Vaping and Mental Illness: Is there Hope?

The mentally ill are overlooked, dismissed, and stigmatized by society. Public stigma is so intense that many people suffering from mental health issues hesitate to get the help they need. Mentally ill people have harder times holding down jobs and managing adult responsibility. An astounding number of of these folks end up in prison, psych wards, or on the streets. They also happen to be much more likely to smoke. This contributes to the fact that they are expected to live one to three decades shorter than people without mental illness.


20150819074500 A mind-blowing percentage of mentally ill people smoke cigarettes. While 17.8% of the US population smokes, 41% of mentally ill people smoke. According to the Substance Abuse and Mental Health Services Administration, mentally ill people smoke one-third of all cigarettes. According to the National Alliance on Mental Illness (NAMI), these mental illnesses have the following rates for smoking cigarettes: Panic Disorder: 56% PTSD: 60% Depression: 60% Bipolar Disorder: 70% Schizophrenia: 90% You might do a double-take reading these statistics. Rates these high cannot be a coincidence. It begs the question: what makes the mentally ill so prone to cigarette addiction?


Nicotine influences brain chemistry.

Nicotine influences brain chemistry.

Compulsive behavior for rewarding stimuli, despite adverse effects, is known as addiction. Emotional stress is a common trigger for compulsive behavior. In the case of mental illness, emotional stress is often working overtime. For example, somebody with Generalized Anxiety Disorder (GAD) can be in a constant state of anxiety, without any negative stimuli; their fight-or-flight reaction is constantly misfiring. Somebody with this level of anxiety is much more likely to give in to compulsion. New research suggests that cigarettes have antidepressant qualities. Among the thousands of chemicals found in a combusted cigarette, monoamine oxidase inhibitors (MAOI) have been detected. Monoamine oxidase is involved in removing the neurotransmitters norepinephrine, serotonin, and dopamine from the brain. MAOI’s stop the monoamine oxidase from extracting these neurotransmitters. For these reasons, MAOI’s were used as one of the first antidepressants in the early days of psychiatric medication as we know it. Since then, MAOI’s are only used as a last resort, because of their debilitating side-effects and withdrawal symptoms. MAOI side effects include: nausea, diarrhea, headache, drowsiness, insomnia, skin reactions, dizziness, muscle spasms, inorgasmia, stunted sex drive, weight gain, muscle aches, and increased suicide risk. MAOI withdrawal symptoms include: agitation, irritability, pressured speech, insomnia, nightmares, hallucinations, disorientation, paranoia, aggressiveness, catatonia, and electric shock feelings. In essence, when you try to quit smoking, not only are you withdrawing from nicotine alone. Along with the additives, tar, and carcinogens, you are withdrawing from a dangerous, outdated antidepressant. You can imagine that quitting smoking could be nearly impossible if you suffer from anxiety or depression, as withdrawal from antidepressants alone is agony. Though bipolar disorder and schizophrenia are not fully understood, research suggests dopamine, norepinephrine, and serotonin are crucially involved in psychotic, catatonic, and mood disorder symptoms. Since cigarettes alter the levels of these neurotransmitters, the high rates of smoking in bipolar and schizophrenic patients is understandable.


"In 1986 I was relieved of my position as an addiction counselor with a state program due to my insistence that smoking should not be allowed. At that time, this was an unheard-of notion.”

“In 1986 I was relieved of my position as an addiction counselor with a state program due to my insistence that smoking should not be allowed. At that time, this was an unheard-of notion.”

Psych wards offer an interesting glimpse into the world of smoking and mental health. Families and psychiatric staff passionately defend a psychiatric patient’s right to smoke, for the alleviation of symptoms. Dr. Dale Archer of The Institute for Neuropsychiatry states, “I was and remain amazed at the fervent arguments that doctors (and other mental health care workers) would give in favor of smoking for psych patients. These professionals – not the patients – were the ones that fought the hardest to allow smoking.” Whatever the reason, cigarettes alleviate psychotic symptoms in schizophrenics and manic bipolar patients. This has lead to an unfortunate and widespread practice in the psychiatric world: incentivizing cigarettes. To control a struggling psychiatric patient, medical professionals will often use cigarettes for both positive and negative reinforcement. If a patient is non-compliant, you can take away their smoke break. If they are cooperating, you can give them extra cigarettes. Imagine the stress of losing your mind, being locked up, dosed with mind-altering substances, and the one solace of cigarettes being taken away. Absolutely hellish. Smoking has been proven to shorten lives. Cigarettes are administered by medical professionals. Something is seriously wrong when doctors and medical staff are poisoning their patients. There must be a better way.


Could vaping be a game-changer?

Could vaping be a game-changer?

In light of the accelerated death associated with mental illness (a huge percentage related to smoking-related illness), vaping should really be researched and considered for psychiatric purposes. Since nicotine alleviates psychotic and depressive symptoms, why not offer a smoking alternative to patients? Of course, research is of the utmost importance. This is not a policy that can be implemented overnight. But when you consider the fact that vaping has a minute fraction of the chemicals of a cigarette and that more and more public health organizations are coming out in favor of replacing cigarettes with vaping, it could be an incredibly promising alternative. In my view, vaping should be tested on depressives, PTSD sufferers, bipolar patients, and schizophrenics. If patients experience the same symptom relief from vaping as they do from smoking, the mentally ill just might live longer, healthier, happier lives.

Kenny Spotz

Kenny joined the Mt. Baker Vapor crew in November of 2014 because he was excited by the idea of working in such a cutting-edge industry. Beyond MBV, he's an avid musician, writer, and hiker.

  • Akanksha says:

    This is a test comment!

  • Elisabeth says:

    Wow! I never knew these statistics before having read this article. From my perspective, this makes perfect sense.

    While I rarely share this with people, it’s very important to share:
    I grew up struggling with General Anxiety Disorder and some Obsessive Compulsive behaviors. When I got into High School, my anxiety increased to uncontrollable levels. My anxiety eventually fueled my OCD with such uncontrollable force that I became depressed, often suicidal, with little to no impulse control, Panic Disorder developed, mood swings were uncontrollable and I found myself in a state of self torture due to the constant stress.
    I saw numerous doctors, who all struggle with diagnosing and treating a teenager, let alone one with so many factors. I spent a total of just under two months in psychiatric care units during my time in high school. I learned that a lot of the other teenagers who were there, were smokers. I didn’t understand why. (Psych-wards for minors don’t allow any smoking, they hand kids cinnamon sticks and shrug at them.)
    Eventually enough doctors had put their heads together to treat me with anti-depressants and anti-psychotics. I spent years, and still do, participating in counseling to learn to cope.
    When I was 17, I began smoking occasionally with friends (many of whom also had mental health struggles: those people are often drawn to one another because so few understand it) and I eventually became a smoker.
    Every time I would try to quit smoking, my anxiety levels would sky rocket and my depression would flare up. I had one failed attempt after another. All it would take to give in is having a panic attack. Which I rarely recognized as withdrawals despite having had my panic disorder under control for a number of years. I read about the mental comforts cigarettes provide to many with depression and anxiety, but never considered the severe effect it has to “just quit.”
    Finding vaping was like striking oil. I took my time to find out what would work for me. (Device, flavor preferences, PG/VG preferences and sources.) While I experimented, I reduced my cigarette use and began to replace it with my vaporizer. The day my little lighter died, was the last day I smoked. My first day without any cigarettes was anxiety ridden.
    To simply be without a pack in my purse was a withdrawal. I had separation anxiety- badly. The next morning that anxiety was gone. I’ve had the occasional craving for a real smoke (like when my mom had a brain tumor removed this spring), but anytime I’ve given in, I’m disgusted by the taste, the lingering stench and I get light headed after two drags. I would rather vape.
    How does this apply to this article? I recently began making changes to my anti-depressant medication combo I’d been on for nearly a decade. I saw a new psychiatrist for a fresh evaluation. I had let ten years pass without considering that I was no longer a teenager, and that the care I had been receiving was stagnant. I learned that, while I must be medicated to manage my anxiety, I was on drugs that had been making me feel awful and I could suffer through to change it.
    The withdrawals I’ve experienced include nausea, low blood pressure, dizziness, aches and pains all over, migraine, vomiting, fever, chills, etc. While these symptoms have been slowly eased by the replacement of an appropriate drug for my needs, I can’t imagine being forced to go without my nicotine.
    I had been reducing my nicotine steadily until these changes came up, at which point I knew I needed to stick with 6mg and not decrease any further. Some of the stress was so severe, I found a bottle that was still halfway filled with 12mg juice, and I made it a staple for my morning vape, and stressful situations.

    In short, I would be pissed off to be in a psych-ward, as an adult who has been free to make my own decisions, like to smoke, and have a doctor or nurse control and manipulate me with my cravings. For a lack of better words, it’s extremely F***** Up.

    What kind of society are we really creating when we allow that type of behavior from the medical professionals who are supposed be helping their patients to feel at ease, safe, comfortable, and empowered by their own decisions. The task of these medical “professionals” is not to use the pain of their mentally ill patients to their advantage. Knowing that doctors would tobacco use to their advantage with mentally ill patients (who I know first hand can be nearly impossible to work with) causes a fire to burn inside me.

    I would love to see vaping or e-cigs available to these patients. I would love to see people actually pull their heads out of their asses and consider the positive opportunities for people that the vaping movement has to offer.

    This is a great article, full of great information. It not only inspires the positive aspect of allowing nicotine use for mentally ill patients, but makes you consider that vaping could be a better option to be offering them. It also has me preparing a number of letters to my representatives. I can’t sit in silence.

  • Kendell R. Rawls says:

    Anxiety and depression seem to go hand in hand with smoking. I have battled with both and a few others. The worse the symptoms on a givin day the more I would smoke. I have found so many people do not understand mental illness. Having lived it for decades I can relate to people with the same or similar problems. Vaping gives me a healthier way to get my nicotine and gives me something to look forward to. Even the maintenance needed on my e-cig gives me something to do to occupy my mind. If only for a little while. Kendell

    • Tim Mechling says:

      Thank you so much for contributing your story. Anxiety and depression are widespread and potentially debilitating. A healthy body is linked to a healthy mind, and whatever you can do to keep healthy with keep you happy!

  • tony says:

    good informative article

  • Crissy says:

    I really wish the medical study communities would offer a double blind study, vape juice chemicals on the brain rather than only nicotine statistics. I love to vape instead of smoking, it is totally enjoyable, I just don’t know what chemicals we are inhaling. They say the first three ingredients…Cool. What does the natural and ARTIFICIAL ingredients mean. A lot of juices come fro China, may be a good idea tom make sure they are made in the USA controlled by the USDA. Thanks for reading, Crissy

  • Deneve says:

    I have PTSD a panic disorder, generalized anxiety, depression, and OCD. The stress hurts so much I actually picked up a cigarette one day because what the hell?
    Then I realized what I was doing after a couple puffs and crunched it into the ground. Picked up a vape pen and on the panic days when it’s hard to breathe, they help and really do take my mind off things.

    • Josh Hanna says:

      My brother has this same problem. He was in Iraq for a year and has PTSD. He adds CBD oil in his e liquid which calms him down.

  • Etchie says:

    I’m bipolar and schizoaffective and my doctors never really brought up my smoking. My psychologist told my parents to let it go, that I might quit some day, but it was highly unlikely. I decided to try vaping and the day I started that, I never had a cigarette again. I don’t plan on quitting vaping though. There’s just no way I ever could. I never have a problem going a whole day vaping zero nic either. I’m usually vaping 6mg. I find it helps with my concentration. All my doctors were blown away. I never thought it could be done either. I’ve been vaping since December 23rd, 2012.

  • Michael says:

    Vaping will never replace smoking when it comes to relieving the agony of ward patients, the author himself acknowledged that cigarettes contain MAOIs, nicotine alone doesn’t do s*** & isn’t even addictive. this is why vaping flies out the window for some.

  • Confessions .. says:

    Confessions of a Vaping …
    It’s now January 2016 and I have been vaping and quit smoking for almost 3 years now. I have fallen back from time to time, into the smoking habit, but usually a pack and I am done for 8-9-10 months.

    I have noticed over the last several months, my paranoia, anxiety and PTSD and vastly increased, to the point, I have set up a appointment to see a mental health provider. I am still on a heavy dose of nicotine (25mg). I have also noticed that my blood sugar over the last 3 years, has climbed sky high, to over 10.1 and working my Doctor to help reduce my A1C.

    I cycle over 6000 miles a year watch my diet and the last thing left, that can be increasing my A1C elevated sugar level is my vape fluid. I have always purchased my fluid from the same place, same strength and trying to reduce the nicotine level, does not work, I just vape twice as much. Prior to vaping, I was a pack a day smoker, but with normal blood sugar.

    I guess if one thing does not kill me in the years to come, it will be blood sugar or one of the various other side effects of smoking cigarettes. I have also been reading that elevated blood sugar is one of the side effects of vaping. I can’t quit vaping, I have tried and I go into anxiety and depression.

  • Confessions .. says:

    Almost forgot. Since I have vaping for so long, that I fit into the field of anxiety, depression and PTED elevated feeling on all of those symptoms. I have begun to research the long term effects of vaping and have read several studies on Anxiety, depression possible changes to to the prefrontal cortex on in both lab rats and humans. More to follow…

  • VA Vaper says:

    Let me start off by saying this is an older thread, so there may be few who run across my comment, but I *found* this by asking if I was the only one with bipolar disorder to ever go into remission because I started vaping (to quit cigarettes).

    I’ve been vaping for four years this month… and I was declared “in remission” three years ago. I haven’t had either a manic OR a depressive episode of any note (a day here or there can be chalked up to the normal stresses of life, I’ve been told; it’s the three-plus days that I am to watch out for).


    But it is a reminder that those of us who might be suffering from a debilitating mental illness and who vape to keep checking in with that doctor and make sure that the drugs you are taking are the ones you actually need right now. I spent many, many years in CBT learning how to manage my stress triggers… and as a reward I allowed myself to experiment with lower and lower doses of mind-killing medications, until I was finally allowed, under doctor supervision, to go off them completely. So far, so good. Might change tomorrow, and I’ll go back on them immediately if told.

    Even still, I credit vaping (started at the max I could get, down to and sticking with 6% now) with no small part of my recovery. Stress management is all about feeling in control, no matter what life throws at you, and being able to take one step back from the edge instead of leaping over it. Vaping lets me do that.

  • Joanna Nicholson says:

    I have bipolar 2 disorder and I have been stable with hardly any severe bouts of hypomania or depression. With my new job, the health insurance offered is double the price if you test positive for nicotine or cotinine, it’s metabolite. So I quit my vape of 6mg for 10 days. By day 3, I was a blubbering mess crying and rapid cycling. I was barely able to concentrate at work, had debilitating irritation, aggravation which would cycle back to severe depression. I couldn’t remember anything and resorted to writing down everything I did to keep it together and recall what I’d done. One night on day 3 or 4, I went out for a run to try and calm down and literally sprinted for an hour straight. I was crying while running and a serious mess. I started to realize this is how my mania used to present. I got home and was crying on the floor of my bedroom. I wanted to die and I hadn’t felt like that since I got on the right meds in 2011. This rapid cycling continued for the next 7 days, until my blood test when I was pretty sure I’d test negative. Literally 15 min after the test I picked up my vape pen and almost instantly felt the misery lift and I am relaxing calmly by the pool right now. The nicotine had been out of my system and by the usual measure, I should have been feeling great, nicotine free. There HAS to be a positive connection between nicotine and bipolar disorder. I am back to my normal self and know 100% that it helps stabilize my mood. People should be studying this bc it was literally life saving.

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