Abstract
Background Cervical screening could be an appropriate moment to provide female smokers with stopping smoking advice and support. In Dutch general practice cervical smears are performed by practice assistants. The aim of this study was to identify potential barriers or enablers for a stopping smoking strategy performed by trained practice assistants after routine cervical screening. The strategy consists of brief stopping smoking advice and is based on the Ask-Advise-Connect approach.Methods Three focus group meetings were held with 10 practice assistants, 3 nurses, and 6 general practitioners. We analysed data using thematic analysis. Identified factors are presented within the framework of the Social Ecological Model.Results Potential influential factors were identified at individual, interpersonal, and workplace levels. At the individual level: practice assistants did not see themselves as having a professional role in a smoking cessation program. While they could register smoking status, they were reluctant to provide advice. However, practice assistants valued having advice at hand in order to make relatively young female smokers aware of the health risks At the interpersonal level: practice assistants thought that their relationship with the women would change if they gave stopping smoking advice. Moreover, the assistant’s own attitude to smokers and her beliefs about the smoker’s willingness to change behaviour could influence the relationship. At the workplace level: the availability and motivation of nurses might hamper referral. The general practitioners’ opinion about primary prevention and smoking cessation could influence the amount of support given to practice assistants when it comes to providing stopping smoking advice.Conclusions At individual, interpersonal, and workplace levels, several factors could influence the provision of a stop smoking strategy by a practice assistant. These factors could be used to design a behavioural change intervention to be provided by practice assistants after cervical cancer screening.
Stopping smoking advice given by practice assistants after routine cervical screening in general practice: a qualitative exploration of potential barriers and enablers.
