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Smoking prevalence in this group has remained largely unchanged, highlighting a major public health concern. This protocol outlines a trial aimed at addressing this issue by evaluating the effectiveness of offering an electronic cigarette (e\u2010cigarette) starter kit for smoking cessation and harm reduction as an adjunct to usual care to adults who smoke with mental illness treated in the community.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Two\u2010arm parallel randomized controlled superiority trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A minimum of eleven UK National Health Service mental health Trusts or general practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Adults who smoke with a diagnosis of mental illness treated in the community.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention and comparator<\/jats:title><jats:p>Participants will be randomly allocated (1\u00a0:\u00a01) to receive: (i) an e\u2010cigarette starter kit, a brief demonstration and both verbal and written information on e\u2010cigarette use as an adjunct to usual care; or (ii) usual care alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The primary outcome is 7\u2010day point prevalence carbon monoxide\u2010validated abstinence, assessed six months after study enrolment or target quit date. Secondary outcomes include: 6\u2010month continuous abstinence defined by Russell Standard, self\u2010reported smoking abstinence at 1\u2009month, \u226550% smoking reduction (cigarettes\/day) at 1 and 6\u2009months, mental health symptoms and general mood and physical symptoms at 1 and 6\u2009months, cost\u2010effectiveness of the intervention and adherence to and satisfaction with the intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Comments<\/jats:title><jats:p>This will be the first large\u2010scale study in the UK to assess the effectiveness and cost\u2010effectiveness of providing an e\u2010cigarette starter kit for smoking cessation and harm reduction in people with mental illness. Results will inform policy and practice related to supporting smoking cessation for this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.70115","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T07:34:59Z","timestamp":1751355299000},"page":"2335-2347","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Offering e\u2010cigarettes for smoking cessation and reduction in people with mental illness (ESCAPE): Protocol for a randomized controlled trial"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8845-7114","authenticated-orcid":false,"given":"Dimitra","family":"Kale","sequence":"first","affiliation":[{"name":"Department of Behavioural Science and Health University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8586-1261","authenticated-orcid":false,"given":"Emma","family":"Beard","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of York  York UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodi","family":"Pervin","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of York  York UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8281-7799","authenticated-orcid":false,"given":"Qi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of York  York UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Arundel","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of York  York UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve","family":"Parrott","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of York  York UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Galdas","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of York  York UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Horspool","sequence":"additional","affiliation":[{"name":"Sheffield Health and Social Care NHS Foundation Trust  Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Hough","sequence":"additional","affiliation":[{"name":"Representative of Patient and Public Involvement Group"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregor","family":"Russell","sequence":"additional","affiliation":[{"name":"Bradford District Care NHS Foundation Trust  Bradford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4766-3971","authenticated-orcid":false,"given":"Suzy","family":"Ker","sequence":"additional","affiliation":[{"name":"Tees, Esk and Wear Valleys NHS Foundation Trust  Darlington UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Ratschen","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of York  York UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4033-442X","authenticated-orcid":false,"given":"Lion","family":"Shahab","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Smoking\u2010related ill health and mortality","author":"Office for National Statistics","year":"2020"},{"key":"e_1_2_10_3_1","unstructured":"Physicians RCo andPsychiatrists RCo.Smoking and mental health. 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