Barriers to smoking cessation: the patient’s perspective

Abstract

Introduction: Despite the associated benefits, smoking cessation(SC) is particularly difficult to achieve among smokers with respiratory diseases. It is crucial to identify factors affecting SC in these patients.

Objectives: Identify factors reported by patients with respiratory diseases that hinder their SC attempts.

Methods: Cross-sectional study carried out among patients followed in a pulmonology outpatient clinic of a central hospital. Data was collected through a self-reported questionnaire. Descriptive analysis was conducted to identify reported barriers to SC.

Results: 136patients enrolled the study (57%males, mean age 66y). Main diagnosis were lung cancer, chronic obstructive pulmonary disease(COPD), asthma and obstructive sleep apnea. The majority were non-smokers (30%) or former smokers (49%). Among active smokers (n=28; 53%males, mean age 65y), the main diagnosis were COPD(60%), lung cancer(30%) and asthma(10%). 59% had previous failed attempts to quit smoking. Main reported barriers to SC were: expensive SC medication (89%), easy access to cigarettes (53%), stress/anxiety (41%) and major family or professional problems at the time they attempt to quit (29%). Cheaper drugs (67%), strategies to restrict access to tobacco (37%), easier access to SC programs (29%) and to get in touch with SC program physician by email(6%) were the most cited facilitators for SC.

Conclusions: In our sample, expensive SC medication was one of the main barriers, since in Portugal varenicline is the only reimbursed prescription drug to SC. Higher levels of anxiety and choosing the wrong time to quit hindered the success of SC. Handing out self-reported questionnaires is a possible way to identify barriers to SC and improve the success of SC programs.