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Experiences of tobacco cessation including a prescription approach among patients in Swedish primary health care with a focus on socioeconomically disadvantaged areas

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  • Anne Leppänen
  • Solvig Ekblad
  • Tanja Tomson

Abstract

Background: Tobacco Cessation on Prescription (TCP) is a new intervention that is being evaluated in socioeconomically disadvantaged areas in Swedish primary health care (PHC). Patients’ perceptions of TCP are important to understand as this may have implications for the acceptability and adherence to treatment and explain cessation outcomes. Patients’ general experiences of tobacco cessation are also important to explore to improve cessation support in this setting. Aim: To explore experiences of tobacco cessation and TCP among patients in Swedish PHC focusing on socioeconomically disadvantaged areas. Methods: Inductive content analysis of transcripts from eight semi-structured interviews with patients recruited from the intervention group in a randomized controlled trial evaluating the effectiveness of TCP in socioeconomically disadvantaged areas in PHC in Stockholm. Results: Two themes were identified: needing individualized support to quit, taking differences in patients’ experiences of tobacco use and cessation into account, acknowledging individual factors such as impact of health and wellbeing on tobacco use and differing attitudes towards tobacco and cessation and needing a supportive environment to facilitate tobacco cessation, taking contextual factors like professional support from the health care system, the importance of the social environment and supportive societal structures into account. Regarding TCP, the prescription form was perceived as useful for providers but did not appear to have a direct impact on tobacco cessation from the informants’ perspective. However, individualized counseling from a tobacco cessation specialist, an empathetic approach in the treatment and long-term follow-up was considered important. Conclusion: A holistic approach may be needed in cessation treatment, combined with interventions outside the health care system, to facilitate tobacco cessation among patients in socioeconomically disadvantaged areas in Swedish PHC. The TCP prescription form may be helpful for PHC providers but counseling and follow-up appear to be the most important components of TCP for patients in this setting.

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  • Anne Leppänen & Solvig Ekblad & Tanja Tomson, 2020. "Experiences of tobacco cessation including a prescription approach among patients in Swedish primary health care with a focus on socioeconomically disadvantaged areas," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-17, October.
    • Handle: RePEc:plo:pone00:0240411
    DOI: 10.1371/journal.pone.0240411
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    References listed on IDEAS

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    1. Anne Leppänen & Solvig Ekblad & Tanja Tomson, 2019. "Tobacco Cessation on Prescription as a primary health care intervention targeting a context with socioeconomically disadvantaged groups in Sweden: A qualitative study of perceived implementation barri," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-17, February.
    2. Evans-Polce, Rebecca J. & Castaldelli-Maia, Joao M. & Schomerus, Georg & Evans-Lacko, Sara E., 2015. "The downside of tobacco control? Smoking and self-stigma: A systematic review," Social Science & Medicine, Elsevier, vol. 145(C), pages 26-34.
    3. World Health Organization, 2017. "WHO report on the global tobacco epidemic 2017: Monitoring tobacco use and prevention policies," University of California at San Francisco, Center for Tobacco Control Research and Education qt8nw5p0zt, Center for Tobacco Control Research and Education, UC San Francisco.
    4. Stuber, Jennifer & Galea, Sandro & Link, Bruce G., 2008. "Smoking and the emergence of a stigmatized social status," Social Science & Medicine, Elsevier, vol. 67(3), pages 420-430, August.
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