The role of nicotine replacement therapy for temporary abstinence in the home to protect children from environmental tobacco smoke exposure: a qualitative study with disadvantaged smokers

BMC Public Health

Laura L Jones³  Sarah Lewis³  Ann McNeill¹  Tim Coleman²  Olesya Atkinson² 

[1]UKCTCS and National Addiction Centre, Institute of Psychiatry, King's College London, London, UK

[2]UKCTCS and Division of Primary Care, University of Nottingham, Nottingham, UK

[3]UKCTCS and Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK

关键词: Caregivers;    Interview;    Qualitative;    Smoke-free home;    Temporary abstinence;    Nicotine replacement therapy;    Environmental tobacco smoke;   

Others  :  1162418
DOI  :  10.1186/1471-2458-13-262

 received in 2012-09-12, accepted in 2013-03-08,  发布年份 2013

【 摘 要 】

Background

Nicotine replacement therapy (NRT) has recently been licensed to help smokers to abstain from smoking for short time periods and recent studies have shown that 8-14% of smokers are regularly using NRT to cope when they cannot or are not allowed to smoke. These data suggest that, potentially, NRT for temporary abstinence might be an acceptable method to help smoking caregivers, who are not able to stop smoking completely, to avoid smoking whilst inside their home in order to protect their children from the harms of environmental tobacco smoke (ETS). The aim of this study was therefore to explore the concept of using NRT for temporary abstinence in the home, to protect children from exposure to ETS.

Methods

Qualitative in-depth interviews were conducted with thirty six disadvantaged smoking parents who were currently, or had recently stopped smoking in the home with at least one child under the age of five. Parents were recruited from Children’s Centres and Health Visitor Clinics in Nottingham, UK. Interviews were audio recorded and transcribed verbatim. Data were coded and analysed thematically to identify emergent main and subthemes.

Results

Overall, participants responded negatively to the concept of attempting temporary abstinence in the home in general and more specifically to the use of NRT whilst at home to reduce children’s exposure to ETS. Many parents would prefer to either attempt cutting down or quitting completely to make a substantial effort to change their smoking behaviour. There was limited interest in the use of NRT for temporary abstinence in the home as a first step to quitting, although some parents did express a willingness to use NRT to cut down as a first step to quitting.

Conclusion

Disadvantaged smoking parents were reluctant to initiate and maintain temporary abstinence with or without NRT as a way of making their homes smoke free to protect their children’s health. More education about the specific risks of ETS to their children and the utility of NRT for use in the home might be needed to have a public health impact on children’s health.

【 授权许可】

   
2013 Atkinson et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Cook DG, Strachan DP: Health effects of passive smoking-10: Summary of effects of parental smoking on the respiratory health of children and implications for research. Thorax 1999, 54(4):357-366.
• [2]Tobacco Advisory Group of the Royal College of Physicians: Passive smoking and children. London: Royal College of Physicians; 2010.
• [3]Department of Health: Secondhand smoke: Review of evidence since 1998. London: Department of Health; 2004.
• [4]Jarvis MJ, Mindell J, Gilmore A, Feyerabend C, West R: Smoke-free homes in England: prevalence, trends and validation by cotinine in children. Tob Control 2009, 18(6):491-495.
• [5]Department of Health: A smokefree future: a comprehensive tobacco control strategy for England. 2010.
• [6]Blackburn C, Spencer N, Bonas S, Coe C, Dolan A, Moy R: Effect of strategies to reduce exposure of infants to environmental tobacco smoke in the home: cross sectional survey. BMJ 2003, 327(7409):257.
• [7]Stead LF, Perera R, Bullen C, Mant D, Lancaster T: Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2008., 1CD000146
• [8]The NHS Information Centre Lifestyles Statistics: Statistics on NHS Stop Smoking Services: England. April 2008 - March 2009
• [9]National Institute for Health and Clinical Excellence: Update on Technology Appraisal NRT and Bupropion. http://www.nice.org.uk/niceMedia/pdf/smt/040406item9.pdf webcite
• [10]Beard E, McNeill A, Aveyard P, Fidler J, Michie S, West R: Use of nicotine replacement therapy for smoking reduction and during enforced temporary abstinence: a national survey of English smokers. Addiction 2011, 106(1):197-204.
• [11]Sims M, Tomkins S, Judge K, Taylor G, Jarvis MJ, Gilmore A: Trends in and predictors of second-hand smoke exposure indexed by cotinine in children in England from 1996 to 2006. Addiction 2010, 105(3):543-553.
• [12]Holdsworth C, Robinson JE: 'I've never ever let anyone hold the kids while they've got ciggies': moral tales of maternal smoking practices. Sociol Health Illn 2008, 30(7):1086-1100.
• [13]Robinson J, Kirkcaldy AJ: 'You think that I'm smoking and they're not': why mothers still smoke in the home. Soc Sci Med 2007, 65(4):641-652.
• [14]Robinson J, Kirkcaldy AJ: Disadvantaged mothers, young children and smoking in the home: mothers' use of space within their homes. Health Place 2007, 13(4):894-903.
• [15]Jones LL, Atkinson O, Longman J, Coleman T, McNeill A, Lewis SA: The motivators and barriers to a smoke-free home among disadvantaged caregivers: identifying the positive levers for change. Nicotine Tob Res 2011, 13(6):479-486.
• [16]De Gruchy J, Robinson J, Hari I: Health Equity Audit. in Nottingham City: The New Leaf Smoking Cessation Service; 2006.
• [17]Robinson J, Kirkcaldy AJ: Imagine all that smoke in their lungs': parents' perceptions of young children's tolerance of tobacco smoke. Health Educ Res 2009, 24(1):11-21.
• [18]Clark JP: How to peer review a qualitative manuscript. 2nd edition. London: BMJ Books; 2003.
• [19]Braun V, Clarke V: Using thematic analysis in psychology. Qual res psychol 2006, 3(2):77-101.
• [20]Helgason AR, Lund KE: Environmental tobacco smoke exposure of young children–attitudes and health-risk awareness in the Nordic countries. Nicotine Tob R 2001, 3(4):341-345.
• [21]Gross B, Brose L, Schumann A, Ulbricht S, Meyer C, Völzke H, Rumpf HJ, John U: Reasons for not using smoking cessation aids. BMC Public Health 2008, 8:129.
• [22]Roddy E, Antoniak M, Britton J, Molyneux A, Lewis S: Barriers and motivators to gaining access to smoking cessation services amongst deprived smokers–a qualitative study. BMC Health Serv Res 2006, 6:147.
• [23]Vogt F, Hall S, Marteau TM: Understanding why smokers do not want to use nicotine dependence medications to stop smoking: qualitative and quantitative studies. Nicotine Tob Res 2008, 10(8):1405-1413.
• [24]Wiltshire S, Bancroft A, Parry O, Amos A: 'I came back here and started smoking again': perceptions and experiences of quitting among disadvantaged smokers. Health Educ Res 2003, 18(3):292-303.