Introduction
Smoking prevalence among individuals with serious mental illness (SMI) remains substantially higher than in the general population, accompanied by notably lower quit rates. This disparity contributes to an elevated burden of carcinogenic exposure, chronic disease incidence, and premature mortality in this vulnerable group. Traditional cessation methods have limited success, highlighting the urgent need to explore innovative harm reduction strategies. Electronic nicotine delivery systems (ENDS), such as disposable e-cigarettes, present a promising alternative by potentially reducing exposure to tobacco-related carcinogens. The present randomized controlled trial (RCT) investigates the impact of ENDS provision on carcinogen exposure, assessed via the tobacco-specific nitrosamine metabolite NNAL, among smokers with SMI who are currently unwilling to quit.
