The SAVINGS study is a randomised controlled trial looking at the impact, cost-effectiveness, personal financial impact, and acceptability of providing very brief advice on smoking and an e-cigarette for people who smoke who are accessing financial support services to help them stop smoking. This study is embedded in the Oxford Tobacco Addiction Group (OXTAG). 

People experiencing socioeconomic disadvantage are more likely to smoke cigarettes which leads to greater health issues experienced in this group compared to others. Brief opportunistic advice on smoking has been found to be acceptable and effective in clinical settings. It could also provide a quick, cost-effective way to reach the populations most affected if delivered within services accessed by people in financial difficulty, such as social housing, debt advice, or other social service settings. Successful quitting could help to reduce health disparities and, as cigarettes are increasingly expensive, reduce financial strain. A recent scoping review and service evaluation have demonstrated the acceptability and feasibility of this approach; however, there is very little information on whether the approach helps more people to stop smoking.

This study is a two-arm randomised control trial, recruiting 1,538 people who smoke daily, accessing a service to provide assistance with their financial difficulties.

The intervention arm (N=769) will receive very brief advice on quitting smoking as part of their usual appointment, including information on the financial benefits of quitting, the best ways to quit and support available. They will be sent an e-cigarette starter kit (e-cigarette and e-liquid), advised of different forms of behavioural support available (local services; a mobile phone app; national quit line and web resources) and directed to the one most suited to them. The comparator arm (N=769) will receive usual care for this setting in the UK (i.e. no advice/resource on quitting smoking). 

We will assess the number of participants who have quit smoking (biochemically verified) at 12 weeks and 9 months follow-up. We will assess the economic impact of the intervention from a public sector perspective and conduct a process evaluation. For the latter, we will record and analyse intervention delivery and interview participants and service providers about their experiences in the study. 

Working in our pilot trial with Clarion Futures, our social housing PPI panel has been involved from the initial development of this research idea through to study design and dissemination planning. Residents strongly supported the project, emphasising the financial benefits of quitting and the need for accessible, community-based support. Their insights shaped key decisions, such as offering multiple support options to accommodate financial and logistical barriers, providing e-cigarettes directly, and assisting with booking behavioural support.

As we progress, we will continue involving people with experience of smoking and financial difficulty to ensure our intervention is appropriately adapted before moving to the next stage. The PPI panel will also contribute to shaping our dissemination strategy to ensure findings reach those who would benefit most.

If you would like to be involved in shaping our research, please consider joining our PPI panel. For more information, please contact Angela (our PPI lead) at savings@phc.ox.ac.uk.

To undertake an RCT, with internal pilot, to evaluate the effectiveness of very brief, opportunistic advice on smoking compared to usual care delivered in financial advice services.

To estimate the intervention's cost-effectiveness relative to usual care.

To conduct a process evaluation to understand factors, e.g., quit attempts; intervention acceptability, influencing intervention effects.

We will share findings with participants, financial guidance providers, the public, policy makers and researchers. We will use innovative methods, such as podcasts, videos and infographics, as well as conference presentations, attending meetings and webinars, peer reviewed papers, and press engagement. We will design outputs with public representatives and other relevant stakeholders. Dissemination will be aided by the National Centre for Smoking Cessation and Training (NCSCT) and Action on Smoking and Health (ASH), through their established networks. NCSCT will develop and implement a training programme for financial guidance settings based on study findings.

If the intervention is effective, we hope it will contribute to helping people accessing financial advice services to quit smoking and improve their overall health, finances and well-being.

On a population level, we hope that it will contribute to reducing health inequalities.

NIHR Public Health Research Programme

University of York Clinical Trials Unit

Clarion Futures

National Centre for Smoking Cessation and Training (NCSCT)

Action on Smoking and Health (ASH)

University of East Anglia

University College London

Brunel University of London

Trinity College Dublin