What Smokers Want focus on bluecollar workers

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What Smokers Want (focus on blue-collar workers)

• Elizabeth M. Barbeau, ScD, MPH
• Dana-Farber Cancer Institute
• Harvard School of Public Health

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Data Source

• Part of large RCT trial to assess efficacy of a
  combined smoking cessation-diet intervention
  (Sorensen, PI)
• Focus groups held around the country in 2001-2002
• Sample n88 84 male 64 white, 15 black, 7
  Hispanic, 11 other 97 had not completed
  college, 17 did not complete high school age
  range 20-63 years, mean of 41 years of age 78
  current smokers

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Major Thematic Categories

• Barriers to quitting
• Attitudes about methods for quitting smoking
• Experiences with cessation aids

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Barriers to Quitting

• Lack of interest in quitting
• Many friends, family and co-workers smoke
• Lack of self-efficacy
• Concerns about weight gain
• Lack of insurance coverage
• Fear of experiencing withdrawal symptoms

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Attitudes about methods for quitting smoking

• Commonly-held view that single most important
  determinant of a successful quit is the strong
  desire and commitment to quit.
• Every time I buy a pack of cigarettes, Im
  putting another nail in my coffinBut I feel that
  if you really want to quit smoking, and you put
  in your mind to quit, you can do it. Doctors
  cant help you. Therapists cant help you. The
  patch is not going to help you. The little drops
  are not going to help youIts another form of
  (...inaudible) throwing you back. Its not going
  to help you. Youve got to decide that. If
  youre not willing to do it, it aint going to
  work. (54 year old African American male, smoker)

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  Attitudes about methods for quitting smoking
(contd)

• Lack of awareness of what is available
• Some serious misconceptions about cessation aids
• That nicotine Patch, it can cause as much harm
  to you as that cigarette.
• (Facilitator notes that smoking while wearing the
  patch can be harmful)
• And, not just with the smoking. The patch.
  They tell you its one thing, and it could be
  something else in there. It can cause cancer,
  too. (41 year old African American female,
  smoker)

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Attitudes about methods for quitting smoking
(contd)

• Tom (39 year old white male) Ive never tried
  the patches before, but some of the guys I know
  have tried and they said they smoked with the
  patches. It gave them such a rush.
• Mary (30-ish white female) I didnt. The gum
  made me sick.
• Tom If I knew there was something that could
  make me quit. I mean a pill, or anything at all.
• Jane (27 year old white female) Or an
  inhalant.
• Mary The pill increases your risk of heart
  attacks. 
• Jane Yeah but didnt they recall that.
  Something was wrong with that.

8
Experiences with cessation aids

• Many participants mentioned use of the nicotine
  patch, with mixed reports of success.
• A few mentioned Zyban, hypnosis, gum, nasal spray
• None mentioned any form of counseling or quitlines

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Experiences with nicotine patch

• I've done the patch, I can't tell you how many
  times. And, it's worked for me. And I've scaled
  down, until I got to the point where I didn't
  need one at all. Whatever situation may have
  arose, whether it be a stressful situation, or I
  was around someone else smoking, and it would
  start slowly again. I'd smoke five a day, and
  then half a pack a day. And then before I knew
  it, I was back to a pack a day. (40 year old
  white male) 

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Experiences with Zyban

• Well, it Zyban cut me back quite a bit, and
  thats during that bad time in my life. But,
  when it came down to it, I still wanted to smoke.
  So I just didnt quit. And with Zyban, you can
  smoke and take the Zyban. So its not like the
  nicotine patch or anything like that where youre
  going to overdose yourself with the nicotine.
  Zyban is more or less just anti-depression.
  Thats all it is. (41 year old white male)

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Experiences with several types of cessation aids

• Many participants had tried several methods of
  quitting over several different quit attempts
• Many reported extended abstinence periods of
  several months to several years, with relapses.
• Ive tried Nicorette, Ive tried the pill, Ive
  tried hypnosis, Ive tried the patches. I enjoy
  smoking. Every one of them worked for a little
  while. Then it didnt.(30-ish year old white
  female)