Motives and perceptions regarding electronic nicotine delivery systems (ENDS) use among adults with mental health conditions

Addict Behav. 2018 May;80:102-109. doi: 10.1016/j.addbeh.2018.01.014. Epub 2018 Jan 16.


Background: Smoking rates are disproportionately high among adults with mental health conditions (MHC), and recent research suggests that among former smokers, those with MHC are more likely to use electronic nicotine delivery systems (ENDS). This study investigated reasons for ENDS use and related risk perceptions among individuals with versus without MHC.

Methods: Among adult current ENDS users (n=550), associations between self-reported MHC diagnoses and motives for ENDS use and ENDS risk perceptions were examined, stratified by smoking status.

Results: There were no significant associations between MHC status and ENDS motives or perceptions in the overall sample. However, current smokers with MHC indicated thinking more about how ENDS might improve their health, and former smokers with MHC reported thinking less about how ENDS might harm their health, compared to their counterparts without MHC. Former smokers with MHC rated several reasons for ENDS use (e.g., less harmful than regular cigarettes; to quit smoking; appealing flavors) as more important than did those without MHC.

Conclusions: Current and former smokers with MHC may be especially optimistic about health benefits of ENDS. However, they might also be prone to health risks of continued ENDS use or concurrent use with traditional cigarettes. It will be important for public health messaging to provide this population with accurate information about benefits and risks of ENDS.

Keywords: E-cigarettes; Electronic nicotine delivery devices; Mental health conditions; Risk perceptions.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety Disorders
  • Attitude to Health*
  • Bipolar Disorder
  • Case-Control Studies
  • Cigarette Smoking
  • Depressive Disorder
  • Electronic Nicotine Delivery Systems*
  • Female
  • Humans
  • Male
  • Mental Disorders*
  • Middle Aged
  • Motivation*
  • Perception
  • Psychotic Disorders
  • Risk
  • Schizophrenia
  • Self Report
  • Vaping / psychology*
  • Young Adult