Missed opportunities: a qualitative study of views and experiences of smoking cessation amongst adults in substance misuse treatment

Abstract

Background: Smoking rates amongst people with a substance use disorder are disproportionately high. This study aimed to explore views and experiences of smoking and smoking cessation amongst people in substance misuse treatment in order to uncover novel perspectives which could assist in addressing this disparity.Methods: A qualitative research design was employed, using individual semi-structured interviews. The sample comprised 15 smokers and ex-smokers with a history of drug misuse who were recruited from four inner city substance misuse services. Interviews were audio recorded and analysed using the Framework method.Results: Several themes were uncovered, including the influence of the environment, peers and staff on motivation to quit and quit attempts; a complex link between smoking and substance use and the impact of substance misuse treatment experiences on attitudes towards smoking cessation. A number of missed opportunities were revealed, as well as unique factors affecting access to smoking cessation treatment for this population, demonstrating support for provision of smoking cessation treatment within both generic and specialist health services.Conclusions: People accessing substance misuse treatment seek to apply their learning from quitting illicit substances to smoking cessation. However, despite the availability of smoking cessation treatment including pharmacotherapy within substance misuse services and interest from service users, quit attempts were not encouraged or supported by substance misuse staff. Opportunities to quit within such services are minimal, inconsistent and not aligned or sustained across services.