Why Don’t Smokers Want Help to Quit? A Qualitative Study of Smokers’ Attitudes towards Assisted vs. Unassisted Quitting

Morphett, Kylie; Partridge, Brad; Gartner, Coral; Carter, Adrian; Hall, Wayne

doi:10.3390/ijerph120606591

Cited by 66 publications

(50 citation statements)

References 43 publications

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“…Tobacco harm reduction in the form of long-term substitution of cigarettes with a less harmful nicotine product was a foreign concept to most participants, with many indicating a belief that quitting smoking was an “all or nothing” activity. This finding corroborates similar studies showing a pervasive belief among general population smokers that unassisted quitting is superior to assisted quitting and negative views of the idea of using medications to aid quitting [30,31,32]. Nevertheless, participants generally indicated an understanding of the benefits of using a less harmful alternative to smoking when it was put to them.…”

Section: Discussionsupporting

confidence: 88%

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

Ford

Sharma

Fitzgerald

et al. 2016

IJERPH

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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.

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Section: Discussionsupporting

confidence: 88%

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

Ford

Sharma

Fitzgerald

et al. 2016

IJERPH

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“…In Smith et al's (45) study of exsmokers, quitting without assistance was believed to be a morally superior method of cessation as it aligned with personal values of independence, strength, autonomy, self-control and self-reliance. Similarly, Morphett et al's study (46) of smokers' attitudes toward assisted and unassisted quitting found smokers identified quitting unassisted as the 'best' way to quit and one they valued for the sense of achievement that it would bring, while using cessation aids was seen as 'cheating'. Possessing sufficient willpower, a strong desire to quit, and being 'ready' were seen as necessary, and generally, sufficient, for a quit attempt to be successful.…”

Section: Discussionmentioning

confidence: 99%

Stuck in the catch 22: attitudes towards smoking cessation among populations vulnerable to social disadvantage

et al. 2016

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Aim To explore how smoking and smoking cessation is perceived within the context of disadvantage, across a broad cross‐section of defined populations vulnerable to social disadvantage. Design Qualitative focus groups with participants recruited through community service organizations (CSO). Setting Metropolitan and regional settings in Queensland, Australia. Focus groups were held at the respective CSO facilities. Participants Fifty‐six participants across nine focus groups, including people living with mental illness, people experiencing or at risk of homelessness (adult and youth populations), people living with HIV, people living in a low‐income area and Indigenous Australians. Measurements Thematic, in‐depth analysis of focus group discussions. Participant demographic information and smoking history was recorded. Findings Smoking behaviour, smoking identity and feelings about smoking were reflective of individual circumstances and social and environmental context. Participants felt ‘trapped’ in smoking because they felt unable to control the stressful life circumstances that triggered and sustained their smoking. Smoking cessation was viewed as an individual's responsibility, which was at odds with participants' statements about the broader factors outside of their own control that were responsible for their smoking. Conclusion Highly disadvantaged smokers' views on smoking involve contradictions between feeling that smoking cessation involves personal responsibility, while at the same time feeling trapped by stressful life circumstances. Tobacco control programmes aiming to reduce smoking among disadvantaged groups are unlikely to be successful unless the complex interplay of social factors is carefully considered.

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“…Concerns about health risks are even more pronounced in relation to prescription pharmacotherapies for smoking cessation. Smokers commonly believe that these have serious and life-threatening side effects,59 67 while ignoring the substantial risk of dying from continuing to smoke.…”

Section: Factors Limiting the Biomedicalisation Of Smokingmentioning

confidence: 99%

Medicalisation, smoking and e-cigarettes: evidence and implications

et al. 2016

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There is debate in the tobacco control literature about the value of a medical model in reducing smoking-related harm. The variety of medical treatments for smoking cessation has increased, health professionals are encouraged to use them to assist smoking cessation and tobacco dependence is being described as a 'chronic disease'. Some critics suggest that the medicalisation of smoking undermines the tobacco industry's responsibility for the harms of smoking. Others worry that it will lead smokers to deny personal responsibility for cessation, create beliefs in 'magic bullets' for smoking cessation, or erode smokers' confidence in their ability to quit. We argue that the medicalisation of smoking will have limited impact due to the emphasis on population-based interventions in tobacco control, the ambiguous place of nicotine among other drugs and the modest efficacy of current pharmacotherapies. These factors, as well as lay understandings of smoking that emphasise willpower, personal choice and responsibility, have contributed to the limited success of medical approaches to smoking cessation. While the rapid uptake of e-cigarettes in some countries has provided an option for those who reject medical treatments for smoking cessation, current regulatory developments could limit the potential of e-cigarettes to provide non-therapeutic nicotine for those who currently smoke tobacco.

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Why Don’t Smokers Want Help to Quit? A Qualitative Study of Smokers’ Attitudes towards Assisted vs. Unassisted Quitting

Cited by 66 publications

References 43 publications

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

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

Stuck in the catch 22: attitudes towards smoking cessation among populations vulnerable to social disadvantage

Medicalisation, smoking and e-cigarettes: evidence and implications

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