Smoking cessation assisted by primary healthcare professionals

Abstract

Background: The effectiveness of smoking cessation treatments have been well studied, but most smokers quit without assistance from a health professional. To further improve our understanding of how primary healthcare efforts can benefit patients who attempt to quit, we need a deeper understanding of how the process unfolds when assisted by a health professional and how this is experienced by the smoker. Objective: To construct an emergent model of the smoking cessation process assited by primary health care professional. Methods: Data were collected from videorecordings of primary healthcare office sessions to promote smoke cessation in Barcelona Province (Catalonia, Spain). Thirteen smokers and their primary healthcare professionals engaged in 24 preparatory sessions and 23 follow-up sessions. Data were analyzed according to Constant Comparative Analysis Method along with conceptual and theory frameworks. Results: Smoking cessation is a social process that is shaped by interactions and relationships with health professionals. Four categories explain the process: 1) Feeling addicted and wanting help to quit smoking; 2) Preparing to quit smoking: anticipating abstinence; 3) Managing smoking abstinence: a positive or transitional process; and 4) Controlling the urge to smoke: a central process in smoking cessation. Conclusions: Health professionals treat smoking behaviors as a health problem and supervise the process of enabling the smoker to learn how to control the urge to smoke. Learning to control smoking abstinence is not always enough to enable the individual to reorganize and restructure daily life without cigarettes. Primary healthcare nurses should be encouraged to incorporate not only logic and scientific evidence but also the subjectivity of the patient’s attitude into efforts to better respond to the changing, complex nature of the smoking cessation process.