Engagement With Stop Smoking Services After Referral or Signposting: A Mixed-Methods Study

Area of Science:

• Public Health
• Clinical Trials
• Tobacco Cessation

Background:

• Screening smokers and referring them to stop smoking services (SSSs) is crucial for tobacco control.
• Limited understanding exists regarding post-referral engagement with SSSs.

Purpose of the Study:

• To evaluate engagement with SSSs following referral or signposting from an emergency department setting.
• To identify barriers to engagement with SSSs.

Main Methods:

• A multicenter randomized controlled trial involving 1007 participants (505 intervention, 502 control).
• Intervention group received referral to SSSs, advice, and an e-cigarette starter kit; control group received signposting.
• Engagement data collected from participants, SSSs, and qualitative interviews.

Main Results:

• Very low engagement rates were observed: 3.2% intervention and 2.4% control attended one-to-one sessions.
• SSS data showed 8.9% engagement and 3.1% quit rates among referred participants.
• Most interviewed participants did not recall SSS contact, indicating a failure in the referral pathway.

Conclusions:

• Referral and signposting to SSSs from emergency departments resulted in minimal engagement.
• Key barriers included lack of SSS contact and unmet participant needs.
• Proactive, in-"moment" cessation support within clinical settings is recommended over passive referral.