A&E Trial Success

Lead author Professor Caitlin Notley, of UEA’s Norwich Medical School, said: “Hospital emergency departments provide an excellent opportunity to help people quit smoking, but there might be concerns about whether it's the right place for such interventions. 

“We discovered that most people enrolled in our trial found it beneficial to receive brief help to quit smoking while in A&E. Many knew they probably had a long time until they would be seen and were amenable to speak to stop smoking staff while they waited. 

“Our research suggests that A&E departments are an opportune location to support smoking cessation to improve long-term health.”

Researchers conducted interviews with both patients and staff in six hospitals involved in the trial, and also observed what happened in the emergency department to understand the context. 

In interviews with 34 patients, most found it acceptable to receive brief help to quit smoking while in A&E. 

Dr Ian Pope, an emergency physician and co-lead of the study, said: “Several factors influenced how well this worked. On a personal level, patients’ attitudes and the staff's ability to adjust the approach based on individual needs were important. 

“For example, providing vape starter kits from a trusted source made vaping feel like a legitimate alternative, boosting patients' confidence to quit smoking.  On a broader level, hospital policies that supported vaping made the program more credible and acceptable.” 

One female participant told researchers: “I was really unsure about the vape until I was in hospital. When they suggested it, I thought great, maybe it’s not as bad as everyone was suggesting it was. If someone in hospital is offering to put you on that, it’s got to be better than smoking.” 

Another male participant said: “In A&E, I was stuck there so, I was there for a couple of hours as it was so, it probably increased my likelihood to actually enrol.” 

Smoking cessation staff said many participants saw it as a way to pass the time, and some patients even said it was a welcome distraction from the discomfort or pain they were experiencing while they waiting to be seen. 

The researchers found that the staff (11 stop smoking advisors) had to be flexible in how they delivered the program, depending on the space and urgency of the emergency department. 

Previous research linked to the wider trial found that of the people who were given free e-cigarette starter packs in A&E, almost one in four (23.4pc) reported to have quit smoking at a six-month follow up. 

This was compared to 12.9pc of the people who were given ‘usual care’ - written information about locally available stop smoking services.   

And another analysis of the data produced in the trial found that experimenting with commercially available vapes may be important for some people’s success in giving up smoking. 

The study was led by the University of East Anglia, sponsored by the Norfolk and Norwich University Hospitals NHS Foundation Trust, and carried out in collaboration with the Norwich Clinical Trials Unit at UEA, the Universities of York, Leicester, Edinburgh and Exeter, as well as six NHS hospitals from across England and Scotland. 

‘The context of the Emergency department as a location for a smoking cessation intervention – process evaluation findings from the COSTED trial’ is published in Nicotine and Tobacco Research.   

As the research was a time limited trial, people who smoke are reminded that A&E departments are not currently handing out free vapes. The research findings suggest that this could be an important approach to supporting people to stop smoking in the future.

References:

• Predictors of Successful Tobacco Cessation After Receiving an E-Cigarette Based Smoking Cessation Intervention, Pope, Clark, Clark, Ward, Stirling, Belderson, and Notley - https://pubmed.ncbi.nlm.nih.gov/39494129/

Photo Credit:

• Photo by Ian Taylor on Unsplash

Dave Cross

Journalist at POTV

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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous start-ups to develop content for their websites.