Emerging Ecigarette Evidence with Dr Cox

Dr Sharon Cox has spoken about her team’s randomised controlled trial based in multiple homeless centres in the UK. The study looks at smokers experiencing homelessness and compares delivering the usual support with offering electronic cigarette starter kits. This trial can take place thanks to funding from the National Institute for Health Research.

homeless smokerStaff working at the homeless centres provide the smokers chosen to receive a kit with a refillable tank‐style starter pack. This includes a choice of nicotine strength e‐liquids and flavours. Recipients will also receive a factsheet about vaping.


E‐liquids will continue to be supplied every week for four weeks by the staff. Participants will be given time to try different flavours and nicotine strengths at baseline and be permitted to switch between flavours in accordance with documented vaping practices.


Dr Cox is a Senior Research Fellow in Behavioural Science at University College London. Most of her time is spent looking at tobacco-related health inequalities, focussing mainly on how electronic cigarettes can be used to reduce the health inequalities.


She says: “I started to become engaged in e-cigarette research about six years ago. I noticed the parallels in harm reduction across other substances. For me, it wasn’t necessarily a hook that these are a smoking cessation aid per se, I wasn’t engaged in smoking cessation research at all at that time, but I was interested in harm reduction.


Harm reduction can really help those people for whom other treatments haven’t suited them at that time in their life. But what harm reduction can do is keep people in treatment or keep them interested in changing their behaviour without necessarily thinking about quitting.”


In particular, Dr Cox is interested in helping improve the lives and health of people experiencing homelessness and saw a missing aspect when they were receiving support for substances but nothing for tobacco harm reduction – “surely this should be offered alongside all the other types of support?”


Along with Professor Lynn Dawkins of London South Bank University, Dr Cox began exploring this area in 2016. They conducted a small feasibility study with the aid of four homeless charities to find out if conducting a full trial would be possible. Nothing like this had been done before anywhere in the world. They found that e-cigarettes and the input from health professionals was accepted by the community and staff, and they could begin planning for a full gold standard randomised control study.


Historically, Dr Cox says, staff at these centres would shy away from conversations about stopping smoking as those experiencing homelessness had so much else going on in their lives. Vaping offered a brand-new way of approaching improving mental and physical health. An unexpected outcome also happened: staff who smoked at the homeless centres also quit by switching to vaping. “That was amazing,” exclaimed Dr Cox.


She added, another benefit they noticed was that even for those who didn’t take up vaping, they appreciated the offer and said it was the first time they felt cared for – “I didn’t think anybody cared if I got lung cancer.”


These were huge wins, massive wins,” Dr Cox continued.


The new trial will take place across 32 centres. It started in September, centres were recruited in January, and participants will be recruited this month. The trial will run for three years until 2024. The results won’t be released until sometime after that but will add to the overall evidence base that vaping helps smokers to quit tobacco.


The kit being used is the Aspire PockeX All-in-One Starter Kit, “this is the kit they found the most manageable, they liked the throat hit and it also had a really good start-up cost.”


Aspire PockeX Review – Should You Buy One? – https://vapekit.co.uk/blog/aspire-pockex-review/

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