The American Commission on science and health refutes the view that the use of electronic cigarettes can lead to depression in adolescents

puff plusConsumer advocacy organizations and non-profit organizations that focus on supporting science, the U.S. Commission on science and health, recently publicly refuted the views of the truth initiative on e-cigarettes and mental health. The Committee ACSH was founded by a group of scientists in 1978. They focus on: publicly supporting evidence-based science and medicine, and exposing junk science and exaggerated health panic.

The following is the full text of Cameron English, director of Bioscience of the society:

As a novice parent, I soon found out how dangerous the world is for children. Sometimes this is an overwhelming understanding. Considering all the real threats that my wife and I must guard against, I can't understand why someone invented a health panic that unnecessarily worried American mothers and fathers, but it seems to be the specialty of the tobacco control movement.

For example, earlier this week, the truth Initiative (TI) launched a campaign to highlight the so-called mental health risks associated with teenagers' e-cigarette use as part of their broader efforts to limit the use of e-cigarettes.

"The two health crises of young people - the mental health crisis and the e-cigarette epidemic - pose a growing threat to a generation of young people," the truth initiative wrote in a report on its new marketing campaign. "Although nicotine is known to damage the developing brain... Little is known about the worrying link between nicotine and mental health."

Aside from the rhetoric of radical groups, there is no evidence that adolescent depression is related to e-cigarettes. There is an established link between the disease and nicotine consumption, although it is a complex relationship that is not suitable for political reasons.

Causality?

Our first clue that the truth initiative is moving away from data comes from the truth initiative. The executive summary of its new report includes the following important qualifiers:

Although it is not known whether there is a causal relationship between nicotine and mental health, there is a disturbing link between nicotine consumption and the deterioration of depression and anxiety symptoms, and the risk of being diagnosed with depression is higher among nicotine users.

The statement tells us that the link between nicotine and mental health is chaotic. There may be many other factors that affect this association in various ways. After investigating the evidence, I think ti's analysis is regressive: stimulants do not cause or amplify depression; People with this disease seek relief from nicotine consumption. According to the review of nearly 300 studies in 2017:

... [a] poor internal state is the main driving factor of smoking behavior in patients with depression. Therefore, experimental treatments that attempt to change the responsiveness to external smoking cues (e.g., through cognitive bias correction) are unlikely to be effective for depressed smokers.

Instead, treatment should identify adverse motivational states that are the main drivers of everyone's smoking and individualize treatment for these states. In addition, effective intervention strategies should address smokers' beliefs about the high return value of smoking in these motivational states.

This is a major challenge to Ti papers. Their radicalism is based on the assumption that eliminating external smoking clues, such as limiting e-cigarette marketing to adults, is the best way to prevent e-cigarettes, which is obviously not the case for patients with depression. In other words, it is always immoral to sell nicotine products to children. ACSH opposes minors from contacting any products containing nicotine.

Why is depression related to smoking?

"Why?" in this case, this is a difficult question to answer, but one possibility to increase some clarity is that nicotine has fully proven antidepressant effect. Because it stimulates the release of dopamine, patients with depression often reduce the adverse effects of stress stimulation by smoking (or e-cigarette). Depressed smokers reported mood improvement, while non depressed smokers did not experience this improvement after smoking a cigarette.

Several studies have produced the same antidepressant effects in rodents, while other experiments have shown that nicotine can enhance the beneficial effects of some antidepressants. The truth initiative seems to recognize that mental illness often leads to nicotine use when patients seek symptom relief, and points out that its survey shows that many young people use feelings of stress, anxiety or depression as the reason why they start and continue to smoke e-cigarettes.

Ti attempts to argue by pointing out nicotine withdrawal symptoms, which can reflect the impact of depression. "The common misconception that nicotine can relieve stress, anxiety and depression may stem from the nicotine withdrawal cycle," the organization's report said. But this is different from causing or aggravating depression in patients.

Crucially, there is some evidence that e-cigarettes actually reduce nicotine dependence by minimizing the peaks and valleys of nicotine in smokers' blood. If this is the case, e-cigarettes may help reduce withdrawal symptoms usually associated with quitting smoking.

Of course, if e-cigarettes can lead to depression, any smoking cessation treatment containing nicotine can also lead to depression, including FDA approved patches and anti tobacco organization approved chewing gum. More importantly, most teenagers don't smoke e-cigarettes. In most cases, a few smokers are already smokers. Therefore, regulations restricting the use of steam products by adults do not help to reduce nicotine use by adolescents.

Long term nicotine intake may alter brain receptors that cause depression, but this is not very useful for arguments against e-cigarettes. We still need to know why depressed people are looking for e-cigarettes first. Do they have a genetic predisposition to nicotine dependence and depression? Do they develop the habit of smoking when they are socializing, which leads to nicotine addiction? These are just some possibilities that researchers are studying.

The bigger problem is that depression, like many other diseases, may have multiple mutually reinforcing causes. "Your genetic makeup will affect your sensitivity to stressful life events," Harvard Medical School pointed out. "When genetic, biological and life stress is high, it will lead to depression." how these different factors lead to disease varies from patient to patient, we still don't know much.

What we know is that although researchers are investigating the depressive effects of childhood sexual abuse and early loss of parents, the truth initiative is running a carefully crafted video, calling e-cigarettes depression sticks, and playing fake e-cigarettes in the video. Company executives are trying to honestly promote his products to convenience stores.

"Nicotine can exacerbate depression and anxiety," he told the cashier, "so I want to sell some depression!"

Is this the work of a group that really cares about mental illness? I doubt it.

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