Barriers and facilitators for smoking cessation in chronic smokers with atherosclerotic cardiovascular disease enrolled in a randomized intervention trial: A qualitative study

Vilde Getz; John Munkhaugen; Hanne C Lie; Toril Dammen

doi:10.3389/fpsyg.2023.1060701

Barriers and facilitators for smoking cessation in chronic smokers with atherosclerotic cardiovascular disease enrolled in a randomized intervention trial: A qualitative study

Front Psychol. 2023 Mar 22:14:1060701. doi: 10.3389/fpsyg.2023.1060701. eCollection 2023.

Authors

Vilde Getz¹, John Munkhaugen^{2

3}, Hanne C Lie², Toril Dammen^{1

4}

Affiliations

¹ Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
² Department of Behavioural Medicine, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
³ Department of Medicine, Drammen Hospital, Drammen, Norway.
⁴ Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.

Abstract

Objectives: Smoking is common in patients with cardiovascular disease. Despite strong recommendations for cessation and the existence of efficacious pharmacological and behavioral interventions, cessation rates remain low. Therefore, in this study, we explore perceived facilitators and barriers to smoking cessation in patients with atherosclerotic cardiovascular disease who have participated in a cessation intervention study.

Methods: Participants (N = 10) from the intervention arm of a randomized controlled study with access to free cessation support and pharmacological aids completed a semi-structured, in-depth telephone interview after a 6-monthfollow-up between October 2021 and July 2022. The interviews were audio recorded, transcribed, and analyzed according to principles of thematic analysis.

Results: The mean age was 65.7 (range: 55-79) years, and three of the 10 participants were women. Among the participants, five had quit smoking, three had relapsed, and two were persistent smokers. The themes identified encompassed barriers and facilitators to cessation, both including individual and contextual factors. Barriers included the upsides of smoking, difficult life situations, addiction to smoking, smoking in social circles, perceived lack of support and understanding from health professionals. Facilitators included intrinsic motivation, concerns about the health condition, financial implications, specific behavioral strategies, positive influence from the social environment, and helpful components of the cessation intervention.

Conclusion: Smokers with cardiovascular disease who have attended a cessation intervention study report several facilitators weighted against barriers, interacting with the intention to cease smoking. The most important potentially modifiable factors of significance for cessation identified may be addressed through motivational interviews and focus groups with other smokers.

Keywords: cardiovascular disease; facilitators and barriers; qualitative; secondary prevention; smoking cessation.

Grants and funding

This study was funded by the University of Oslo and Drammen Hospital.