Journal Article

A cluster feasibility trial to explore the uptake and use of e-cigarettes versus usual care offered to smokers attending homeless centres in Great Britain

Ford, Allison, Li, Jinshuo, Uny, Isabelle, Robson, Deborah, Hajek, Peter, Dawkins, Lynne, Bauld, Linda, Best, Catherine, Parrott, Steve, Tyler, Allan, Cox, Sharon

2020

Overview

Smoking rates in the UK are at an all-time low but this masks considerable inequalities; prevalence amongst adults who are homeless remains four times higher than the national average. The objective of this trial was to assess the feasibility of supplying free e-cigarette starter kits to smokers accessing homeless centres and to estimate parameters to inform a possible future larger trial. In this feasibility cluster trial, four homeless centres in Great Britain were non-randomly allocated to either a Usual Care (UC) or E-Cigarette (EC) arm. Smokers attending the centres were recruited by staff. UC arm participants (N = 32) received advice to quit and signposting to the local Stop Smoking Service. EC arm participants (N = 48) received an EC starter kit and 4-weeks supply of e-liquid. Outcome measures were recruitment and retention rates, use of ECs, smoking cessation/reduction and completion of measures required for economic evaluation. Eighty (mean age 43 years; 65% male) of the 153 eligible participants who were invited to participate, were successfully recruited (52%) within a five-month period, and 47 (59%) of these were retained at 24 weeks. The EC intervention was well received with minimal negative effects and very few unintended consequences (e.g. lost, theft, adding illicit substances). In both study arm, depression and anxiety scores declined over the duration of the study. Substance dependence scores remained constant. Assuming those with missing follow up data were smoking, CO validated sustained abstinence at 24 weeks was 3/48 (6.25%) and 0/32 (0%) respectively for the EC and UC arms. Almost all participants present at follow-up visits completed data collection for healthcare service and health-related quality of life measures. Providing an e-cigarette starter kit to smokers experiencing homelessness was associated with reasonable recruitment and retention rates and promising evidence of effectiveness and cost-effectiveness.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Abstinence / Addictive behaviors / Adult / Adults / Anxiety / Beliefs, opinions and attitudes / Biology and Life Sciences / Cigarette smoking / Cigarettes / Clusters / Consortia / Cost analysis / Cost-Benefit Analysis / Data collection / Data quality / Demographic aspects / Drug addiction / Drug therapy / Electronic cigarettes / Electronic Nicotine Delivery Systems / Feasibility / Feasibility Studies / Female / Health aspects / Health Behavior / Health care / Health disparities / Health sciences / Health services / Health status / Homeless people / Homeless persons / Homelessness / Humans / Ill-Housed Persons - psychology / Inequality / Intervention / Male / Measures / Medicine and Health Sciences / Mental disorders / Mental health / Middle Aged / Outcome Assessment, Health Care / Parameter estimation / Population / Prevalence / Preventive medicine / Quality of life / Recruitment / Research and Analysis Methods / Retention / Retention in Care - statistics & numerical data / Smoking / Smoking - epidemiology / Smoking - psychology / Smoking - therapy / Smoking cessation / Smoking Cessation - methods / Smoking Cessation - psychology / Social marketing / Social Sciences / Socioeconomic Factors / Supervision / Theft / United Kingdom / Uptake