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2033 Results of the cessation of smoking trial in the emergency department (COSTED)
  1. Ian Pope1,
  2. Caitlin Notley1,
  3. Adrian Boyle2
  1. 1University of East Anglia
  2. 2Cambridge University Hospitals NHS Foundation Trust


Aims and Objectives Emergency Departments (EDs) offer a valuable opportunity to support people to change their behaviour to improve health. Smoking remains the leading cause of morbidity and mortality. E-cigarettes are effective for supporting smoking cessation, yet there have been no randomised controlled trials of smoking cessation interventions in the ED using e-cigarettes. This approach offers a valuable opportunity to reach unmotivated quitters and provide them an alternative to smoking tobacco.

The aim of this study is to definitively test real-world effectiveness of an ED based smoking cessation intervention in comparison to usual care.

Method and Design Two-group, multi-centre, pragmatic, individually randomised controlled trial ( NCT04854616). We recruited adults who smoke tobacco and were attending one of six EDs across the UK. They were randomised to either control (in which case they were given written information about stop smoking services) or intervention (in which case they received a brief smoking cessation intervention, provision of an e-cigarette starter kit and referral to stop smoking services). Both groups were followed up 1, 3 and 6 months after randomisation. Smoking abstinence was biochemically verified at 6 months.

Results and Conclusion Of 2,888 screened, 1,327 were eligible and 972 were randomised (488 control and 484 intervention). The mean age was 40, 62% were male and 72% were White British. By the time of the conference we will be able to report biochemically verified quit rates between groups (primary outcome), self-reported point prevalence by group and changes to number of cigarettes per day between the groups. The results of the economic evaluation will also be presented in terms of cost per QALY and cost per quitter.

It is feasible to implement a smoking cessation intervention in EDs with dedicated staff time to deliver the intervention. Recruitment was above target indicating that EDs may represent an excellent opportunity to engage hard to reach smokers.

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