The Essex Lifestyle Service worked with selected e-cigarette (vape) stores in Essex, training staff to deliver stop smoking support to their customers wishing to quit smoking by using an e-cigarette. To date, it has resulted in over 900 people stopping smoking through the use of an e-cigarette.
There were 159,465 adult smokers in Essex in 2016 to 2017, according to the Annual Population Survey (APS) and 2,345 Essex residents die every year from smoking-related diseases.
Provide, a community interest company commissioned by Essex County Council, delivers a broad range of community services including the Essex Lifestyle Service. In 2016 the service, which has a stop smoking element, started to work with vape stores in Essex, with the intention to train the staff to deliver stop smoking support to their customers wishing to quit smoking through the use of an e-cigarette.
What was involved?
The customers likely to visit stores with trained staff are people who have tried a number of ways to give up smoking, such as using nicotine patches or gums, but have not succeeded, as well as people who are both smoking and using e-cigarettes (dual users).
The stores should be based in a location that is easily accessible and where residents recognise that it will support them through their journey of behaviour change.
E-cigarette retailers and reputable suppliers were identified who were interested in supporting people stopping smoking and who met the following factors:
- quality branded products and products stocked that comply with current British Standards
- established retailer
- locally popular
- variety of communication channels used with their customers – email, telephone, social media
- compliant with the UK regulation on e-cigarette products
- easily accessible location
Our aim was to include stores in a deprived location.
After identifying appropriate stores, they were contacted to discuss working collaboratively. Public Health England’s report, E-Cigarettes: an evidence update, was also discussed.
If the store was interested in being involved, a contract was agreed, covering:
- training of staff to support clients
- quit date rule
- sharing of patient information
- the patient’s liability for using an e-cigarette or e-liquid and the long-term use effects
- disclaimer or expectation agreement that nicotine replacement therapy (NRT) would not be offered by the shop during the consultation and support programme
Due to e-cigarettes only being available for purchase by individuals aged 18 and above, we ensured the contract also reflected this.
Training was offered to staff either in the shop or externally at one of Essex Lifestyle Service’s sessions. Once training was completed, further support was offered to the retailers’ staff when required, as well as monitoring of their progress with clients, activity and quit rates.
The project commenced in September 2016 and was scheduled to run for 9 months, allowing time to monitor results. The stores had the opportunity to promote public health campaigns, including Stoptober and No Smoking Day, by displaying posters and using social media to show the partnership of working with the local stop smoking service.
The customer is supported by the trained shop staff to stop smoking through 6 sessions at the shop, with the key outcome measure being a carbon monoxide (CO) verified 4 week quit. To verify as a quit for the purposes of data collection by the Department of Health and Social Care, a smoker needs to be smokefree for at least 28 days, at which point they can be registered as a ‘quitter’. There is also the opportunity to follow up on quit rates to monitor that cessation of tobacco smoking has been sustained. The retailer receives £50 for each CO verified quitter from the Essex Lifestyle Service budget.
What went well?
The project proved to be successful in a number of ways. To date, it has resulted in over 900 people stopping smoking through with the use of an e-cigarette. It has led to positive partnership working with private businesses, and Trading Standards have been supportive when scoping potential stores for Essex Lifestyle Service to work with. Essex GPs are also signposting to the stores where appropriate.
With the support of Essex County Council, the project has been extended and will continue into the next financial year. The project has resulted in a net saving of over £100,000 and was a finalist in the LGC 2018 awards for the category of Innovation.
Behaviour change has been a large element of this project, especially for those who were dual users. For many people who chose to get support from a vape shop, the CO monitoring, behavioural support from the trained shop staff, and knowing they need to set a quit date proved to be successful.
What could be improved?
There should be promotion and campaigns to communicate that vaping is at least 95% less harmful than smoking.
Essex Lifestyle Service will start to work with housing associations to encourage smokefree homes. This will be implemented with the support of the vape stores by incentivising residents with free e-liquids or discounted offers on vaping equipment. Training of vape retailers will also continue to increase the number of stores in Essex supporting the project.
The project will be promoted throughout Stoptober.
Donna Porter, South and West Essex Locality Team Lead, Essex Lifestyles Service