Date: 08/17/2025
Source: Health Technology Assessment (2025); 29(35)
The Essentials
A randomized clinical trial conducted in six UK hospitals evaluated the distribution of vaping kits in emergency departments.
After six months, confirmed abstinence: 7.2% in the vaping group vs. 4.1% in the leaflet group.
Average intervention cost: £48 per person; kit cost: £23.15.
Economic evaluation: ICER of £7,750 per QALY — considered cost-effective for the NHS.
Evidence suggests that opportunistic, low-cost interventions in emergency settings can help reduce health inequalities.
Why It Matters
Smoking remains concentrated among the most vulnerable. Many never reach formal cessation services. CoSTED shows that the emergency room — a universal space, where everyone passes through in moments of fragility — can also serve as an entry point to public health.
For policymakers, this is a rare opportunity to align three forces: harm reduction, economic efficiency, and social equity. A hospital corridor, designed only for the immediate, can also become a place of possibility.
What Changes in Practice
Health/Regulation – Robust cost-effectiveness evidence puts pressure on the NHS and regulators to recognize e-cigarettes as legitimate cessation tools.
Industry/Innovation – Creates room for partnerships with manufacturers of simple and affordable devices designed for clinical use, without direct dependence on the tobacco industry.
Society/Environment – Emergency room interventions target smokers in vulnerable contexts, expanding access to less harmful alternatives and helping to reduce health disparities.
Scenarios and Next Steps
Short term (1–2 years): replication of the study in other regions, adjustments in staff training and referral protocols.
Medium term (3–5 years): integration of the model into NHS routine practice and expansion to other clinical services — primary care, outpatient visits.
Long term (5–10 years): consolidation of vaping kits as part of national cessation policy, with lasting impact on smoking prevalence and healthcare costs.
The Takeaway
A simple kit, distributed in a hospital corridor, can save years of life at a low cost and with a high social impact.
For Further Reading
Read the full analysis here → claudioteixeira.substack.com/p/costed