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CoSTED Team Release Protocol

The team responsible for the cessation of smoking trial in the emergency department (CoSTED) study have released the protocol for the multicentre randomised controlled trial

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The people responsible for the cessation of smoking trial in the emergency department (CoSTED) study have released the protocol for the multicentre randomised controlled trial. The trial has come about due to the higher than national levels of smokers who present at NHS A&E departments. The team are looking into whether targeted advice about and support for vaping can play a role in helping get these smokers to quit.

Dr Caitlin Notley is one of those responsible for the CoSTED study. Dr Notley has over a decade of experience in addiction research and has become convinced by the potential for vaping as a tobacco harm reduction tool.

The e-cigarette has recently become the most popular method of smoking cessation, chosen by people in the general population,” she previously said. “Although many people successfully quit smoking, many people then relapse back to smoking, and it’s staying abstinent from smoking which is the really difficult thing to do.”

The ability for vaping to continue working for longer is one of the reasons given for it helping to prevent relapse back to smoking among those studied. This, and that vapers can engage in group behaviour similar to when they were smokers.

Vaping is important because it “redefines the landscape of smoking cessation” and this is why it is particularly important “in relapse intervention”.

When last year’s evidence update was released by the UK Government, she said: ““The latest evidence review confirms that vaping is substantially less harmful than continuing to smoke tobacco. Reassuringly, the evidence shows that people who switch away from smoking to vaping are exposed to fewer toxic chemicals that may cause disease in later life.

The CoSTED study is “a two-arm pragmatic, multicentred, parallel-group, individually randomised, controlled superiority trial with an internal pilot, economic evaluation and mixed methods process evaluation. The trial will compare ED-based [emergency department] brief smoking cessation advice, including provision of an e-cigarette and referral to local stop smoking services (intervention) with the provision of contact details for local stop smoking services (control).

The team has now released the protocol for the CoSTED study, aiming to recruit almost a thousand patients across six National Health Service emergency departments in England and Scotland.

The team plans on measuring outcomes at 1, 3 and 6 months following the patients joining the trial.

They state that strengths of this new study will include:

  • Being the first study in the UK to assess the effectiveness of an emergency department delivered smoking cessation intervention using e-cigarettes opportunistically to aid smoking cessation in those not currently seeking smoking cessation advice.
  • The intervention will involve extensive patient and public involvement, particularly in the choice of e-cigarette.
  • A mixed methods process evaluation will assess the delivery, implementation, fidelity and contamination of the intervention through site observations and interviews with both staff and participants.
  • An economic evaluation will establish the cost-effectiveness of the intervention.

Given the success of similar research conducted in non-NHS locations, outcomes from this study should prove positive and lend more weight to the UK’s approach to vaping.

Dave Cross avatar

Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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