Understanding decisions to use e‐cigarettes or behavioural support to quit tobacco: a qualitative study of current and ex‐smokers and stop smoking service staff

Background In most European countries, women are relatively more susceptible to smoking-related diseases, find it more difficult to quit and more likely to relapse than men. With the aim to improve understanding of women’s needs from smoking cessation services, this qualitative study examines perceptions of women from deprived communities on the National Health Service Stop Smoking Service in England.Methods A qualitative study of 11 women, smokers and ex-smokers, who had used Stop Smoking Services located in disadvantaged communities in East Sussex, England. Data were collected through focus group and semi-structured interviews, and were subjected to thematic analysis.Results Women felt that services tailored to their needs would improve cessation rates. They expect smoking cessation facilitators to be non-judgemental and to offer psychological insight into addiction. However, women’s opinions differed on the importance for facilitators to be female or ex-smokers, and on the preference of group or one-to-one services, some women expressed a preference for women only groups. The women praised the continuity of care, capacity for peer support, flexibility of time and location and free cessation aids offered. Conversely, the women felt that services were poorly advertised, that access was not universally good, and that services at work place and drop-in groups would improve access for working women and women with young children.Conclusion Flexible services that are tailored towards the needs of individual smokers and better dissemination of information regarding the range of services available could facilitate greater uptake of smoking cessation services for women in deprived communities.

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Exploring the experiences of pregnant women using an NHS stop smoking service: a qualitative study

Perspectives in Public Health ◽

10.1177/1757913915577156 ◽

2015 ◽

Vol 135 (3) ◽

pp. 138-144 ◽

Cited By ~ 4

Author(s):

Anne B Pledger

Keyword(s):

Qualitative Study ◽

Pregnant Women ◽

Stop Smoking ◽

Stop Smoking Service

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Qualitative study of perceptions of senior health service staff as to factors influencing the development of Advanced Clinical Practice roles in mental health services

Journal of Psychiatric and Mental Health Nursing ◽

10.1111/jpm.12792 ◽

2021 ◽

Author(s):

Neil Brimblecombe ◽

Fiona Nolan

Keyword(s):

Mental Health ◽

Clinical Practice ◽

Mental Health Services ◽

Health Service ◽

Qualitative Study ◽

Health Services ◽

Factors Influencing ◽

Service Staff ◽

Senior Health

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A pilot randomized controlled trial to increase smoking cessation by maintaining National Health Service Stop Smoking Service attendance

British Journal of Health Psychology ◽

10.1111/bjhp.12078 ◽

2013 ◽

Vol 19 (4) ◽

pp. 795-809 ◽

Cited By ~ 10

Author(s):

Faith Matcham ◽

Lisa McNally ◽

Florian Vogt

Keyword(s):

Randomized Controlled Trial ◽

Smoking Cessation ◽

National Health Service ◽

Health Service ◽

Controlled Trial ◽

Randomized Controlled ◽

Stop Smoking ◽

Stop Smoking Service ◽

Pilot Randomized Controlled Trial ◽

Service Attendance

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124: Electronic cigarette use and risk perception in a Stop Smoking Service in England

Lung Cancer ◽

10.1016/s0169-5002(15)50118-9 ◽

2015 ◽

Vol 87 ◽

pp. S45

Author(s):

F. Sherratt ◽

M. Marcus ◽

J. Robinson ◽

L. Newson ◽

J. Field

Keyword(s):

Risk Perception ◽

Electronic Cigarette ◽

Cigarette Use ◽

Stop Smoking ◽

Stop Smoking Service

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Investigating change in non-government mental health service organisations’ ‘smoke-free’ attitudes and practice in New Zealand

The Journal of Smoking Cessation ◽

10.1017/jsc.2014.9 ◽

2014 ◽

Vol 10 (2) ◽

pp. 124-134

Author(s):

Penny Marlowe ◽

Janine Paynter

Keyword(s):

Mental Health ◽

Mental Health Service ◽

Health Service ◽

Logistic Models ◽

Cross Sectional ◽

Response Options ◽

Attitudes And Practices ◽

Quit Smoking ◽

Stop Smoking ◽

Service Staff

Smoking prevalence amongst service users from the mental health and addictions sectors is higher than the general population. Cross-sectional web- or paper-based surveys comprising open and closed response options were used to examine changes in prevailing attitudes and practices amongst non-government mental health service staff and users. Thematic analysis was used to interpret and present open response answers. Multi-variate logistic models were used to investigate which factors are associated with smoke-free attitudes and practices. Staff who smoke were found to be less likely to provide cessation support to clients (AOR 0.51, 95% CI 0.31–0.82) and gave significantly lower estimates of the percentage of clients who wish to stop smoking (30% vs 44%, p < 0.0001). Those who had completed cessation training also had more positive views about the importance of providing cessation support and service user desire to stop smoking. Staff who had not completed cessation training had significantly lower odds of reporting they carried out quit smoking support often and routinely (AOR 0.33, 95% CI 0.23–0.47) The results suggest that continuing improvement will be enabled by increasing rates of cessation training amongst staff of mental health and addictions non-government organisations. In addition, there is a need for increased incentive and support for staff who smoke to quit.

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Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study

Health Technology Assessment ◽

10.3310/hta19950 ◽

2015 ◽

Vol 19 (95) ◽

pp. 1-156 ◽

Cited By ~ 31

Author(s):

Fiona Dobbie ◽

Rosemary Hiscock ◽

Jo Leonardi-Bee ◽

Susan Murray ◽

Lion Shahab ◽

...

Keyword(s):

Prospective Study ◽

Secondary Analysis ◽

Routine Data ◽

Well Being ◽

Behavioural Support ◽

Stop Smoking ◽

Stop Smoking Services

BackgroundNHS Stop Smoking Services (SSSs) provide free at the point of use treatment for smokers who would like to stop. Since their inception in 1999 they have evolved to offer a variety of support options. Given the changes that have happened in the provision of services and the ongoing need for evidence on effectiveness, the Evaluating Long-term Outcomes for NHS Stop Smoking Services (ELONS) study was commissioned.ObjectivesThe main aim of the study was to explore the factors that determine longer-term abstinence from smoking following intervention by SSSs. There were also a number of additional objectives.DesignThe ELONS study was an observational study with two main stages: secondary analysis of routine data collected by SSSs and a prospective cohort study of service clients. The prospective study had additional elements on client satisfaction, well-being and longer-term nicotine replacement therapy (NRT) use.SettingThe setting for the study was SSSs in England. For the secondary analysis, routine data from 49 services were obtained. For the prospective study and its added elements, nine services were involved. The target population was clients of these services.ParticipantsThere were 202,804 cases included in secondary analysis and 3075 in the prospective study.InterventionsA combination of behavioural support and stop smoking medication delivered by SSS practitioners.Main outcome measuresAbstinence from smoking at 4 and 52 weeks after setting a quit date, validated by a carbon monoxide (CO) breath test.ResultsJust over 4 in 10 smokers (41%) recruited to the prospective study were biochemically validated as abstinent from smoking at 4 weeks (which was broadly comparable with findings from the secondary analysis of routine service data, where self-reported 4-week quit rates were 48%, falling to 34% when biochemical validation had occurred). At the 1-year follow-up, 8% of prospective study clients were CO validated as abstinent from smoking. Clients who received specialist one-to-one behavioural support were twice as likely to have remained abstinent than those who were seen by a general practitioner (GP) practice and pharmacy providers [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.2 to 4.6]. Clients who received group behavioural support (either closed or rolling groups) were three times more likely to stop smoking than those who were seen by a GP practice or pharmacy providers (OR 3.4, 95% CI 1.7 to 6.7). Satisfaction with services was high and well-being at baseline was found to be a predictor of abstinence from smoking at longer-term follow-up. Continued use of NRT at 1 year was rare, but no evidence of harm from longer-term use was identified from the data collected.ConclusionsStop Smoking Services in England are effective in helping smokers to move away from tobacco use. Using the 52-week CO-validated quit rate of 8% found in this study, we estimate that in the year 2012–13 the services supported 36,249 clients to become non-smokers for the remainder of their lives. This is a substantial figure and provides one indicator of the ongoing value of the treatment that the services provide. The study raises a number of issues for future research including (1) examining the role of electronic cigarettes (e-cigarettes) in smoking cessation for service clients [this study did not look at e-cigarette use (except briefly in the longer-term NRT study) but this is a priority for future studies]; (2) more detailed comparisons of rolling groups with other forms of behavioural support; (3) further exploration of the role of practitioner knowledge, skills and use of effective behaviour change techniques in supporting service clients to stop smoking; (4) surveillance of the impact of structural and funding changes on the future development and sustainability of SSSs; and (5) more detailed analysis of well-being over time between those who successfully stop smoking and those who relapse. Further research on longer-term use of non-combustible nicotine products that measures a wider array of biomarkers of smoking-related harm such as lung function tests or carcinogen metabolites.FundingThe National Institute for Health Research Health Technology Assessment programme. The UK Centre for Tobacco and Alcohol Studies provided funding for the longer-term NRT study.

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