Views and Preferences for Nicotine Products as an Alternative to Smoking: A Focus Group Study of People Living with Mental Disorders

Abstract

Aims and Background: People living with mental disorders experience a disproportionately higher burden of tobacco-related disease than the general population. Long-term substitution with less harmful nicotine products could reduce the tobacco-related harm among this population. This study investigated the views and preferences of people with mental health disorders about different nicotine products and their use as long-term substitutes for cigarettes. Methods: Semi-structured focus group discussion followed by a brief questionnaire. The discussion transcripts were analysed for content and themes and quantitative data summarised with descriptive statistics. Results: Twenty-nine participants took part in four focus groups. Vaping devices were the most acceptable nicotine products discussed; however preferences for nicotine products were individual and varied along aesthetic, pragmatic, sensory and symbolic dimensions. The concept of tobacco harm reduction was unfamiliar to participants, however they generally agreed with the logic of replacing cigarettes with less harmful nicotine products. Barriers to activating tobacco harm reduction included the symbolism of smoking and quitting; the importance placed on health; the consumer appeal of alternatives; and cost implications. Discussion and Conclusions: Engaging this population in tobacco harm reduction options will require communication that challenges black and white thinking (a conceptual framework in which smoking cigarettes or quitting all nicotine are the only legitimate options) as in practice this serves to support the continuance of smoking. Consumers should be encouraged to trial a range of nicotine products to find the most acceptable alternative to smoking that reduces health harms. Providing incentives to switch to nicotine products could help overcome barriers to using less harmful nicotine products among mental health consumers.

Are Electronic Cigarettes an Effective Aid to Smoking Cessation or Reduction Among Vulnerable Groups? A Systematic Review of Quantitative and Qualitative Evidence

“…One cohort observational study was included (n=956) (21). Four qualitative studies were included (62–65); three involving focus groups (n=128) (63–65) and one qualitative analysis of online postings (62). Five studies were performed in the USA (6, 21, 60, 63, 64) and one in each of Australia (65), Italy (59, 61), New Zealand (57) and international posters online (62).…”

“…Six studies included participants with mental illness (6, 21, 57, 59, 61, 62, 65), two homelessness (63, 64), and one substance misusers (60). No studies involving the CJS were identified.…”

Nicotine vaping product use, harm perception and policy support among pharmacy customers in Brisbane, Australia

“…No suitable validated tool was identified, so the questionnaire was developed based on other surveys conducted by our collaborators about consumer views and preferences of lower‐risk alternatives to smoking including NVPs . The questionnaire was piloted for comprehensibility with five members of the general public recruited through the research team′s social networks, and slight adjustments made accordingly.…”

Are Australian smokers with mental illness receiving adequate smoking cessation and harm reduction information?

“…Keeping the cost low would also facilitate more smokers trying out different forms of NRT, which would increase the likelihood of finding one's preferred NRT product (Meurk et al . ). Review of existing restrictions on availability of subsidized varenicline (1 course per year) is also needed.…”