Abstract
Objectives: The purpose of this study was to explore the characteristics of hardcore smokers who were previously hospitalized. Study design: A descriptive qualitative design was used to investigate a sample of 29 male Taiwanese smokers. Methods: Male hardcore smokers were recruited at a hospital in southern Taiwan and their smoking behaviors and attitudes were explored in semistructured interviews. Inclusion criteria were: (1) smoking at least weekly or daily during the past year, (2) 100 cigarettes during the lifetime, (3) persistent smoking, or (4) at least one hospitalization. Audio-recorded interview data were analyzed using content categorization of the responses. Results: Four main themes emerged to describe characteristics of Taiwanese hardcore smokers: (1) physiological and psychological dependence, (2) no motivation to quit despite knowledge of negative health consequences, (3) social interaction and cultural norms, and (4) negative attitudes toward, but compliance with, smoking-free policies. Conclusions: The results can inform public health nurses of characteristics of Taiwanese hardcore smokers, which in turn may develop effective smoking cessation program to increase smoking cessation rate among Taiwanese hardcore smokers.
Highlights
In Taiwan, the smoking rate decreased from 20.9% in 2005 to 14.0% in 2017 because of populationlevel tobacco control interventions (Centers for Disease Control and Prevention, 2019)
Hardcore smokers are relatively closed to cessation interventions and have been identified as an intractable public health problem
Hardcore smoking is a significant concern for public health professionals in many countries
Summary
In Taiwan, the smoking rate decreased from 20.9% in 2005 to 14.0% in 2017 because of populationlevel tobacco control interventions (Centers for Disease Control and Prevention, 2019). This decline has recently slowed because of the supposedly irreducible number of highly nicotine-dependent smokers (i.e., hardcore smokers) who do not intend to quit (Hughes, 2011; Perez-Rios, Fernandez, Schiaffino, Nebot, & Lopez, 2015). One study defined hardcore smoking as “established daily smokers” who consume 15 or more cigarettes per day with no history of quit attempts or plans (Kang, Lee, & Cho, 2017). Another study defined aDepartment of Nursing, Chung Hwa University of Medical Technology, Taiwan bDepartment of Family Medicine, Kaohsiung Veterans General Hospital, Taiwan cS chool of Nursing, San Francisco State University, United States dSchool of Nursing, Fooyin University, Taiwan
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