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Stephen Padilla, 29 Sep 2020
The coronavirus disease (COVID-19) pandemic appears to have quickened the acceptance of prescription digital therapeutics (PDT), or software that helps treat human disease, by clinicians and patients, particularly those suffering from mental health conditions, according to experts from one of the sessions at the 2020 Virtual Forum of the Asia Pacific Medical Technology Association (APACMed 2020).

E-cigarette use linked to poor mental health

Tristan Manalac
15 Oct 2020
To smoke or not to smoke: Whether e-cigarettes can be used as a mean to quit smoking is still in debates.

Stress and depressive moods appear to be heightened in people who use e-cigarettes, regardless of gender, according to a recent Korea study.

“Conventional cigarettes, which contain the addictive substance nicotine, are known to be highly related to mental health conditions (MHC), but research on e-cigarettes, which also often contain nicotine, is insufficient,” the researchers said. “The purpose of the study was to examine the association between e-cigarette use and MHC, focusing especially on stress status and elevated depressive symptoms among men and women of all ages.”

Drawing from the seventh cycle of the KNHANES*, data of 5,469 respondents were included in the present analysis. Five percent of the respondents were deemed to be at high risk of depression. Current smokers (p<0.001) and past users of e-cigarettes (p=0.001) were more predominant in the depressed subgroup. [Medicine 2020;9:e22514]

In both men and women, self-perceived high stress was highest among current smokers who had a history of e-cigarette use (40.1 percent and 54.5 percent, respectively). Analysis of variance revealed a significant between-group difference (p<0.001), as compared to smokers and nonsmokers who had never used a vape device.

Similarly, the prevalence of depressive mood was highest in smokers with prior e-cigarette use, both in men (4.9 percent; p=0.001) and women (27.3 percent; p<0.001). Mean scores on the Patient Health Questionnaires were likewise greatest in those who were current smokers and reported prior device use (p<0.001 for both men and women).

Multivariable logistic regression analysis confirmed that prior use of e-cigarettes was a significant risk factor for self-perceived high stress not only in smokers (odds ratio [OR], 1.83, 95 percent confidence interval [CI], 1.46–2.30; p<0.001) but also in nonsmokers (OR, 1.19, 95 percent CI, 1.03–1.36; p=0.016).

Similarly, smokers (OR, 2.08, 95 percent CI, 1.34–3.23; p=0.001) and nonsmokers (OR, 1.42, 95 percent CI, 1.08–1.85; p=0.011) who had used the device before were at a significantly greater risk of depressive mood. For both MHC outcomes, disaggregating according to sex only strengthened the effect of e-cigarette use on the risk estimates.

Though there remains no literature consensus, the researchers offered two potential mechanisms by which e-cigarettes may correlate with depressive moods.

“First, the substances contained in e-cigarettes contribute to this association,” they said, noting that “although e-cigarettes have manufacturer-related variations, like conventional cigarettes they usually contain the addictive substance nicotine, which is known to be highly correlated with depression.” [Tob Control 2014;23:77-78]

“Second, a depressive mood often results from trying to quit smoking and people often use e-cigarettes when attempting to quit smoking traditional cigarettes,” they added.

Further research is needed to better elucidate causal links, if any, the researchers said. “[L]ongitudinal studies should be conducted and include detailed information such as the duration, amount, and pattern of e-cigarette use.”

“Furthermore, social regulations regarding e-cigarettes, which are often perceived to be relatively safer than conventional cigarettes, must be established based on empirical research about the association between e-cigarettes and health outcomes,” they added.

*Korea National Health and Nutrition Examination Survey

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Most Read Articles
Stephen Padilla, 29 Sep 2020
The coronavirus disease (COVID-19) pandemic appears to have quickened the acceptance of prescription digital therapeutics (PDT), or software that helps treat human disease, by clinicians and patients, particularly those suffering from mental health conditions, according to experts from one of the sessions at the 2020 Virtual Forum of the Asia Pacific Medical Technology Association (APACMed 2020).