Cessation of Smoking Trial in the Emergency Department
Research type
Research Study
Full title
Cessation of Smoking Trial in the Emergency Department
IRAS ID
263674
Contact name
Ian Pope
Contact email
Sponsor organisation
NNUH
Clinicaltrials.gov Identifier
Duration of Study in the UK
2 years, 5 months, 30 days
Research summary
Research Summary:
This trial will offer brief stop smoking advice and a ‘starter pack’ e-cigarette to patients attending hospital Emergency Departments (EDs), to support an attempt to quit smoking. The study will be run over 30 months in two parts. First, we will do a small study to understand whether it is practical to carry out a larger study. We will ask adult smokers who attend one of five EDs in England and Scotland whether they would agree to take part. Those who say yes, will be randomly assigned to one of two groups: 1) brief (approximately 15 minutes) stop smoking advice during their wait at the ED, with the offer of a ‘starter pack’ e-cigarette and referral to local stop smoking services (SSS), or 2) written information about locally available SSS. Both groups of patients will be asked if they are still smoking at 1, 3 and 6 months after they attended the ED. At 6 months, if patients in either group say they have quit smoking, this will be confirmed by checking the amount of carbon monoxide they breathe out using a breath test monitor. If we meet pre-determined criteria for continuing, we aim to recruit approximately 1,000 patients who are current smokers, from both studies combined. Once the studies have finished, the number of people who quit smoking in each group will be compared and we will work out how much it costs to advise people to quit smoking in the ED, including the cost of providing the e-cigarettes. We will ask some of those who took part how they felt about taking part and why they quit or did not quit smoking and ask the advisors about delivering the intervention. Involving patients and members of the public has been key to the design of this study.Summary of Results:
Smoking remains the main cause of death and illness in the UK. We wanted to find out if providing brief stop smoking support might help people quit smoking. People who smoke, who were attending the Emergency Department (ED), were randomly assigned (as if by the toss of a coin) to one of two groups: stop smoking advice including the offer of an e-cigarette ‘starter pack’ and referral to local stop smoking services OR given information about locally available stop smoking services. Six months later, if people in either group told us they had quit smoking, their smoking status was confirmed by checking the amount of carbon monoxide (a gas you inhale from cigarettes) they breathed out using a breath test monitor.We recruited 972 people from six EDs. We found that about twice as many people quit smoking if they received the COSTED intervention compared to those who did not.
We worked out that it costs £48 to advise people to quit smoking in the Emergency Department, including the cost of the e-cigarette starter kit given out. This is very cheap compared to the cost of treating someone who develops a health condition caused by tobacco smoking.
We talked to some people who took part in the study. People told us that they welcomed the distraction of talking to a stop smoking advisor while they were waiting, and that having the e-cigarette given to them by someone in this setting gave them confidence to give it a try. We also interviewed ED staff. They said that they had to be flexible in the way in which they spoke with people, and that it was critical that they had dedicated time to do this.
REC name
South Central - Oxford B Research Ethics Committee
REC reference
21/SC/0288
Date of REC Opinion
24 Sep 2021
REC opinion
Favourable Opinion