People with mental illness to be offered vaping ‘starter kits’ in £1 million clinical trial

People with mental illness will be invited to quit smoking with the help of vaping products and advice in a new £1 million clinical trial funded by Yorkshire Cancer Research.

Led by Elena Ratschen, Associate Professor in Health Sciences at the University of York and Lion Shahab, Professor in Health Psychology at University College London, the research will test whether offering a vaping starter kit to patients who smoke as part of their routine care can help increase the number who quit successfully.

Although smoking rates are declining in the UK, no change has been seen in people with mental illness¹. The proportion of people with mental illness who smoke is extremely high compared with the general population.

In Yorkshire, 15.4% of the population are smokers, but in people with common mental health conditions, such as anxiety and depression, the rate is 27.3%. In people with serious mental illnesses, the rate can reach 42%².

According to Public Health England, vaping products are significantly less harmful than smoking. They have become the most popular stop smoking aid in England, with up to 57,000 people using them to quit smoking each year³.

Dr Ratschen said: “Until very recently, smoking has remained deeply embedded within the culture of mental health care and treatment settings, where it was commonly accepted as a coping mechanism for patients. We now know that smoking worsens mental illness symptoms and may even be linked to its development.

“There is an urgent need to address smoking-related inequalities in mental health. People with mental illness lose up to 20 years of life expectancy, mainly to consequences of smoking and often cancer.

“People with mental illness are just as motivated to quit as those without. However, giving up smoking can be difficult because of limited access to support and high dependence. Contact with health professionals presents a ‘teachable moment’ with opportunities to address smoking.”

Professor Shahab added: “There is growing evidence that e-cigarettes can help smokers kick the habit of a lifetime and that these devices may be particularly helpful for smokers with common mental health conditions.”

Around 740 people in Yorkshire who are currently receiving outpatient treatment for mental illness will be recruited to take part in the four-year trial. As well as receiving standard stop smoking support, they will be offered a starter kit including a vaping device and e-liquid.

If the trial is successful, the initiative could be adopted by mental health trusts in Yorkshire and across the country.

Dr Ratschen continued: “There is an emerging track record for the delivery of internationally relevant research into innovative approaches to tackling the epidemic of smoking and smoking-related harms in Yorkshire mental health services.

“This study will enable Yorkshire people who smoke and use mental health services to participate in a world-leading research programme, allowing them to benefit from effective stop smoking strategies.”


1. Szatkowsk L, McNeill A. Diverging trends in smoking behaviours according to mental health status. Nicotine & Tobacco Research 2015; 3: 356-60

2. Public Health England (2020). Local Tobacco Control Profiles. Available from:

3. Evidence review of e-cigarettes and heated tobacco products 2018