High-strength nicotine e-cigarettes can help adults with schizophrenia quit smoking

Reviewed by Emily Henderson, B.Sc.Mar 16 2021

A new study in Nicotine & Tobacco Research, published by Oxford University Press, finds that the use of high-strength nicotine e-cigarettes can help adults with schizophrenia spectrum disorders quit smoking.

Some 60-90% of people with schizophrenia smoke cigarettes, compared to 15-24% of the general population. The researchers from the University of Catania, in collaboration with colleagues from City University of New York and Weill Medical College of Cornell University, have assessed here the feasibility of using a high-strength nicotine e-cigarette to modify smoking behavior in people with schizophrenia spectrum disorders who smoke cigarettes.

In this study 40 adults with schizophrenia spectrum disorders who smoked and did not intend to reduce or quit smoking participated in a 12-week study using Juul e-cigarettes loaded with 5% nicotine pods with a follow-up visit at 24 weeks. Researchers measured smoking frequency, smoking reduction, carbon monoxide expired air reduction, smoking cessation, and continuous abstinence 24 weeks after the study began.

Some 40% of participants had stopped smoking traditional cigarettes by the end of 12 weeks. Researchers observed an overall, sustained 50% reduction in smoking or complete smoking abstinence in 92.5% of participants at the end of 12 weeks. Researchers also observed an overall 75% reduction in median daily cigarette consumption from 25 to 6, by the end of the 12 weeks.

After six months, 24 weeks after the study began, 35% of participants had completely stopped smoking conventional tobacco cigarettes, while continuing to use e-cigarettes. Researchers here also measured a significant decrease in daily cigarette consumption was also confirmed at the end of 24 weeks. The study's authors report that 57.5% of participants reduced their cigarette usage by over 50%.

Additionally, researchers found that participants' mean blood pressure, heart rate and weight measurably decreased between the start of the study and the 12-week follow up. Positive and negative symptoms of schizophrenia were not significantly different after using e-cigarettes throughout the whole duration of the study. At the end of the study 61.9% of participants reported feeling more awake, less irritable, and experiencing greater concentration, and reduced hunger.

Smoking is the primary cause of the 15-25 years mortality gap between users of mental health services and the general population. This study demonstrates that switching to high-strength nicotine e-cigarettes is a feasible highly effective smoking cessation method for smokers who have schizophrenia. And it improves their quality of life too!"

Riccardo Polosa, Study Author and Professor of Internal Medicine, University of Catania