Quitline Counsellors' Experiences With Vaping and Nicotine Replacement Therapy for Smoking Cessation in Australian Drug and Alcohol Services

INTRODUCTION: In Australia, people undergoing inpatient treatment for alcohol and other drug (AOD) use disorders have a high prevalence of tobacco smoking. Smoking cessation support is routinely offered to clients within inpatient withdrawal settings, but continued support post-discharge typically is not. The current study qualitatively explores attitudes and experiences of Quitline counsellors involved in a two-armed trial for clients with provision of 12 weeks of nicotine vaping products (NVPs) or combination nicotine replacement therapy (cNRT). METHODS: Two focus groups of Quitline counsellors (six per group) explored how they felt about training received, their beliefs and attitudes about NVPs and cNRT for smoking cessation for AOD-use population and their wider experience supporting AOD clients. Data were inductively coded. RESULTS: Six themes were identified: (i) Counsellor Readiness and Professional Adaptation to Emerging Cessation Tools; (ii) Addressing Complexity: Behavioural Support in Multi-Substance Recovery Contexts; (iii) Client Preferences and Product Engagement in Cessation Support; (iv) Continuity of Care: Bridging Residential Treatment and Community Support; (v) Enablers of Quality Practice: Training, Resources and Organisational Support; and (vi) Service Integration and Boundary Management in Specialised Populations. DISCUSSION AND CONCLUSIONS: The agility of Quitline services models their potential to partner with clinical research teams and AOD services to build the evidence-base around the effectiveness of reduced-harm nicotine products for people with complex needs. The Victorian Quitline partnership with the NEAT trial produced a comprehensive service model assisting people seeking AOD treatment to quit smoking that highlights the workforce as a modifiable factor by involving staff in evidence-building adaptability.