Exploring the Uptake and Use of Electronic Cigarettes Provided to Smokers Accessing Homeless Centres: A feasiblity Study

Smoking prevalence amongst adults experiencing homelessness is four times higher than the UK national average. The harms of smoking are likely to be exacerbated in this group due to poor cardiac and respiratory health and risky smoking practices. Although many homeless smokers would like to quit, they are less likely to engage with traditional stop smoking services, make fewer quit attempts and are less likely to stop smoking.

This NIHR funded cluster feasibility trial aimed to evaluate the feasibility of supplying free e-cigarette starter kits for smoking cessation to smokers accessing homeless centres (n=80). Four homeless centres were assigned to either an e-cigarette (EC) or usual care (UC) arm. Participants in the UC arm received advice to quit and sign-posting to the local Stop Smoking Service. Those in the EC arm received a starter kit, e-liquid and access to technical support from trained centre staff. Data on participation, retention, smoking behaviour, use of EC, quit attempts, and engagement with local cessation services was collected at baseline and 4, 12 and 24 weeks.

A qualitative process evaluation with a subsample of participants and service centre staff was conducted between weeks 4 and 8 to examine the facilitators and barriers to engagement and service providers’ capacity to support the study.

The study was led by Professor Lynne Dawkins at London South Bank University. The University of Stirling led the fieldwork at the Scottish homeless site and process evaluation.

The findings of the study informed a full trial, due to start in September 2021.