Emergency Medicine Journal 2024

Original research

Table 1 Baseline characteristics of the intention-to-treat population

Intervention (n=484) 302 (62.4%) 182 (37.6%) 40.52 (13.58) 353 (72.9%)

Control (n=488)

Total

Sex

Men

301 (61.7%) 187 (38.3%) 40.48 (13.72) 350 (71.7%)

603 (62.0%) 369 (38.0%) 40.50 (13.65) 703 (72.3%) 122 (12.6%)

Women

Mean (SD) age (years)

Ethnic origin

White British White – Other

66 (13.6%) 29 (6.0%) 28 (5.8%) 7 (1.5%)

56 (11.5%) 28 (5.7%) 36 (7.4%) 17 (3.5%)

Black

57 (5.9%) 64 (6.6%) 24 (2.5%) 2 (0.2%)

South Asian

Other

Refused/missing

1 (0.2%)

1 (0.2%)

Mean (SD) deprivation decile

4.31 (2.57) (n=478) 291 (60.1%) 50 (10.3%) 89 (18.4%) 52 (10.7%)

4.53 (2.61) (n=483) 305 (62.5%) 46 (9.4%) 87 (17.8%) 50 (10.3%)

4.42 (2.59) (n=961) 596 (61.3%)

Employment status

Employed

Unemployed

96 (9.9%)

Unable to work due to sickness or disability

176 (18.1%) 102 (10.5%)

Carer, retired or student

Other

2 (0.4%)

0

2 (0.2%)

Median (IQR) number of cigarettes smoked/day

15 (10–20) 4.13 (1.58) 16.13 (5.06) (n=484) 4.94 (2.27)

15 (10–20) 4.14 (1.62) 15.51 (4.14) (n=487) 4.84 (2.34)

15 (10–20) 4.13 (1.60) 15.82 (4.63) (n=971) 4.89 (2.31)

Mean (SD) motivation to quit score Mean (SD) age started smoking

Mean (SD) Fagerström test for nicotine dependence score Use of nicotine replacement therapy in last 3 months

42 (8.7%)

46 (9.4%)

88 (9.1%)

Use of e-cigarettes in last 3 months

Not used

353 (72.9%)

369 (75.6%) 55 (11.3%)

722 (74.3%)

Once a month or less On 2–4 days a month On 2–3 days a week On 5–6 days a week

39 (8.1%) 36 (7.4%) 26 (5.4%) 30 (6.2%)

94 (9.7%) 56 (5.8%) 49 (5.0%) 51 (5.3%)

20 (4.1%) 23 (4.7%) 21 (4.3%)

Daily

0

0

0

Lives with other smoker(s)

214 (44.2%) 199 (41.1%) 84 (17.4%) 54 (11.2%) 74 (15.3%) 50 (10.3%) 23 (4.8%)

185 (37.9%) 201 (41.2%) 84 (17.2%) 53 (10.9%) 76 (15.6%) 50 (10.3%) 24 (4.9%)

399 (41.1%) 400 (41.2%) 168 (17.3%) 107 (11.0%) 150 (15.4%) 100 (10.3%)

Recruitment by site

Site 1 Site 2 Site 3 Site 4 Site 5 Site 6

47 (4.8%)

30 (95% CI 16 to 343) and for self-reported abstinence at 6 months it was 9 (95% CI 6 to 11). At 6 months the median (IQR) number of quit attempts was 2 (1–4) in the intervention group and 1 (0–3) in the control group (p<0.0001). Of those who responded, the number of participants using an e-cigarette daily at 6 months was 39.4% (125/317) in the intervention group and 17.5% (53/303) in the control group (table 3). The number reporting not having used an e-cigarette in the past 6 months was 14.8% (47/317) in the intervention group and 54.5% (165/303) in the control group. Safety The number of participants reporting serious adverse events was 5.2% (25/484) in the intervention group and 5.1% (25/488) in the control group (table 4). None were related to the intervention.

biochemically verified. Sixty-eight participants in the interven- tion group and 32 in the control group declined to provide a CO reading, and 19 in the intervention group and 12 in the control group had a CO reading ≥8ppm. The online supplemental material shows a sensitivity analysis for the assumption that those who did not respond or did not provide a CO reading were still smoking. Provided the dropouts have <0.2 times the odds of being abstinent than those who remain, the intervention is statistically significant. Even under the assumption that the dropouts are equally likely to smoke as those who remain, the estimated adjusted OR is still larger than 1.5 (1.56, 95% CI 0.88 to 2.76), but no longer statistically significant. Secondary outcomes Self-reported 7-day abstinence at 6 months was 23.3% (113/484) in the intervention group and 12.9% (63/488) in the control group (RR 1.80 (95% CI 1.36 to 2.38); p<0.0001). Table 2 shows the abstinence rates at all time points. The number needed to treat to achieve biochemically-­ validated smoking continuous abstinence at 6 months was

DISCUSSION Principal findings

In this trial adults attending the ED who smoked and received the intervention of brief advice, an e-cigarette starter kit and referral to stop smoking services were statistically significantly

Pope I, et al . Emerg Med J 2024; 41 :276–282. doi:10.1136/emermed-2023-213824

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