b Department of Psychiatry , Yale University School of Medicine , New Haven , Connecticut , USA.
J Dual Diagn. 2016 Apr-Jun;12(2):109-17. doi: 10.1080/15504263.2016.1172895. Epub 2016 Apr 11.
Individuals with mental illness and substance use disorders smoke at elevated rates and tend to have greater difficulty quitting smoking as compared to the general population. Some believe that e-cigarettes may reduce harm associated with smoking, but little is known about e-cigarette use, perceptions, and motivations for their use among individuals with mental health and/or substance use disorders.
Rates and correlates of e-cigarette use, perceptions, and sources of information about e-cigarettes among smokers seeking mental health and/or substance use services (N = 188) at the VA Connecticut Healthcare System were assessed via a brief survey. The Pearson χ(2) test of independence was used to compare veterans who currently used e-cigarettes with those who did not. Logistic regression was used to examine independent attitudinal differences controlling for potentially confounding variables.
Participants were generally male (90%), Caucasian (54%), and older than 50 (69%), with high rates of at least one mental health condition (82%), at least one substance use disorder (73%), and comorbid mental health and substance use disorders (55%). A relatively high proportion of the sample (30.9%) used e-cigarettes. These participants, compared to those who did not use e-cigarettes, were more likely to have a mental health disorder and less likely to have a substance use disorder, started smoking later in life, spent less money on smoking, and were more likely to have tried to quit "cold turkey." Knowledge of e-cigarettes originated most often from TV, radio, or personal contacts. Respondents held generally positive perceptions and motivations regarding e-cigarette use (i.e., it is socially acceptable, may help reduce/quit smoking, less harmful to others). Despite positive attributions, rates of dual use of e-cigarettes and traditional cigarettes was high (86.2%), and very few people using e-cigarettes (6.9%) indicated that e-cigarettes actually helped them quit smoking, suggesting little related harm reduction.
E-cigarettes are commonly used by smokers with mental health conditions and/or substance use disorders, a high-risk group that feels positive about e-cigarettes. However, positive regard of e-cigarettes did not appear to translate to ability to reduce or quit cigarette smoking. Safety and effectiveness research on e-cigarettes is urgently needed.
与普通人群相比，患有精神疾病和物质使用障碍的个体吸烟率较高，且戒烟难度往往更大。一些人认为电子烟可能会减少与吸烟相关的危害，但对于患有精神健康和/或物质使用障碍的个体使用电子烟的情况、认知以及使用动机知之甚少。
通过一项简短调查评估了在康涅狄格州退伍军人医疗系统寻求精神健康和/或物质使用服务的吸烟者（N = 188）中电子烟的使用情况、认知以及电子烟信息来源的比率和相关因素。使用Pearson卡方独立性检验比较当前使用电子烟的退伍军人与未使用电子烟的退伍军人。使用逻辑回归分析来检验在控制潜在混杂变量的情况下独立的态度差异。
参与者大多为男性（90%）、白种人（54%），年龄超过50岁（69%），至少有一种精神健康状况的比例较高（82%），至少有一种物质使用障碍的比例较高（73%），同时患有精神健康和物质使用障碍的比例为（55%）。样本中使用电子烟的比例相对较高（30.9%）。与未使用电子烟的参与者相比，这些参与者更有可能患有精神健康障碍，而患有物质使用障碍的可能性较小，开始吸烟的时间较晚，在吸烟上花费较少，并且更有可能尝试“突然戒烟”。对电子烟的了解大多来自电视、广播或个人接触。受访者对电子烟的使用普遍持有积极的认知和动机（即，在社交上是可接受的，可能有助于减少/戒烟，对他人危害较小）。尽管有积极的认知，但电子烟和传统香烟同时使用的比例很高（86.2%），而且很少有使用电子烟的人（6.9%）表示电子烟实际上帮助他们戒烟，这表明在减少相关危害方面作用不大。
患有精神健康状况和/或物质使用障碍的吸烟者普遍使用电子烟，这是一个对电子烟持积极态度的高危群体。然而，对电子烟的积极看法似乎并未转化为减少或戒烟的能力。迫切需要对电子烟进行安全性和有效性研究。
