Hostname: page-component-76fb5796d-zzh7m Total loading time: 0 Render date: 2024-04-25T11:11:15.377Z Has data issue: false hasContentIssue false

‘I Sat Filling in This Form While Smoking and It Was Divine’. An Analysis of Free-Text Comments from Smokers Who Report They Have No Intention of Quitting in the Next Six Months

Published online by Cambridge University Press:  16 December 2014

M. Sweeney-Magee*
Affiliation:
Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
D. Kale
Affiliation:
Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
A. Hamill
Affiliation:
Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
H. Gilbert
Affiliation:
Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
*
Address for correspondence: Molly Sweeney Magee BA Hons MSc, Research Associate, Department of Primary Care and Population Health, University College London, Royal Free and University College Medical School, London NW3 2PF. Email: molly.magee.09@ucl.ac.uk

Abstract

Introduction: Smokers unmotivated to quit are neglected by smoking cessation research. Free-text comment analysis is a potentially useful way to gain insight into this group's beliefs.

Aims: To analyse the free-text comments provided by smokers unmotivated to quit as part of a randomized controlled trial of computer-tailored feedback for smoking cessation.

Method: A random sample of 58,660 smokers were sent a smoking behaviour questionnaire (SBQ). The responses and follow-up outcomes of those providing free-text comments were compared to those who did not to assess the representativeness of the former group of smokers. The comments of participants unmotivated to quit (631) were thematically analysed.

Results: Those who provided a comment differed from those who did not on variables including education level and quit attempts at six-month follow-up. Emergent themes included; justification of smoking and restricting smoking instead of quitting.

Conclusions: The findings illustrate the value of free-text comments in identifying issues important to respondents. The identified themes highlight areas for future research in smokers unmotivated to quit including cutting down as a path to quitting and explicit messages regarding the inability of positive health behaviours to balance out the negative impact of smoking on health.

Trial registration: Current Controlled Trials ISRCTN05385712.

Type
Original Articles
Copyright
Copyright © The Author(s) 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bayer, R. (2008). Stigma and the ethics of public health: Not can we but should we. Social Science & Medicine, 67 (3), 463472.CrossRefGoogle Scholar
Blaxter, M. (1997). Whose fault is it? People's own conceptions of the reasons for health inequalities. Social Science & Medicine, 44 (6), 747756.Google Scholar
Bolliger, C. T., Zellweger, Danielsson, J.-P., Biljon, T., Robidou, X. v. Westin, A., , Å. et al. (2000). Smoking reduction with oral nicotine inhalers: Double blind, randomised clinical trial of efficacy and safety. British Medical Journal, 321 (7257), 329333.Google Scholar
Borland, R., Balmford, J., & Hunt, D. (2004). The effectiveness of personally tailored computer-generated advice letters for smoking cessation. Addiction, 99 (3), 369377.Google Scholar
Brose, L. S., West, R., McDermott, M. S., Fidler, J. A., Croghan, E., & McEwen, A. (2011). What makes for an effective stop-smoking service? Thorax, 66 (10), 924926.Google Scholar
Catley, D., Harris, K., Goggin, K., Richter, K., Williams, K., Patten, C. et al. (2012). Motivational Interviewing for encouraging quit attempts among unmotivated smokers: Study protocol of a randomized, controlled, efficacy trial. BMC Public Health, 12 (1), 18.CrossRefGoogle ScholarPubMed
Cheong, Y., Yong, H.-H., & Borland, R. (2007). Does how you quit affect success? A comparison between abrupt and gradual methods using data from the international tobacco control policy evaluation study. Nicotine & Tobacco Research, 9 (8), 801810.Google Scholar
Fagerström, K. O. (2005). Can reduced smoking be a way for smokers not interested in quitting to actually quit? Respiration, 72 (2), 216220.Google Scholar
Fagerström, K. O., Tejding, R., Westin, A., & Lunell, E. (1997). Aiding reduction of smoking with nicotine replacement medications: Hope for the recalcitrant smoker? Tobacco Control, 6 (4), 311316.CrossRefGoogle ScholarPubMed
Garcia, J., Evans, J., & Reshaw, M. (2004). “Is there anything else you would like to tell us” – methodological issues in the use of free-text comments from postal surveys. Quality and Quantity, 38 (2), 113125.Google Scholar
Gilbert, H. M., Leurent, B., Sutton, S., Alexis-Garsee, C., Morris, R. W., & Nazareth, I. (2013). ESCAPE: A randomised controlled trial of computer-tailored smoking cessation advice in primary care. Addiction, 108 (4), 811819.Google Scholar
Hyland, A., Borland, R., Li, Q., Yong, H.-H., McNeill, A., Fong, G. T. et al. (2006). Individual-level predictors of cessation behaviours among participants in the international tobacco control (ITC) four country survey. Tobacco Control, 15 (suppl 3), iii83iii94.Google Scholar
Knäuper, B., Rabiau, M., Cohen, O., & Patriciu, N. (2004). Compensatory health beliefs: Scale development and psychometric properties. Psychology & Health, 19 (5), 607624.Google Scholar
McColl, E., Jacoby, A., Thomas, L., Soutter, J., & Bamford, C. (2002). Design and use of questionnaires: A review of best practice applicable to surveys of health service staff and patients. Health Technology Assessment, 5 (31), 256.Google Scholar
McDermott, M. S., Beard, E., Brose, L. S., West, R., & McEwen, A. (2013). Factors associated with differences in quit rates between ‘specialist’ and ‘community’ stop-smoking practitioners in the english stop-smoking services. Nicotine & Tobacco Research, 15 (7), 12391247.Google Scholar
Moore, D., Aveyard, P., Connock, M., Wang, D., Fry-Smith, A., & Barton, P. (2009). Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: Systematic review and meta-analysis. British Medical Journal, 338.Google Scholar
NHS (2012). Statistics on Smoking: England, 2012.Google Scholar
O’Cathain, A., & Thomas, K. (2004). “Any other comments?” Open questions on questionnaires – a bane or a bonus to research? BMC Medical Research Methodology, 4 (1), 25.Google Scholar
Ong, R., Dunn, K., & Croft, P. (2006). “Since You're Asking. . .”: Free Text Commentaries in an Epidemiological Study of Low Back Pain Consulters in Primary Care. Quality and Quantity, 40 (4), 651659.Google Scholar
Phelps, C., Wood, F., Bennett, P., Brain, K., & Gray, J. (2007). Knowledge and expectations of women undergoing cancer genetic risk assessment: A qualitative analysis of free-text questionnaire comments. Journal of Genetic Counseling, 16 (4), 505514.Google Scholar
Pill, R., Wood, F. C., Renold, E., Robling, M., Edwards, A., Wilkinson, C. et al. (2003). Welsh women's comments about breast problems and the care given: A qualitative study in the community. European Journal of Cancer Care, 12 (3), 240248.Google Scholar
Poland, B. D. (2000). The ‘considerate’ smoker in public space: The micro-politics and political economy of ‘doing the right thing’. Health & Place, 6 (1), 114.Google Scholar
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51 (3), 390395.CrossRefGoogle ScholarPubMed
Putland, C., Baum, F., & Ziersch, A. (2011). From causes to solutions - insights from lay knowledge about health inequalities. BMC Public Health, 11 (1), 111.Google Scholar
Rabiau, M., Knäuper, B., & Miquelon, P. (2006). The eternal quest for optimal balance between maximizing pleasure and minimizing harm: The compensatory health beliefs model. British Journal of Health Psychology, 11 (1), 139153.Google Scholar
Riiskjær, E., Ammentorp, J., & Kofoed, P.-E. (2012). The value of open-ended questions in surveys on patient experience: number of comments and perceived usefulness from a hospital perspective. International Journal for Quality in Health Care, 24 (5), 509–16.Google Scholar
Ritchie, D., Amos, A., & Martin, C. (2010). ‘But it just has that sort of feel about it, a leper’ – Stigma, smoke-free legislation and public health. Nicotine & Tobacco Research, 12 (6), 622629.Google Scholar
Stuber, J., Galea, S., & Link, B. G. (2008). Smoking and the emergence of a stigmatized social status. Social Science & Medicine, 67 (3), 420430.Google Scholar
Taylor, S., & Bogdan, R. (1984). Introduction to Research Methods: New York: Wiley.Google Scholar
Thomas, D. R. (2006). A General Inductive Approach for Analyzing Qualitative Evaluation Data. American Journal of Evaluation, 27 (2), 237246.Google Scholar
Tønnesen, P. (2002). Smoking reduction for smokers not able or motivated to quit? Respiration, 69 (6), 475478.Google Scholar
West, R., McEwen, A., Bolling, K., & Owen, L. (2001). Smoking cessation and smoking patterns in the general population: A 1-year follow-up. Addiction, 96 (6), 891902.Google Scholar
Zhou, X., Nonnemaker, J., Sherrill, B., Gilsenan, A. W., Coste, F., & West, R. (2009). Attempts to quit smoking and relapse: Factors associated with success or failure from the ATTEMPT cohort study. Addictive Behaviors, 34 (4), 365373.Google Scholar