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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