Psychologists probably won't like the implication that e-cigarettes cause mental illness, or vice versa, but in the topsy-turvy world of the American culture wars, where vaccines are bad and inhaling marijuana smoke is good, all fields are going to take their lumps.
E-cigarettes should be healthier for people - there is no smoke and smoking is what causes 10 percent of lung cancer - but there is definitely a concerted effort to undermine them. A new pape in Tobacco Control, for example, warns us that the FDA has not approved e-cigarettes as a cessation aid. It doesn't mean they are harmful or homeopathy but that is how the issue is framed. And in science and health, framing is always bad.
The authors from University of California, San Diego School of Medicine have tortured some statistics and gotten them to say that people living with depression, anxiety or other mental health conditions are twice as likely to have tried e-cigarettes and three times as likely to be current users of e-cigarttes as people without mental health disorders.
How did they reach this conclusion? A survey of Americans' smoking history, efforts to quit and their use and perceptions about e-cigarettes who were also asked whether they had ever been diagnosed with an anxiety disorder, depression or other mental health condition. There it is. Correlation and causation.
They then use that to warn that mentally ill people are more likely to try them if they smoke, in order to quit. Why are patches acceptable but e-cigarettes are not, since they both deliver nicotine? It is unclear but it looks fishy to people who don't smoke at all.
"The faces of smokers in America in the 1960s were the 'Mad Men' in business suits," said lead author Sharon Cummins, PhD, assistant professor in the Department of Family and Preventive Medicine. "They were fashionable and had disposable income. Those with a smoking habit today are poorer, have less education, and, as this study shows, have higher rates of mental health conditions."
That's only the first glaring error they get wrong. 'Mad Men' was entirely created from whole cloth by advertising people in the 1960s to try and make themselves sound more interesting. It never caught on, even then, even among actual advertising people on Madison Avenue, because it was so ridiculous. But quotes like that warn you facts are not going to be part of the discussion. E-cigarettes may cause global warming and three-headed fish but you would never know it from an article that doesn't even bother with correlation and causation and just frames the correlation in scary-sounding terms.
For example - they claim that people with psychiatric disorders consume approximately 50 percent of all cigarettes sold annually in the U.S. 30% of the population smokes, which means 80% of them must have psychiatric disorders. Psychologists can't ordinarily object to anyone else making spurious unfounded claims using statistics, but they would win here.
"Since the safety of e-cigarettes is still unknown, their use by nonsmokers could put them at risk," Cummins said. See the framing? Identify one product that has known levels of safety. Not one. Not cars, not water, not doctors.
The real concern of social authoritarians is that they have spent all this time demonizing and ostracizing smokers and they want smokers to have fewer rights, not more. They are worried e-cigarettes may make smokers less disgusting in the eyes of the public who have been rather expensively forced to stop.
The paper says it is not a smoking cessation device but then concedes it is mostly smokers using them to quit. If they were as dangerous as this paper tries to make it sound, mentally ill people who don't smoke would start smoking e-cigarettes, but that has not happened.
Among the 10,041 people who responded to the survey, 27.8 percent of current smokers had self-reported mental health conditions, compared with 13.4 percent of non-smokers; 14.8 percent of individuals with mental health conditions had tried e-cigarettes, and 3.1 percent were currently using them, compared with 6.6 percent and 1.1 percent without mental health conditions, respectively.
In addition, 60.5 percent of smokers with mental health conditions indicated that they were somewhat likely or very likely to try e-cigarettes in the future, compared with 45.3 percent of smokers without mental health conditions.
"People with mental health conditions have largely been forgotten in the war on smoking," Cummins said. "But because they are high consumers of cigarettes, they have the most to gain or lose from the e-cigarette phenomenon. Which way it goes will depend on what product regulations are put into effect and whether e-cigarettes ultimately prove to be useful in helping smokers quit."