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Cessation of Smoking Trial in the Emergency Department (COSTED): a multicentre randomised controlled trial.

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posted on 2024-06-10, 11:15 authored by Ian Pope, Lucy V Clark, Allan Clark, Emma Ward, Pippa Belderson, Susan Stirling, Steve Parrott, Jinshuo Li, Tim Coats, Linda Bauld, Richard Holland, Sarah Gentry, Sanjay Agrawal, Benjamin Michael Bloom, Adrian A Boyle, Alasdair J Gray, M Geraint Morris, Jonathan Livingstone-Banks, Caitlin Notley

Background

Supporting people to quit smoking is one of the most powerful interventions to improve health. The Emergency Department (ED) represents a potentially valuable opportunity to deliver a smoking cessation intervention if it is sufficiently resourced. The objective of this trial was to determine whether an opportunistic ED-based smoking cessation intervention can help people to quit smoking.

Methods

In this multicentre, parallel-group, randomised controlled superiority trial conducted between January and August 2022, adults who smoked daily and attended one of six UK EDs were randomised to intervention (brief advice, e-cigarette starter kit and referral to stop smoking services) or control (written information on stop smoking services). The primary outcome was biochemically validated abstinence at 6 months.

Results

An intention-to-treat analysis included 972 of 1443 people screened for inclusion (484 in the intervention group, 488 in the control group). Of 975 participants randomised, 3 were subsequently excluded, 17 withdrew and 287 were lost to follow-up. The 6-month biochemically-verified abstinence rate was 7.2% in the intervention group and 4.1% in the control group (relative risk 1.76; 95% CI 1.03 to 3.01; p=0.038). Self-reported 7-day abstinence at 6 months was 23.3% in the intervention group and 12.9% in the control group (relative risk 1.80; 95% CI 1.36 to 2.38; p<0.001). No serious adverse events related to taking part in the trial were reported.

Conclusions

An opportunistic smoking cessation intervention comprising brief advice, an e-cigarette starter kit and referral to stop smoking services is effective for sustained smoking abstinence with few reported adverse events.

Trial registration number

NCT04854616.

History

Author affiliation

College of Life Sciences Cardiovascular Sciences

Version

  • VoR (Version of Record)

Published in

Emergency medicine journal : EMJ

Volume

41

Issue

5

Pagination

276 - 282

Publisher

BMJ Publishing Group

issn

1472-0205

eissn

1472-0213

Copyright date

2024

Available date

2024-06-10

Spatial coverage

England

Language

eng

Deposited by

Mrs Louise Thompson

Deposit date

2024-05-31

Data Access Statement

Data are available upon reasonable request. The protocol, consent form, statistical analysis plan, medical ethics committee approvals, training materials and other relevant study materials are available online at https://osf.io/8hbne/. Deidentified participant data will be made publicly available within 3 months at the above address.

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