Not listed HARM REDUCTION FOR SMOKERS WITH MENTAL ILLNESS: RCT OF E-CIGARETTE PROVISION WITH OR WITHOUT BEHAVIORAL SUPPORT TO BOOST SWITCHING - PROJECT SUMMARY/ABSTRACT AMONG THE 51.5 MILLION US ADULTS WITH MENTAL ILLNESS (MI), OVER 18 MILLION SMOKE CIGARETTES, 7-9,50-52 LEADING TO HIGH MORBIDITY60-62 AND DRAMATIC EARLY MORTALITY.12-14 SMOKERS WITH MI ARE LESS LIKELY TO QUIT AND/OR SUSTAIN ABSTINENCE THAN SMOKERS WITHOUT MI,17-21 DUE IN PART TO LOWER SELF-EFFICACY65 AND MORE USE OF SMOKING TO COPE WITH STRESS.67-69 LOWER LEVELS OF READINESS TO PURSUE SMOKING CESSATION TREATMENTS,64,66 MOST OF WHICH REQUIRE A DESIRE FOR COMPLETE ABSTINENCE, LEAVES MOST SMOKERS WITH MI CONTINUING TO SMOKE, CREATING AN URGENT NEED TO DEVELOP NEW WAYS TO DECREASE THE HARMS FROM CIGARETTES. TOBACCO HARM REDUCTION IS NOT CLEARLY DEFINED, BUT IT INVOLVES A VALUE-NEUTRAL VIEW OF SMOKING, FOCUSED ON DECREASING THE HARMS FROM TOBACCO USE, NEITHER OBJECTING TO NOR INSISTING ON ABSTINENCE AS THE ONLY GOAL.71 E-CIGARETTES (E-CIGS) DELIVER MUCH LOWER LEVELS OF CARCINOGENS THAN CIGARETTES;72,73 THUS, SUPPORT FOR REPLACEMENT OF MOST OR ALL CIGARETTES WITH E-CIGS ("SWITCHING") MAY BE AN EFFECTIVE HARM REDUCTION STRATEGY FOR SMOKERS WITH MI. THREE PILOT STUDIES FOUND THAT PROVIDING E-CIGS TO SMOKERS WITH MI SIGNIFICANTLY REDUCED USE OF CIGARETTES (UP TO 65%),34-36 AND 10-14.3% OF SMOKERS REPLACED THEIR CIGARETTES WITH E-CIGS.34,35 IN THE ONLY RCT COMPARING E-CIG PROVISION TO SMOKING-AS-USUAL IN SMOKERS WITH MI (R01DA041416), WE FOUND THAT 18.6% OF THE E-CIG GROUP SWITCHED TO E-CIGS, 46% REDUCED TO 5 CIGS/DAY, AND NNAL, A POTENT CARCINOGEN, WAS SIGNIFICANTLY REDUCED.3 BUT, MANY SMOKERS DID NOT ACHIEVE HARM REDUCTION WITH E-CIG PROVISION ALONE. FEEDBACK FROM PARTICIPANTS INDICATED THAT A KEY BARRIER TO GIVING UP CIGARETTES WAS THE HABITUAL USE OF CIGARETTES WHEN UNDER STRESS. THIS STUDY RESPONDS TO PAR-22-182'S CALL FOR "RESEARCH ON TOBACCO HARM REDUCTION STRATEGIES SUCH AS SWITCHING FROM COMBUSTIBLES TO E-CIGARETTES." WE DEVELOPED AND PILOTED "SWITCH IT," CONSISTING OF BEHAVIORAL SUPPORT TO BOOST E-CIG USE AND MANAGE STRESS, FOR SMOKERS WITH MI WHO ARE NOT READY TO QUIT. SWITCH IT WAS DELIVERED TO 50 SMOKERS WITH MI VIA 10 VIDEO CALLS. ATTENDANCE WAS 90.3%, INDICATING HIGH APPEAL OF BEHAVIORAL SUPPORT. TWICE AS MANY SMOKERS (38% VS. 19%) SWITCHED TO E-CIGS (CONFIRMED BY BREATH CO $660.5k 3/20/26 Not listed HARM REDUCTION FOR SMOKERS WITH MENTAL ILLNESS: RCT OF E-CIGARETTE PROVISION WITH OR WITHOUT BEHAVIORAL SUPPORT TO BOOST SWITCHING - PROJECT SUMMARY/ABSTRACT AMONG THE 51.5 MILLION US ADULTS WITH MENTAL ILLNESS (MI), OVER 18 MILLION SMOKE CIGARETTES, 7-9,50-52 LEADING TO HIGH MORBIDITY60-62 AND DRAMATIC EARLY MORTALITY.12-14 SMOKERS WITH MI ARE LESS LIKELY TO QUIT AND/OR SUSTAIN ABSTINENCE THAN SMOKERS WITHOUT MI,17-21 DUE IN PART TO LOWER SELF-EFFICACY65 AND MORE USE OF SMOKING TO COPE WITH STRESS.67-69 LOWER LEVELS OF READINESS TO PURSUE SMOKING CESSATION TREATMENTS,64,66 MOST OF WHICH REQUIRE A DESIRE FOR COMPLETE ABSTINENCE, LEAVES MOST SMOKERS WITH MI CONTINUING TO SMOKE, CREATING AN URGENT NEED TO DEVELOP NEW WAYS TO DECREASE THE HARMS FROM CIGARETTES. TOBACCO HARM REDUCTION IS NOT CLEARLY DEFINED, BUT IT INVOLVES A VALUE-NEUTRAL VIEW OF SMOKING, FOCUSED ON DECREASING THE HARMS FROM TOBACCO USE, NEITHER OBJECTING TO NOR INSISTING ON ABSTINENCE AS THE ONLY GOAL.71 E-CIGARETTES (E-CIGS) DELIVER MUCH LOWER LEVELS OF CARCINOGENS THAN CIGARETTES;72,73 THUS, SUPPORT FOR REPLACEMENT OF MOST OR ALL CIGARETTES WITH E-CIGS ("SWITCHING") MAY BE AN EFFECTIVE HARM REDUCTION STRATEGY FOR SMOKERS WITH MI. THREE PILOT STUDIES FOUND THAT PROVIDING E-CIGS TO SMOKERS WITH MI SIGNIFICANTLY REDUCED USE OF CIGARETTES (UP TO 65%),34-36 AND 10-14.3% OF SMOKERS REPLACED THEIR CIGARETTES WITH E-CIGS.34,35 IN THE ONLY RCT COMPARING E-CIG PROVISION TO SMOKING-AS-USUAL IN SMOKERS WITH MI (R01DA041416), WE FOUND THAT 18.6% OF THE E-CIG GROUP SWITCHED TO E-CIGS, 46% REDUCED TO 5 CIGS/DAY, AND NNAL, A POTENT CARCINOGEN, WAS SIGNIFICANTLY REDUCED.3 BUT, MANY SMOKERS DID NOT ACHIEVE HARM REDUCTION WITH E-CIG PROVISION ALONE. FEEDBACK FROM PARTICIPANTS INDICATED THAT A KEY BARRIER TO GIVING UP CIGARETTES WAS THE HABITUAL USE OF CIGARETTES WHEN UNDER STRESS. THIS STUDY RESPONDS TO PAR-22-182'S CALL FOR "RESEARCH ON TOBACCO HARM REDUCTION STRATEGIES SUCH AS SWITCHING FROM COMBUSTIBLES TO E-CIGARETTES." WE DEVELOPED AND PILOTED "SWITCH IT," CONSISTING OF BEHAVIORAL SUPPORT TO BOOST E-CIG USE AND MANAGE STRESS, FOR SMOKERS WITH MI WHO ARE NOT READY TO QUIT. SWITCH IT WAS DELIVERED TO 50 SMOKERS WITH MI VIA 10 VIDEO CALLS. ATTENDANCE WAS 90.3%, INDICATING HIGH APPEAL OF BEHAVIORAL SUPPORT. TWICE AS MANY SMOKERS (38% VS. 19%) SWITCHED TO E-CIGS (CONFIRMED BY BREATH CO $672.9k 4/22/25 Not listed HARM REDUCTION FOR SMOKERS WITH MENTAL ILLNESS: RCT OF E-CIGARETTE PROVISION WITH OR WITHOUT BEHAVIORAL SUPPORT TO BOOST SWITCHING - PROJECT SUMMARY/ABSTRACT AMONG THE 51.5 MILLION US ADULTS WITH MENTAL ILLNESS (MI), OVER 18 MILLION SMOKE CIGARETTES, 7-9,50-52 LEADING TO HIGH MORBIDITY60-62 AND DRAMATIC EARLY MORTALITY.12-14 SMOKERS WITH MI ARE LESS LIKELY TO QUIT AND/OR SUSTAIN ABSTINENCE THAN SMOKERS WITHOUT MI,17-21 DUE IN PART TO LOWER SELF-EFFICACY65 AND MORE USE OF SMOKING TO COPE WITH STRESS.67-69 LOWER LEVELS OF READINESS TO PURSUE SMOKING CESSATION TREATMENTS,64,66 MOST OF WHICH REQUIRE A DESIRE FOR COMPLETE ABSTINENCE, LEAVES MOST SMOKERS WITH MI CONTINUING TO SMOKE, CREATING AN URGENT NEED TO DEVELOP NEW WAYS TO DECREASE THE HARMS FROM CIGARETTES. TOBACCO HARM REDUCTION IS NOT CLEARLY DEFINED, BUT IT INVOLVES A VALUE-NEUTRAL VIEW OF SMOKING, FOCUSED ON DECREASING THE HARMS FROM TOBACCO USE, NEITHER OBJECTING TO NOR INSISTING ON ABSTINENCE AS THE ONLY GOAL.71 E-CIGARETTES (E-CIGS) DELIVER MUCH LOWER LEVELS OF CARCINOGENS THAN CIGARETTES;72,73 THUS, SUPPORT FOR REPLACEMENT OF MOST OR ALL CIGARETTES WITH E-CIGS ("SWITCHING") MAY BE AN EFFECTIVE HARM REDUCTION STRATEGY FOR SMOKERS WITH MI. THREE PILOT STUDIES FOUND THAT PROVIDING E-CIGS TO SMOKERS WITH MI SIGNIFICANTLY REDUCED USE OF CIGARETTES (UP TO 65%),34-36 AND 10-14.3% OF SMOKERS REPLACED THEIR CIGARETTES WITH E-CIGS.34,35 IN THE ONLY RCT COMPARING E-CIG PROVISION TO SMOKING-AS-USUAL IN SMOKERS WITH MI (R01DA041416), WE FOUND THAT 18.6% OF THE E-CIG GROUP SWITCHED TO E-CIGS, 46% REDUCED TO 5 CIGS/DAY, AND NNAL, A POTENT CARCINOGEN, WAS SIGNIFICANTLY REDUCED.3 BUT, MANY SMOKERS DID NOT ACHIEVE HARM REDUCTION WITH E-CIG PROVISION ALONE. FEEDBACK FROM PARTICIPANTS INDICATED THAT A KEY BARRIER TO GIVING UP CIGARETTES WAS THE HABITUAL USE OF CIGARETTES WHEN UNDER STRESS. THIS STUDY RESPONDS TO PAR-22-182'S CALL FOR "RESEARCH ON TOBACCO HARM REDUCTION STRATEGIES SUCH AS SWITCHING FROM COMBUSTIBLES TO E-CIGARETTES." WE DEVELOPED AND PILOTED "SWITCH IT," CONSISTING OF BEHAVIORAL SUPPORT TO BOOST E-CIG USE AND MANAGE STRESS, FOR SMOKERS WITH MI WHO ARE NOT READY TO QUIT. SWITCH IT WAS DELIVERED TO 50 SMOKERS WITH MI VIA 10 VIDEO CALLS. ATTENDANCE WAS 90.3%, INDICATING HIGH APPEAL OF BEHAVIORAL SUPPORT. TWICE AS MANY SMOKERS (38% VS. 19%) SWITCHED TO E-CIGS (CONFIRMED BY BREATH CO $740.5k 5/10/24 Not listed HARM REDUCTION FOR SMOKERS WITH MENTAL ILLNESS: RCT OF E-CIGARETTE PROVISION WITH OR WITHOUT BEHAVIORAL SUPPORT TO BOOST SWITCHING - PROJECT SUMMARY/ABSTRACT AMONG THE 51.5 MILLION US ADULTS WITH MENTAL ILLNESS (MI), OVER 18 MILLION SMOKE CIGARETTES, 7-9,50-52 LEADING TO HIGH MORBIDITY60-62 AND DRAMATIC EARLY MORTALITY.12-14 SMOKERS WITH MI ARE LESS LIKELY TO QUIT AND/OR SUSTAIN ABSTINENCE THAN SMOKERS WITHOUT MI,17-21 DUE IN PART TO LOWER SELF-EFFICACY65 AND MORE USE OF SMOKING TO COPE WITH STRESS.67-69 LOWER LEVELS OF READINESS TO PURSUE SMOKING CESSATION TREATMENTS,64,66 MOST OF WHICH REQUIRE A DESIRE FOR COMPLETE ABSTINENCE, LEAVES MOST SMOKERS WITH MI CONTINUING TO SMOKE, CREATING AN URGENT NEED TO DEVELOP NEW WAYS TO DECREASE THE HARMS FROM CIGARETTES. TOBACCO HARM REDUCTION IS NOT CLEARLY DEFINED, BUT IT INVOLVES A VALUE-NEUTRAL VIEW OF SMOKING, FOCUSED ON DECREASING THE HARMS FROM TOBACCO USE, NEITHER OBJECTING TO NOR INSISTING ON ABSTINENCE AS THE ONLY GOAL.71 E-CIGARETTES (E-CIGS) DELIVER MUCH LOWER LEVELS OF CARCINOGENS THAN CIGARETTES;72,73 THUS, SUPPORT FOR REPLACEMENT OF MOST OR ALL CIGARETTES WITH E-CIGS ("SWITCHING") MAY BE AN EFFECTIVE HARM REDUCTION STRATEGY FOR SMOKERS WITH MI. THREE PILOT STUDIES FOUND THAT PROVIDING E-CIGS TO SMOKERS WITH MI SIGNIFICANTLY REDUCED USE OF CIGARETTES (UP TO 65%),34-36 AND 10-14.3% OF SMOKERS REPLACED THEIR CIGARETTES WITH E-CIGS.34,35 IN THE ONLY RCT COMPARING E-CIG PROVISION TO SMOKING-AS-USUAL IN SMOKERS WITH MI (R01DA041416), WE FOUND THAT 18.6% OF THE E-CIG GROUP SWITCHED TO E-CIGS, 46% REDUCED TO 5 CIGS/DAY, AND NNAL, A POTENT CARCINOGEN, WAS SIGNIFICANTLY REDUCED.3 BUT, MANY SMOKERS DID NOT ACHIEVE HARM REDUCTION WITH E-CIG PROVISION ALONE. FEEDBACK FROM PARTICIPANTS INDICATED THAT A KEY BARRIER TO GIVING UP CIGARETTES WAS THE HABITUAL USE OF CIGARETTES WHEN UNDER STRESS. THIS STUDY RESPONDS TO PAR-22-182'S CALL FOR "RESEARCH ON TOBACCO HARM REDUCTION STRATEGIES SUCH AS SWITCHING FROM COMBUSTIBLES TO E-CIGARETTES." WE DEVELOPED AND PILOTED "SWITCH IT," CONSISTING OF BEHAVIORAL SUPPORT TO BOOST E-CIG USE AND MANAGE STRESS, FOR SMOKERS WITH MI WHO ARE NOT READY TO QUIT. SWITCH IT WAS DELIVERED TO 50 SMOKERS WITH MI VIA 10 VIDEO CALLS. ATTENDANCE WAS 90.3%, INDICATING HIGH APPEAL OF BEHAVIORAL SUPPORT. TWICE AS MANY SMOKERS (38% VS. 19%) SWITCHED TO E-CIGS (CONFIRMED BY BREATH CO $740.5k 5/10/24