Using vapes to support the smokers of Bexley

To mark World No Tobacco Day, 31 May, we spoke with Emma Barry [pictured], Tobacco and Stop Smoking Service Manager, London Borough of Bexley (LB Bexley), who outlines below how vape starter kits are being used to help residents quit smoking.Emma Barry

I’ve been working as a Stop Smoking Advisor for over 7 years, and have been supporting the field for even longer, and during that time I have seen lots of changes in the treatments used to support smokers to quit smoking. I’ve seen people’s attitudes to E-cigarettes and vaping change vastly too; coming a long way from initial scepticism at this new fad, followed by fear of potential dangers they may present as more smokers embraced them, and finally to acceptance that they can provide a valuable role in helping smokers to finally move away from their addiction to tobacco.

The LB Bexley Stop Smoking Service has worked closely with our local vape shops for several years, and as the evidence around vaping grew stronger supporting their relative safety in comparison to smoking, we have looked at ways to improve access to E-cigarettes to our service users.

Data has regularly shown that in Britain, E-cigarettes are predominantly used among smokers or ex-smokers, with the main reasons for use being to quit smoking, prevent relapse or cut down smoking.

Being able to offer these devices within our service, would help to attract more smokers that may not normally engage with traditional support, or who have tried and failed using these methods in the past, particularly in our more deprived wards where smoking rates and health inequalities are higher.

When the opportunity came to set up a pilot scheme to offer a starter vape device to services users, we built on the strong relationships we had already developed with our local vape shops to make this possible. While we were experienced advisors, these shops were experts in using vapes and understanding the vast range of devices and liquids available. By the time the pilot was ready to begin, the world had changed; we were in a pandemic and supporting smokers was no longer done in person, instead being carried out through weekly telephone support sessions. Therefore, working in partnership with our local vape shops become a vital way of maintaining patients' access to their starter devices.

Patients entering the programme could choose the offer of a Public Health funded starter device as part of their treatment programme, as monotherapy or in combination with nicotine replacement therapy (NRT), alongside our usual 12-week support. They were issued a unique code by text to their mobile that they could then present to one of our participating vape shops to collect their device. Patients were successful using these devices as well. Quit rates for patients using a vape as part of their Quit plan was over 64% (October 2020- December 2021) and in pregnant smokers that figure was 52%, which was 10% higher than pregnant smokers who did not use a vape. With the loss of varenicline last year it also gave the service an alternative option over NRT and reduced the impact on quit attempts and success seen in some services.

Due to the success and popularity of the offer, it seemed only logical that we should make this part of our permanent offer to patients accessing the service. It is important to visit the vape shops you want to work with, ensure that they support the public health messaging and get to know the environment in-store. Many smokers will be new to this and may feel uncomfortable or intimidated entering these shops so can be reassured knowing that we have vetted them in advance, particularly if they are older or more vulnerable patients. All codes are now issued with an expiry date to ensure patients collect their device promptly to maintain their momentum to start their quit attempt, and also encouraging those who lack engagement from collecting their devices months later without accessing follow up behavioural support that is so important for their quit success. Redeemed codes are regularly monitored with the shop.

I would like to recognise the former Service Manager Jo Woodvine, who was instrumental in building these initial relationships and devising the pilot scheme. For further information on the programme, please contact Emma Barry at emma.barry@bexley.gov.uk and for further details of our service visit www.smokefreebexley.co.uk.