What Differentiates Underserved Smokers Who Successfully Quit From Those Who Do Not
- 270 Downloads
Poor persons continue to smoke at high rates and suffer grave health effects. We have been working with our community partners since 2008 to help poor people in the surrounding neighborhoods stop smoking through a multi-phase CBPR intervention known as CEASE. Our study used qualitative methods to identify factors that characterized those who successfully quit smoking (doers) and those who did not (non-doers). Both doers and non-doers identified social pressure as the main reason for starting to smoke, and health as the main motivator for quitting. Although they were similar in many ways, the doers seemed to have more social support for cessation—i.e., more people in their lives who wanted them to quit and whom they wanted to protect from secondhand smoke. The non-doers offered more feedback on how to improve the cessation classes, including making them longer, reducing the class size, adding extra counseling, and using quitting partners. Both doers and non-doers reported increased self-confidence, appreciation for the cessation support they received from CEASE, and a desire that the group classes continue. Cessation is a social event and smokers with more social support appear to be more successful at quitting. Showing interest in and offering social support to poor underserved smokers in their own communities is a powerful way to help them.
KeywordsCommunity-based participatory research (CBPR) Peer motivator Doer/non-doer analysis Social capital
The funding was provided by National Institute of General Medical Sciences (UL1GM118973) and National Institute on Minority Health and Health Disparities (MD000217 and MD002803).
Compliance with Ethical Standards
Conflict of interest
The authors whose names are listed immediately above certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
- 1.General, S. (1964). Report of the advisory committee to the surgeon general of the public health service(p. 1103). Wasington, DC: US Department of Health, Education and Welfare, Public Health Service PublicationGoogle Scholar
- 2.CDC’s Office on Smoking and Health (2016). Trends in current cigarette smoking among high school students and adults, United States, 1965–2014. Retrieved from http://www.cdc.gov/tobacco/data_statistics/tables/trends/cig_smoking/.
- 4.Substance Abuse and Mental Health Services Administration (2013). The NSDUH Report: Adults with mental illness or substance use disorder account for 40 percent of all cigarettes smoked. National Survey on Drug and Health. Retrieved from https://www.samhsa.gov/data/sites/default/files/spot104-cigarettes-mental-illness-substance-use-disorder/spot104-cigarettes-mental-illness-substance-use-disorder.pdf.
- 5.American Cancer Society. (2015). Why people start using tobacco, and why it’s hard to stop. Retrieved from https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/why-people-start-using-tobacco.html.
- 6.US Department of Health and Human Services. (1988). The health and consequences of smoking. Nicotine addiction: A report of the surgeon general.Google Scholar
- 8.William, B. T. D. M. B., & Shopland, R. L. D. (1998). Community-based Interventions for smokers: The commit field experience. Collingdale: DIANE Publishing.Google Scholar
- 12.Cummings, K. M., & Orleans, C. T. (2009). Policies to achieve a smoke-free society: A research agenda for 2010–2015. Princeton: Robert Wood Johnson Foundation.Google Scholar
- 14.Sheikhattari, P., Apata, J., Kamangar, F., Schutzman, C., O’Keefe, A., Buccheri, J., & Wagner, F. A. (2016). Examining smoking cessation in a community-based versus clinic-based intervention using community-based participatory research. Journal of Community Health, 41(6), 1146–1152.CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Estreet, A., Apata, J., Kamangar, F., Schutzman, C., Buccheri, J., O’Keefe, A. M., Wagner, F., & Sheikhattari, P. (2017). Improving participants’ retention in a smoking cessation intervention using a community-based participatory research approach. International Journal of Preventive Medicine, 8, 106PubMedPubMedCentralGoogle Scholar
- 16.Scientific Software Development. (2014). ATLAS.ti: The qualitative data analysis & research software [computer software]. Berlin: Scientific Software Development.Google Scholar
- 18.Brown, T., Platt, S., & Amos, A. (2014). Equity impact of interventions and policies to reduce smoking in youth: Systematic review. Tobacco Control. https://doi.org/10.1136/tobaccocontrol-2013-051451.CrossRefPubMedPubMedCentralGoogle Scholar
- 27.Williams, G. C., McGregor, H. A., Sharp, D., Levesque, C., Kouides, R. W., Ryan, R. M., & Deci, E. L. (2006). Testing a self-determination theory intervention for motivating tobacco cessation: Supporting autonomy and competence in a clinical trial. Health Psychology, 25(1), 91.CrossRefPubMedGoogle Scholar
- 29.Silagy, C., Lancaster, T., Stead, L., Mant, D., & Fowler, G. (2004). Nicotine replacement therapy for smoking cessation. Cochrane Database System Review, 3, CD000146.Google Scholar
- 30.Benson, F. E., Stronks, K., Willemsen, M. C., Bogaerts, N. M., & Nierkens, V. (2014). Wanting to attend isn’t just wanting to quit: Why some disadvantaged smokers regularly attend smoking cessation behavioural therapy while others do not: A qualitative study. BMC Public Health, 14(1), 695.CrossRefPubMedPubMedCentralGoogle Scholar
- 32.MacPherson, L., Tull, M. T., Matusiewicz, A. K., Rodman, S., Strong, D. R., Kahler, C. W., Hopko, D. R., Zvolensky, M. J., Brown, R. A., & Lejuez, C. W. (2010). Randomized controlled trial of behavioral activation smoking cessation treatment for smokers with elevated depressive symptoms. Journal of Consulting and Clinical Psychology, 78(1), 55–61.CrossRefPubMedPubMedCentralGoogle Scholar