Could free e-cigarettes help people experiencing homelessness to quit smoking?

Up to 82 per cent of those who experience homelessness smoke – far higher than the UK average of 14.1 per cent. Could supplying free e-cigarette starter kits at homeless services combat this problem? We catch up with Jessica Lennon, DECIPHer’s new research assistant, who works on SCeTCH, a project exploring this.

Jessica Lennon

What is the issue?

The health of people experiencing homelessness is extremely poor compared to those not experiencing homelessness and smoking is a significant contributor to this.  Smoking is also the leading cause of premature death in this group. A large proportion of those experiencing homelessness want to quit and have made attempts in the past, but these are often unaided and unsuccessful.

There is a lack of evidence on what works to help people experiencing homelessness to stop smoking.  They may benefit from support provided by NHS stop smoking services or they may benefit from different approaches, like e-cigarettes. 

E-cigarettes are the most popular method of quitting smoking but for people on low or no income however, the price of an e-cigarette starter kit is high (~£25). Supplying free e-cigarette starter kits at homeless services may help to overcome this problem.

Where is the research taking place and what does it involve?

Smoking Cessation Trial in Centres for the Homeless (SCeTCH) is funded by the National Institute of Health Research (NIHR) and is taking place in 32 homeless centres across Great Britain.  Here at DECIPHer we are the Wales and South West England hub.  There are also hubs at London Southbank University (covering London and South East England), University of Stirling (covering Scotland) and University of East Anglia (covering the East of England).

The centres taking part are allocated to either the e-cigarette intervention group or usual care intervention group where participants are provided with an e-cigarette starter kit or given very brief advice (VBA) and signposted to their local stop smoking service.  We complete a range of assessments with participants about their smoking and health at baseline, 4 weeks, 12 weeks and 24 weeks later. 

The staff within the centres are provided with training on smoking cessation and how to support the study, as they are an important part of the intervention, including supplying e-liquids and providing VBA.

We will also look at how delivery of the intervention worked, and which parts of the intervention led to a change (if any) in participants’ smoking and also examine cost effectiveness.

What led you to this role?

My background is in Psychology and since my studies I have been lucky to work with a variety of vulnerable populations with complex needs in clinical and research settings, including physical health and mental health teams. 

What interested me in this role was having the opportunity to work on public health research with a group of people that experience such health inequalities but are often missed by public health policies.  I really enjoy working closely with those we do research for and as part of this role I’ll be spending most of my time within the homeless centres with participants.

What progress has SCeTCH made so far?

We are well underway with centre recruitment across the country.  Within our hub at DECIPHer we are in the process of undertaking staff training and recruiting participants at our first centres in Wales and South West England.  The study will run until 2024.

If we find that the intervention helps people stop smoking, we will be discussing the results with decision makers and those responsible for funding streams in Wales, Scotland and England, concerning the potential to roll out the intervention for all homeless services and service users to benefit from.

Further information and publications

Cox, S., Bauld, L., Brown, R., Carlise, M., Ford, A., Hajek, P., et al. (2022) Evaluating the effectiveness of e-cigarettes compared with usual care for smoking cessation when offered to smokers at homeless centres: Protocol for a multi-centre cluster randomised controlled trial in Great Britain. Addiction

Full protocol

Twitter: @ProjectSCeTCH

Study page

2016 DECIPHer article

This study is funded by the National Institute for Health Research (NIHR) PHR programme (PHR Reference Number: NIHR132158). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. 

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