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. 2023 Oct 13:3:1201447.
doi: 10.3389/frhs.2023.1201447. eCollection 2023.

Implementing smoking cessation in routine primary care-a qualitative study

Petra Dannapfel  1   2 , Preben Bendtsen  2   3 , Marcus Bendtsen  1 , Kristin Thomas  1
Affiliations

Implementing smoking cessation in routine primary care-a qualitative study

Petra Dannapfel et al. Front Health Serv. .

Abstract

Background: The use of digital tools has been proposed as a solution to some of the challenges of providing preventative services in primary care. Although there is a general acceptance among patients to use digital self-help tools to quit smoking, and healthcare organizations are increasingly urged to incorporate these tools in clinical practice, it is unclear how and for whom these innovations can be incorporated into clinical practice.

Objectives: To explore health care professionals' perceptions about smoking cessation practice in routine primary care and the use of digital tools in this work.

Methods: A qualitative study with nine in-depth telephone interviews with health care professionals working in primary care in Sweden. Convenience sampling and snowball technique was used as recruitment strategy. Informants included registered, district and auxiliary nurses as well as behavioral therapists. All informants were female, between 43 and 57 years old and experience of working with smoking cessation in primary care and possibility to recommend digital interventions to smokers.

Results: Informants described smoking cessation practice in primary care as (i) identifying smoking patients, (ii) pursuing standardized routines for smoking cessation practice and (iii) keeping smoking cessation practice on the agenda. Digital tools were described by informants to be used in different ways: (i) replicating practice, (ii) complementing practice and (iii) enabling access to health care practitioners. Finally, the analysis showed that patients' expectations and behaviors contributed to how and when smoking cessation practice was conducted, including the use of digital tools.

Conclusions: Implementing smoking cessation practice in primary care in Sweden encompass continuous work of reaching smoking patients, building buy-in among peers and keeping tobacco on the practice agenda. Digital interventions are used to replicate, complement and enabling access to care. The findings suggest that poor continuity of staff and negative attitudes towards preventative work may challenge smoking cessation practice. However, societal changes in the awareness of the health risks of tobacco use including shifting social norms regarding the acceptance of smoking may contribute to a normalization of speaking about smoking in primary care practice. Increased knowledge is needed on how, and for whom digital tools can be incorporated in clinical practice.

Keywords: implementation science; primary health care; qualitative research; smoking cessation; telemedicine.

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Conflict of interest statement

KT and PD declare that they have no competing interests. PB and MB own a private company (Alexit AB) that maintains and distributes evidence-based lifestyle interventions to be used by the public and in health care settings. Alexit AB played no role in study design, data analysis, data interpretation, or writing of this report. Services developed and maintained by Alexit AB were used to provide the intervention (sending text messages). All authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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