intEgrating Smoking Cessation treatment As part of usual Psychological care for dEpression and anxiety (ESCAPE): a randomised and controlled, multicentre, acceptability and feasibility trial with nested qualitative methods.

Conference:

SAPC ASM 2024 - Bristol

Talk Code:

6A.7

Presenter:

Gemma Taylor

Twitter:

@gemmamjtaylor

Co-authors:

Katherine Sawyer, Pamela Jacobsen, Shadi Dryan, Tom Freeman, Chris Metcalfe, David Kessler, Marcus Munafo, Paul Aveyard

Author institutions:

University of Bath, University of Bristol, University of Oxford

Problem

Smoking prevalence is twice as high in people with depression and anxiety making this population twice as likely to die from smoking related disease. Stopping smoking may reduce symptoms of depression and anxiety but cessation support is not integrated in routine psychological care for depression and anxiety in the UK or internationally.

Approach

A pragmatic, randomised controlled feasibility trial of a co-designed smoking cessation intervention, with nested qualitative methods (ISRCTN99531779). We recruited adult daily tobacco smokers starting psychological treatment, across six UK NHS psychology services providing cognitive behavioural therapy. The treatment group received a co-designed behavioural and pharmacological support for smoking cessation as integrated into usual care, and the control group recieved care as usual with later signposting to smoking cessation services. The primary outcome was “study completion” by 3-months follow-up. Engagement with smoking cessation was assessed by comparing quit attempts and abstinence between allocated groups.

Findings

Between June 2018 and August 2021, 68 participants were allocated to treatment and 67 participants to the control arm. At 3-months follow-up we found no strong evidence suggesting that offering smoking cessation treatment affected study completion (adjusted OR 0.81 (95% CI 0.34 to 1.91)). Smoking abstinence was achieved in 8/68 (12%) in the intervention group and 1/67 (1%) at 3-months (adjusted OR 8.80, 95% CI: 1.07 to 72.96). We recruited at an acceptable rate, and practitioners and participants reported that they accepted and were satisfied with the intervention.

Consequences

Integrating smoking cessation treatment into NHS psychology services for depression and anxiety is acceptable, feasible, and may increase abstinence from smoking compared with standard treatment alone

Submitted by:

Gemma Taylor

Funding acknowledgement:

Cancer Research UK