Abstract
PurposeNicotine replacement therapy (NRT) is often used suboptimally by smokers. Previous research has focused on cognitions and attitudes as potential reasons. This study drew on theoretical frameworks of behaviour to comprehensively explore smokers’ NRT use to identify new intervention targets.MethodsSemi-structured face-to-face interviews were conducted with 16 adult UK-based smokers and ex-smokers who used NRT in recent quit attempts (mean (SD) age = 34.9(10.3); 82.3% women). The COM-B (capability, opportunity, motivation, behaviour) model and the theoretical domains framework informed the interviews and analyses. Data were analysed in NVivo 11.ResultsTwo related behaviours were identified relevant to NRT use: use of NRT per se and engaging with information and support with NRT use. A meta-theme of “missed opportunity” identified instances when smokers did not or could not engage in these behaviours. For use of NRT per se, these included limited knowledge, poor technique of use, low motivation to optimise use, and lack of role models. For engaging with information and support, they included low awareness of optimal use techniques, selective information-seeking, low expectations, limited exposure to guidelines, deficient advice from healthcare professionals, and suboptimal product display. Prior suboptimal experience tended to negatively affect subsequent use and views. Participants were interested in accessible and comprehensive guidelines on NRT and its use.ConclusionsThere appear to be important missed opportunities for optimal use of NRT both in terms of use itself and engagement with information on optimal use. These missed opportunities arise from a range of capability, motivational, and opportunity-related factors.
Highlights
Nicotine replacement therapy (NRT) is the most commonly used medically licenced pharmacology for smoking cessation, its use has been declining over the past decade and is over taken by electronic cigarettes [1, 2]
There is a disconnect between the observed effectiveness of NRT in clinical trials and that found when NRT is bought over the counter (OTC) [3,4,5,6]
The study was conducted as part of a larger research programme that aimed to understand what kind of support would be acceptable and potentially beneficial to smokers to optimise their use of NRT, with focus on OTC NRT
Summary
Nicotine replacement therapy (NRT) is the most commonly used medically licenced pharmacology for smoking cessation, its use has been declining over the past decade and is over taken by electronic cigarettes [1, 2]. (2018) 25:579–591 and attitudinal factors (e.g. what smokers know and think about NRT), but it is possible that a wider range of factors might play a role [10, 11], for example the support received and the technique of application, as was shown to be the case with other medications [12]. This study explored these wider factors using a systematic and theory-driven method
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