Ward Emma, Belderson Pippa, Clark Allan, Stirling Susan, Clark Lucy, Pope Ian, Notley Caitlin
Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, UK.
Addiction. 2024 Dec;119(12):2185-2196. doi: 10.1111/add.16633. Epub 2024 Sep 10.
BACKGROUND AND AIMS: Pathways of transitioning from tobacco smoking to vaping after receiving an e-cigarette-based smoking cessation intervention have been minimally explored. STUDY AIMS: 1) identify pathways between intervention delivery and final follow-up; 2) describe baseline and post-intervention statistical data in relation to smoking/vaping behaviour of the different pathway groups; 3) explore qualitative participant perspectives contextualising pathway groups. DESIGN: Embedded mixed-methods analysis of data collected for the Cessation of Smoking Trial in the Emergency Department (COSTED) randomised controlled trial. SETTING: Recruitment from 6 Emergency Departments (5 in England and 1 in Scotland) between January and August 2022. PARTICIPANTS: 366 adult smokers who were randomised to receive the COSTED intervention and provided data at 6-month follow-up. Qualitative subsample of 24 participants interviewed after follow-up. INTERVENTIONS: Brief smoking cessation advice, provision of an e-cigarette starter kit and referral to the local Stop Smoking Service. MEASUREMENTS: Descriptive statistical reporting of identified pathways and smoking/vaping behaviour at baseline and 6-month follow-up. Semi-structured phone/video interviews analysed thematically. FINDINGS: 13.4% (n = 49) of participants quit smoking within 1 month of receiving the intervention, 19.1% (n = 70) quit between 1 and 6 months, 24.9% (n = 91) reduced cigarettes per day (CPD) by at least 50%, and 42.6% did not experience a significant smoking reduction. Approximately a third of participants who quit reported not vaping at follow-up. Reporting dual use was associated with a reduction in CPD. Appoximately a third reported experimenting with a different device to the one provided as part of the intervention. Quitters reported themes of satisfaction with vaping, changes in environment facilitating quitting and motivation to quit. CONCLUSIONS: Dual use of cigarettes and e-cigarettes can result in a reduction of smoking and may prelude quitting smoking. Sustained e-cigarette use is not always necessary for quitting success. Success depends on personal context as well satisfaction with vaping.
背景与目的：在接受基于电子烟的戒烟干预后，从吸烟转变为吸电子烟的途径鲜有研究。 研究目的：1）确定干预实施与最终随访之间的途径；2）描述不同途径组在吸烟/吸电子烟行为方面的基线和干预后统计数据；3）探讨参与者对途径组情况的定性观点。 设计：对急诊科戒烟试验（COSTED）随机对照试验收集的数据进行嵌入式混合方法分析。 地点：2022年1月至8月期间从6个急诊科（英格兰5个，苏格兰1个）招募。 参与者：366名成年吸烟者，他们被随机分配接受COSTED干预，并在6个月随访时提供数据。随访后对24名参与者进行了定性子样本访谈。 干预措施：简短的戒烟建议、提供电子烟入门套件并转介至当地戒烟服务机构。 测量方法：对确定的途径以及基线和6个月随访时的吸烟/吸电子烟行为进行描述性统计报告。对半结构化电话/视频访谈进行主题分析。 研究结果：13.4%（n = 49）的参与者在接受干预后1个月内戒烟，19.1%（n = 70）在1至6个月内戒烟，24.9%（n = 91）每天吸烟量（CPD）减少至少50%，42.6%的人吸烟量没有显著减少。约三分之一戒烟的参与者在随访时报告不吸电子烟。报告同时使用与CPD减少有关。约三分之一的人报告试用了与作为干预一部分提供的不同的设备。戒烟者报告了对吸电子烟的满意度、有利于戒烟的环境变化和戒烟动机等主题。 结论：同时使用香烟和电子烟可导致吸烟量减少，并可能为戒烟做准备。持续使用电子烟并非成功戒烟的必要条件。成功取决于个人情况以及对吸电子烟的满意度。
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