Patients find it useful to receive quit smoking help while at hospital accident and emergency

Giving out vapes at accident and emergency (A&E) boosted patients’ confidence to switch away from smoking, according to new research. 

A University of East Anglia led study in collaboration with Exeter and other partner institutions has looked at how well a smoking cessation program worked when offered to people unexpectedly in emergency departments.

The researchers conducted interviews with both patients and staff in six hospitals involved in the trial and 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.  

Professor Richard Holland, Dean of University of Exeter Medical School and co-author on the study, said: “Helping cigarette smokers quit is so important for their health. Some people may raise questions about giving out vapes in hospital. Given the huge toll that smoking can take, it’s important to try new and innovative ways to encourage people to consider less harmful options.

“Our research showed that giving brief advice, provision of an e-cigarette starter kit and referral to stop-smoking services in this setting can really help, and was welcomed by smokers whilst waiting in A&E.”

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 also 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. 

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.” 

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.” 

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 research was funded by the National Institute for Health and Care Research and sponsored by the Norfolk and Norwich University Hospitals NHS Foundation Trust. It was also led by the University of East Anglia 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 study is entitled ‘The context of the Emergency department as a location for a smoking cessation intervention – process evaluation findings from the COSTED trial’ and 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. 

Help to stop smoking is available at https://www.nhs.uk/better-health/quit-smoking/