"I'm not strong enough; I'm not good enough. I can't do this, I'm failing"- A qualitative study of low-socioeconomic status smokers' experiences with accesssing cessation support and the role for alternative technology-based support.
"I'm not strong enough; I'm not good enough. I can't do this, I'm failing"- A qualitative study of low-socioeconomic status smokers' experiences with accesssing cessation support and the role for alternative technology-based support.
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DOI：
10.1186/s12939-017-0689-5
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发表时间：
2017-11-13
影响因子：
4.8
通讯作者：
Courtney RJ
中科院分区：
文献类型：
--
作者：
Boland VC;Mattick RP;McRobbie H;Siahpush M;Courtney RJ
吸烟率的社会梯度持续存在，吸烟及其相关危害集中在社会经济地位（SES）较低的人群中。低社会经济地位吸烟者有戒烟动机，但在尝试戒烟时面临多重障碍。需要从寻求治疗的低 SES 吸烟者的角度了解当前的治疗服务模式，以便为设计适合低 SES 人群需求的替代戒烟支持服务提供信息。这项定性研究旨在： i) 探索低 SES 吸烟者近期的戒烟经历； ii) 评估影响治疗参与的因素； iii) 确定替代戒烟方法的可接受性和可行性。先前参加戒烟随机对照试验的低SES参与者（n = 24）参加了半结构化焦点小组或深入电话访谈。数据是通过2015年10月至2016年6月的主题分析获得和分析的。分析是根据访谈指南进行演绎并以归纳法进行补充。参与者对自己的吸烟行为表示内疚和羞耻，并因吸烟而遭受耻辱。内疚、羞耻和污名对寻求治疗的行为产生了负面影响，大多数人会避免目前的戒烟服务。药物治疗的费用和治疗依从性是治疗成功的常见障碍。由于其法律地位和监管限制的不确定性，电子烟被认为是不安全的。与现有的行为治疗服务相比，基于技术的短信戒烟支持被认为是更有利的替代方案。污名化普遍受到认可，并成为当前治疗利用的障碍。电子烟可能是一种可行的减少危害的替代方案，但由于吸烟者对其监管和合法性的不确定性，澳大利亚社会经济弱势群体对电子烟的接受可能受到限制。基于手机的戒烟支持可以提供电话咨询的替代方案，并克服低社会经济地位吸烟者在尝试戒烟时面临的耻辱。
The social gradient in smoking rates persist with an overrepresentation of smoking and its associated harms concentrated within lower socioeconomic status (SES) populations. Low-SES smokers are motivated to quit but face multiple barriers when engaging a quit attempt. An understanding of the current treatment service model from the perspectives of treatment-seeking low-SES smokers is needed to inform the design of alternative smoking cessation support services tailored to the needs of low-SES populations. This qualitative study aimed to: i) explore low-SES smokers’ recent quitting experiences; ii) assess factors that impact treatment engagement; and iii) determine the acceptability and feasibility of alternative approaches to smoking cessation. Low-SES participants (n = 24) previously enrolled in a smoking cessation RCT participated in either a semi-structured focus group or in-depth telephone interview. Data was obtained and analysed using thematic analysis from October 2015 to June 2016. Analysis was deductive from the interview guide and supplemented inductively. Participants expressed feelings of guilt and shame around their smoking behaviour and experienced stigmatisation for their smoking. Guilt, shame, and stigmatisation negatively impacted treatment seeking behaviours with most avoiding current quit services. Costs of pharmacotherapy and treatment adherence were commonly cited barriers to treatment success. Electronic-cigarettes were perceived to be unsafe due to uncertainty on their legal status and regulatory restrictions. Technology-based text-messaging quit support was endorsed as a more favourable alternative compared to existing behavioural treatment services. Stigmatisation was commonly endorsed and acted as an impediment to current treatment utilisation. Electronic-cigarettes may present a viable harm reduction alternative, but their likely uptake in socioeconomically disadvantaged groups in Australia is limited by smokers’ uncertainty about their regulation and legality. Mobile phone based cessation support may provide an alternative to telephone counselling and overcome the stigmatisation low-SES smokers face while trying to quit.
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DOI：
10.1111/j.1749-6632.2011.06202.x
发表时间：
2012-01-01
期刊：
ADDICTION REVIEWS
影响因子：
--
作者：
Hiscock, Rosemary;Bauld, Linda;Munafo, Marcus
通讯作者：
Munafo, Marcus
影响因子：
5.5
作者：
Burns, Emily K.;Levinson, Arnold H.
通讯作者：
Levinson, Arnold H.
影响因子：
6
作者：
Courtney, Ryan J.;Bradford, Deborah;Mattick, Richard P.
通讯作者：
Mattick, Richard P.
影响因子：
4.4
作者：
Hoek, Janet;Smith, Katie
通讯作者：
Smith, Katie
DOI：
10.1016/j.cnur.2011.10.013
发表时间：
2012-03
期刊：
The Nursing clinics of North America
影响因子：
--
作者：
Andrews JO;Newman SD;Heath J;Williams LB;Tingen MS
通讯作者：
Tingen MS