The association between need frustration and subjective well-being among Chinese vocational college students in physical education contexts: a moderated mediation model.

The relationship between e-cigarettes (vaping) and schizophrenia has garnered increasing attention in recent years, particularly as vaping becomes more prevalent among individuals with psychiatric conditions. Among individuals diagnosed with schizophrenia spectrum disorders, the risk of mortality due to smoking-related illnesses is significantly higher compared to non-smokers (, ). Smoking is a leading cause of premature mortality in this population, contributing to tobacco-related cancers, respiratory diseases, and cardiovascular conditions. In addition, smoking in individuals with schizophrenia spectrum disorders (SSD) is linked to depressive symptoms, increased hospitalizations, heightened stress levels, poor treatment outcomes, reduced quality of life, and exacerbation of psychotic symptoms (). Despite a decline in smoking prevalence in the general population of developed countries, individuals with SSD continue to smoke at markedly higher rates, estimated at two to four times those without psychiatric disorders (, ). They also exhibit greater nicotine dependence (). Possible explanations include self-medication hypotheses, whereby nicotine transiently improves cognitive function, as well as a complex interplay of illness-related symptoms, patient characteristics, and systemic healthcare barriers (). While genetic factors have been implicated in both nicotine addiction and schizophrenia progression, psychosocial determinants such as unemployment, social isolation, and the use of smoking to manage stress, boredom, and self-esteem appear equally important (–). Attitudes toward smoking cessation within this population present additional challenges. Smoking remains socially accepted within the SSD community, and patients are less likely to be advised to quit by healthcare providers (, –). Additionally, many clinicians remain concerned that stopping smoking could worsen psychiatric outcomes or deprive patients of one of their few perceived pleasures (). Together, these systemic and provider-related barriers help explain persistently high smoking rates.