Last update:
   13-Jan-2026
 

Arch Hellen Med, 43(2), March-April 2026, 205-211

ORIGINAL PAPER

Smoking cessation for people with severe mental illness
A pilot, randomized controlled trial

G. Papadosifaki,1,2 V. Psarra,3 A. Andreopoulou,2 C. Touloumis,2 C. Tzavara,1 E. Sakellari,1 A. Barbouni,1 K. Farsalinos
 1Department of Public and Community Health, School of Public Health, University of West Attica, Athens
2Psychiatric Hospital of Attica, Haidari, Attica
3Psychiatrist in Private Practice, Athens, Greece

OBJECTIVE To examine the feasibility and acceptability of an intervention for tobacco harm reduction among smokers with severe mental illness (SMI).

METHOD Α pilot randomized controlled trial was conducted involving SMI smokers (n=43). With a simple randomization procedure (1:1 ratio), participants were assigned to the intervention (behavioral support and e-cigarette use, n=21) or control group (behavioral support only, n=22). The primary outcome was self-reported smoking cessation, biochemically validated by ≤6 ppm levels of expired carbon monoxide (eCO) at 6 months. The secondary outcome measures included potential changes in nicotine dependence, physical and mental health, and quality of life (QoL).

RESULTS At six months, nicotine dependence fell significantly in both groups, as compared to baseline. In this period, the intervention group's cessation rate was remarkably higher (33.3%) than that of the control group (13.6%). In addition, the intervention group's general health and QoL significantly improved overall.

CONCLUSIONS Following a personalized smoking cessation program, SMI smokers can acquire the skills necessary to manage nicotine addiction, quit smoking or reduce smoking-related harm.

Key words: e-cigarette, Harm reduction, Severe mental illness, Smoking, Smoking cessation.

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