Addiction Psychiatry Presidential Theme: Vaping

As you may know by now, the theme I have chosen for my presidential year is addiction psychiatry, with a focus on four areas: vaping, opioids, alcohol, and technology. With this article, I am launching the campaign on vaping (“Special Report: Vaping—A Call to Action for Psychiatrists”) . Vaping is a topic our patients often ask about, and patients who vape are showing up more and more in our clinical practices. With a special focus on youth and adolescents, APA is taking the lead on raising awareness about vaping, its risks, its clinical manifestations, and its treatments.

As psychiatrists, we know tobacco use continues to be the leading preventable cause of death in our country especially affecting people with mental illness in terms of the burden of morbidity and mortality. While e-cigarettes are still being studied for helping people quit smoking, there is much to be understood before they are part of practice guidelines. Many people who take up e-cigarettes in an effort to quit smoking end up using them along with cigarettes, which carries the same cardiovascular risks as using cigarettes alone, according to a study from the American Heart Association.

Further, for some populations it is essential to not take up vaping or to quit vaping, including young people, pregnant people, and people who have never smoked cigarettes before. Driven by (1) the appeal of flavors, (2) aggressive marketing aimed at youth, (3) a lower cost compared with cigarettes, (4) being less noticeable and less odorous, and (5) a perceived reduction in health risks, the popularity of vaping has increased rapidly in recent years. In 2018, the U.S. Surgeon General declared an epidemic of e-cigarettes and vaping among adolescents and young adults.

According to estimates from the Centers for Disease Control and Prevention, approximately two-thirds of people between the ages of 15 and 24 do not know that some e-cigarette brands like JUUL always contain nicotine. Outside of nicotine, vaping products present an additional challenge given that they often contain cannabis oil with high potency delta-9-tetrahydrocannabinol.

My hope is that the launch of this campaign will not only help us psychiatrists in our clinical work, but also help our communities learn more about a topic clouded in mystery and misinformation. Keeping up with our plans for a new campaign on addiction psychiatry every three months, we will discuss opioids later in the year and close out the addiction campaign in 2024 with alcohol use disorder and technological addictions, another emerging topic. ■