The Context of the Emergency Department as a Location for a Smoking Cessation Intervention—Process Evaluation Findings From the Cessation of Smoking Trial in the Emergency Department Trial

Introduction: This text is a summary of a research study examining the emergency department (ED) as a location for a smoking cessation intervention. The study is a process evaluation embedded in the Cessation of Smoking Trial in the Emergency Department (COSTED) randomized controlled trial. The research used qualitative interviews and ethnographic observations to explore the context of intervention delivery within the ED.

Key Points:

* Participants generally found the ED context to be acceptable for receiving a smoking cessation intervention.
* Contextual factors influencing intervention delivery include participant views and experiences, staff tailoring, adaptations to intervention delivery, hospital policies supportive of vaping, and environmental cues such as signage.
* Despite challenges, the context is helpful in supporting people to switch away from tobacco.
* The intervention, with flexible and tailored implementation, is adaptable to different ED contexts.
* Wider implementation across NHS Trusts of the effective COSTED intervention is feasible and will ultimately support smoking cessation for people attending EDs.

Main Message: The study suggests that the emergency department is a viable location for a smoking cessation intervention, with participants finding it acceptable and the context offering a "teachable moment" for behavior change. The intervention, with its flexible and tailored implementation, has the potential to be widely implemented in EDs across NHS Trusts, supporting smoking cessation for people who may not otherwise have sought support. The study highlights the importance of considering contextual factors in the implementation of behavioral interventions, and the need for supportive policies and environmental cues to facilitate success.

Caitlin Notley, Pippa Belderson, Emma Ward, Lucy V Clark, Allan Clark, Susan Stirling, Steve Parrott, Jinshuo Li, Timothy J Coats, Linda Bauld, Richard Holland, Sarah Gentry, Sanjay Agrawal, Benjamin M Bloom, Adrian Boyle, Alasdair Gray, M Geraint Morris, Ian Pope, The Context of the Emergency Department as a Location for a Smoking Cessation Intervention—Process Evaluation Findings From the Cessation of Smoking Trial in the Emergency Department Trial, Nicotine & Tobacco Research, Volume 27, Issue 5, May 2025, Pages 909–916, https://doi.org/10.1093/ntr/ntae223