What factors are important in smoking cessation amongst deprived communities?

Abstract

Objective: There is limited evidence regarding effective smoking cessation interventions in deprived communities. This study explored what factors are considered most important in smoking cessation, from the perspective of a group of NHS Stop Smoking Service users from a deprived community. Design: A qualitative study. Setting: A deprived community in Brighton and Hove City, Southeast England. Methods: Fifteen adults who had used the local NHS Stop Smoking Service were recruited to the focus groups. Thematic analysis was used to identify key themes regarding factors that were considered most helpful during the smoking cessation attempt. Results: Factors deemed most important for a successful smoking cessation attempt were counsellors' attitude and knowledge, flexibility of appointments, personalized one-to-one support including additional support between sessions, all provided in an accessible local community setting. Individuals were most likely to decide to quit smoking for health reasons, and support from family and friends was important during the quit attempt. Conclusion: This study shows that smokers from deprived communities require more intensive, flexible and personalized support from a stop smoking service which should ideally be located in their community setting. A more innovative, tailored and less prescriptive approach to providing stop smoking services may help to improve cessation rates among smokers in deprived communities.

Opinions of women from deprived communities on the NHS stop smoking service in England - person-centered perspectives.

“…This is consistent with previous research which has shown that fear of health professional judgement can act as a barrier for disadvantaged smokers to access smoking cessation services [22,23]. Several women felt that group sessions were highly valuable, notably in the support, advice and shared experiences provided from attending the groups.…”

“…Meta-analysis of randomised control trials shows quit attempts are more successful when a smoking cessation facilitator is combined with nicotine replacement therapy (NRT) or other cessation therapies [30]. The cost of smoking cessation aids has also been shown to be a deterrent for people from deprived communities [23]. Evidence suggests that utility of NRTs is particularly important for women.…”

Smoking Cessation in Lower Socioeconomic Groups: Adaptation and Pilot Test of a Rolling Group Intervention

“…Overall (see Figure 1), our literature search revealed that lower SES smokers find it more difficult to quit because of severe nicotine addiction [9,10], strong smoking habits, and the absence of alternative behaviors that can replace smoking [9,38,39]. Also, they experience low self-efficacy and coping skills [10,40], low social support for quit attempts [10,29,39,41], and a strong prosmoking social norm [38,42]. In addition, lower SES smokers are often unfamiliar with the services available [43,44] and tend to have negative attitudes towards smoking cessation support (e.g., perceiving support as ineffective and expensive) [9,43,45].…”

“…Important reasons to smoke include coping with povertyrelated stress [10,38], loneliness and boredom [9,42], and weight-gain prevention [39]. Additional needs indicated by lower SES smokers included peer support [10,29,41] and support regarding material and social circumstances [42,[46][47][48].…”

“…BioMed Research International relapses), intensive (e.g., extra support in between formal meetings), and permanent (i.e., allowing for long-lasting and repeated participation) [9,40,41,43,45,49]. Based on the above needs, the program goal we formulated for the adapted intervention was to transform lower SES smokers into nonsmokers (see Figure 2).…”