M3 Supporting ‘swap to stop’ smoking cessation: a pilot trial of vape information provision within lung cancer screening

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Introduction Vaping is an effective quit tool, yet people mistakenly believe it is more harmful than smoking. This mixed-methods study (REC ref:24/NW/0351) assessed the impact of low-cost, easy-read information materials on acceptance of a free vape offered through the ‘Swap-to-Stop’ scheme within lung cancer screening (LCS). Methods This single-centre two-arm crossover study entailed six one-week blocks (A-B-B-A-B-A) between Feb-May 2025. Control weeks (A) consisted of usual care: very brief advice from an NCSTC-certified nurse, followed by a vape offer with usage guidance. Intervention weeks (B) consisted of usual care plus an educational video, posters and leaflets in the waiting area. Outcomes included the number of vapes offered, acceptance rates and number of smokers leaving with a vape. Vape usage and quit data were collected via phone at 30-days (data collection ongoing, to be presented at the conference). A subset of participants took part in qualitative interviews to explore perceptions of the materials. Results 517 smokers attended LCS during the study, of whom 302 (58.4%) were offered a vape and 172 (57.0%) accepted. Overall 33.3% (172/517) smokers left with a vape (table 1). More vapes were offered during intervention weeks (207/298:69.5% vs 95/219:43.4%, p<0.001) but acceptance rates were similar (114/207:55.1% vs 58/95:61.1%, p=0.330). The higher offer rate meant more smokers left with a vape in intervention weeks (114/298:38.3% vs 58/219:26.5%, p=0.005). Acceptance did not differ with sex, ethnicity, education or pack years, but vapes were more likely to be accepted by socioeconomically deprived participants (unadjOR=1.16, 95%CI 1.06–1.26, p=0.001), people who had previously struggled to quit (unadjOR=2.41, 95%CI 1.57–4.02, p<0.001) and younger participants (unadjOR=0.95, 95%CI 0.91–0.99, p=0.02). Preliminary qualitative findings suggest mixed impact of the materials. While some found them helpful, others reported limited impact due to pre-existing, strong, negative beliefs. An important influence on vape acceptance was the attitude of the nurse offering it. Conclusions Informational materials increased the likelihood of smokers leaving LCS with a vape, due to more offers from clinical staff rather than higher acceptance among participants. Nurses’ attitudes influenced acceptance. To maximise impact, staff should receive training to deliver consistent vape offers combined with supportive, accurate messaging that addresses misconceptions and builds trust.

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