A brief intervention for smoking cessation in the ambulance setting-an exploratory mixed methods study to reach health equity.

Background: The role of a brief intervention (BI) for smoking cessation with patients using National Health Service (NHS) ambulance services is underexplored but may reach tobacco smokers currently not engaging with NHS stop smoking services (SSS).

Methods: A BI comprising smoking cessation education, a referral to local NHS SSS and nicotine replacement therapy (NRT) was delivered to consenting patients aged ≥18 years in a regional NHS ambulance service in England.

Results: Of 140 patients (56% female, mean age 54.9 (14.6) years), 103 (74%) were conveyed, and 41 (29%) admitted to hospital. Outcomes included 28-day quit achieved (n = 31), current supported quit attempt (n = 6), reconsidered decision to quit/lost to follow-up after commencing NRT (n = 76), and uncontactable (n = 27). There was no association between a successful quit attempt and patient age, gender, ethnicity, or socio-economic status. Reasons behind being lost to follow-up included reconsidering the quit attempt, competing co-morbidity, and digital poverty.

Conclusion: A BI delivered in the ambulance setting may be the only opportunity to connect tobacco smokers currently not reached by the current model, with NHS SSS. A repeated offer of support with 'all' smokers in this setting may help reduce disparities in health inequality.