The context of the emergency department as a location for a smoking cessation intervention – process evaluation findings from the COSTED trial

Notley, Caitlin ORCID: https://orcid.org/0000-0003-0876-3304, Belderson, Pippa, Ward, Emma ORCID: https://orcid.org/0000-0002-7579-3215, Clark, Lucy V. ORCID: https://orcid.org/0000-0001-7162-0512, Clark, Allan ORCID: https://orcid.org/0000-0003-2965-8941, Stirling, Susan, Parrott, Steve, Li, Jinshuo, Coats, Timothy J., Bauld, Linda, Holland, Richard, Gentry, Sarah, Agrawal, Sanjay, Bloom, Benjamin M., Boyle, Adrian, Gray, Alasdair, Morris, M. Geraint and Pope, Ian ORCID: https://orcid.org/0000-0002-5623-4178 (2024) The context of the emergency department as a location for a smoking cessation intervention – process evaluation findings from the COSTED trial. Nicotine and Tobacco Research. ISSN 1462-2203

Microsoft Word (OpenXML) (COSTED PE paper NTR 11-09-2024_revised_clean) - Accepted Version Available under License Creative Commons Attribution. Download (83kB)

Abstract

Introduction: Hospital emergency departments (ED) offer an opportunity to engage with large numbers of people who smoke to prompt cessation, although acceptability of opportunistic intervention in this context has been questioned. This process evaluation study was embedded into the COSTED randomised controlled trial (RCT) and sought to explore the context of intervention delivery within the ED. Methods: Qualitative interviews were conducted with participants and staff across six EDs participating in the COSTED RCT. Interview data were thematically analysed specifically exploring contextual influences. Data were triangulated with ethnographic observations. Results: In participant interviews (N=34), it was acceptable overall to receive a brief opportunistic smoking cessation intervention in the ED. Contextual factors impacted at a range of levels. At the micro level participant views and experiences combined with staff tailoring were important. Being given an e-cigarette starter kit by a ‘credible source’ helped to legitimise vaping for smoking cessation and gave confidence in personal ability to switch away from tobacco. At the meso level adaptations to intervention delivery were made responding to the context of the ED. Stop smoking advisors (N=11) had to adapt and deliver the intervention flexibly depending on space and clinical need. At the macro level, hospital policies supportive of vaping legitimised the approach. Conclusions: Smoking cessation outcomes reported in the main trial across sites were very similar because of the high credibility, acceptability and flexible approach of delivering the COSTED intervention in the ED.

Item Type:	Article
Additional Information:	Data Availability Statement: Qualitative data is available on request to the corresponding author. Funding information: This study is funded by the National Institute for Health Research [Health Technology Assessment (NIHR129438)]. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The funder had no role in considering the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication.
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Social Sciences > Research Groups > Child Protection & Family Support Faculty of Social Sciences > Research Centres > Centre for Research on Children and Families Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care
Depositing User:	LivePure Connector
Date Deposited:	12 Sep 2024 13:30
Last Modified:	21 Nov 2024 03:31
URI:	https://ueaeprints.uea.ac.uk/id/eprint/96746
DOI:	10.1093/ntr/ntae223

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