Health Education Research, Vol. 18, No. 3, 292-303,
June 2003
© 2003 Oxford University Press
‘I came back here and started smoking again’: perceptions and experiences of quitting among disadvantaged smokers
Public Health Sciences, and 1 Research Unit in Health, Behaviour and Change, Department of Community Health Sciences, Edinburgh University, Teviot Place, Edinburgh EH8 9AG, UK. E-mail: amanda.amos{at}ed.ac.uk
This paper draws upon qualitative research with 100 smokers (50 male and 50 female) in two Scottish areas of disadvantage to investigate their perceptions and experiences of quitting. The fieldwork took place between 1999 and 2000, with data collected through in-depth individual interviews and the completion of a smoking day grid. While many interviewees wanted to quit, they drew on their understandings of habit and addiction to illustrate the difficulties which quitting posed. Addiction was referenced through accounts of actual and anticipated unpleasant withdrawal symptoms, while accounts of the difficulties associated with quitting drew primarily upon habitual usage and routine aspects of their lives. Interviewees reported interacting frequently with other smokers. They also highlighted how stressful aspects of their lives perpetuated habitual smoking and prompted relapse following periods of cessation. Although the contexts inhabited by the interviewees were crucial in inhibiting successful quitting attempts, these factors acted in conjunction with and exacerbated feelings of physiological dependence on tobacco. Interviewees were sceptical about the effectiveness of nicotine replacement therapy (NRT) other than in the immediate or short term. For the most part, interviewees felt that NRT could not address aspects of their lives that appeared to support and sustain smoking in the long term. The paper concludes that in order to facilitate and sustain smoking cessation, tobacco control interventions need to tackle both nicotine addiction and the material circumstances experienced by disadvantaged smokers.
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