Smoking cessation for people accessing homeless support centres (SCeTCH): Comparing the provision of an E-cigarette versus Usual Care in a cluster randomised controlled trial in Great Britain

Dawkins, Lynne, Soar, Kirstie, Pesola, Francesca, Ford, Allison, Notley, Caitlin, Brown, Rachel, Ward, Emma, McMillan, Lauren, Robson, Deborah, Varley, Anna, Mair, Charlotte, Lennon, Jessica, Brierley, Janine, Edwards, Amy, Hajek, Peter, Tyler, Allan, Parrott, Steve, Li, Jinshou, Bauld, Linda, Gardner, Bethany and Cox, Sharon (2025) Smoking cessation for people accessing homeless support centres (SCeTCH): Comparing the provision of an E-cigarette versus Usual Care in a cluster randomised controlled trial in Great Britain. BMC Medicine, 23. ISSN 1741-7015

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Abstract

Background: Smoking rates are exceptionally high among people experiencing homelessness. We aimed to test the effectiveness of an e-cigarette (EC) intervention designed to help people accessing homeless support services to stop smoking. Methods: A two-arm cluster randomised controlled trial. We recruited 32 homeless centres (clusters) across Great Britain. Participants were aged 18 + and known by centre staff to smoke. Randomisation of clusters (1:1; using various block sizes) to EC or usual care (UC) was generated in Stata by the trial statistician, concealed from researchers. Participants in EC clusters received a refillable EC, 4-week supply of e-liquid, and a fact sheet. UC participants received very brief advice on smoking, a support leaflet, and signposting to the stop smoking service. Interventions were delivered by centre staff. The primary outcome was sustained abstinence from smoking from 2 weeks post-baseline through to 24 weeks, verified by carbon monoxide (CO) measurements below 8 ppm. Secondary outcomes included CO-verified 7-day point prevalence abstinence. Analysis was intention-to-treat. Results: Between February 22, 2022, and June 22, 2023, 16 centres were randomised to EC (n = 239 participants) and 16 to UC (n = 238 participants). In UC, one participant died, and one withdrew consent. Final sample analysed: n = 239 (EC); n = 236 (UC). Sustained 24-week CO-validated smoking cessation rates were 5/239 (2.1%) with EC vs. 2/236 (0.8%) with UC (aRR: 2.43, 95%CI: 0.51–11.64). Seven-point prevalence abstinence was 15/239 (6.3%) in the EC arm vs. 5/236 (2.1%) in UC (aRR: 2.95, 95%CI: 1.05–8.29). Four adverse events were reported in the EC arm; three deemed EC-related and not serious; one serious and not EC-related. Conclusions: EC did not support sustained smoking abstinence for 24 weeks. Seven-day point prevalence abstinence rates suggest that cessation is possible, but more support may be needed to sustain this. Trial registration: The trial was preregistered on the ISTCTN registry #18566874. Registration date: 12/10/2021.

Item Type:	Article
Additional Information:	Data availability: The underpinning anonymised data and data dictionary along with the study protocol, Statistical Analysis Plan (SAP), participant information sheet, consent form, Case Record Forms (CRFs), and other study materials are available on the Open Science Framework (OSF) at https://doi.org/10.17605/OSF.IO/YHMK9. Funding: This study was funded by the National Institute for Health and Care Research (NIHR132158). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Uncontrolled Keywords:	abstinence,cluster randomised controlled trial,e-cigarettes,health inequalities,homelessness,smoking cessation,smoking reduction,tobacco harm reduction,medicine(all) ,/dk/atira/pure/subjectarea/asjc/2700
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 Centres > Centre for Research on Children and Families
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	08 Jul 2025 09:30
Last Modified:	14 Jul 2025 12:33
URI:	https://ueaeprints.uea.ac.uk/id/eprint/99859
DOI:	10.1186/s12916-025-04167-y

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