Introduction:
The negative effects of smoking seem particularly pronounced and challenging among people with schizophrenia (Kelly et al, 2011). For example, Callaghan et al. (2014) found that tobacco-related conditions comprised approximately 53% (23,620/44,469) of total deaths in those with schizophrenia. This included an increased risk of tobacco-related deaths from cancer (standardised mortality ratio (SMR), 1.30, 95% CI 1.3–1.4), cardiovascular disease (SMR 2.46, 95% CI 2.41–2.50) and respiratory diseases (SMR 2.45, 95% CI 2.41–2.48) (Kelly et al., 2011) in these groups. The scientific evidence indicates that ECs are much less harmful than conventional cigarettes (Farsalinos, Polosa 2014; Nutt et al., 2016). To observe cigarette use behavior and harm reduction impact among a group of cigarette smokers with a schizophrenia spectrum disorder diagnosis who smoked tobacco cigarettes daily, did not intend to reduce or quit smoking, and were invited to use an electronic cigarette (e-cigarette).

Methods:
A prospective observational 3 month feasibility study including in-person study visits at weeks-4, 8, and 12 using convenience sampling. The participants were forty Caucasian smokers in out-patient treatment for schizophrenia spectrum disorders not motivated to quit smoking (≥20 cig die). Assessments included Blood Pressure (BP), Heart Rate (HR), Body Weight (BW), carbon monoxide in exhaled breath (eCO), e-cigarette use, Fagerstrom Test for Cigarettes Dependence (FTCD), Scale for the Assessment of Negative Symptoms of Schizophrenia (SANS), Scale for the Positive Symptoms of Schizophrenia (SAPS). The study has been conducted at the “Centro per Prevenzione e Cura del Tabagismo (CPCT) Università di Catania at the Policlinico Vittorio Emanuele”, Catania, Italy.

Results:
Declines in cigarettes per day (cpd) use and eCO, BP and HR levels were observed at each study visits. Conclusions: In smokers not intending to quit, the use of e-cigarettes, decreased cigarette consumption and elicited Blood Pressure (BP), Heart Rate (HR) and carbon monoxide in exhaled breath (eCO) improvements without causing significant side effects.

Funding:
Funding statement: No funding has been received to conduct this study.