Barriers and facilitators to smoking cessation in smokers: a semi-structured and qualitative interview

Smoking remains a significant public health concern in China, with a high prevalence of tobacco use. This qualitative study aimed to explore the facilitators and barriers to smoking cessation among Chinese people with a history of smoking. A total of 30 Chinese individuals with diverse ages and professions, who self-reported a smoking history, participated in both one-on-one online video interviews, and face-to-face offline semi-structured interviews. The transcripts of all interview sessions were imported into Nvivo to facilitate thematic coding and subsequent theme analysis. The collected data was analyzed using the framework-theme analysis approach based on the Behavior Change Wheel (BCW) theory, resulting in categorization of codes and basic themes into four sub-themes: capability, opportunity, motivation, and behavior (COM-B). The age range of the participants was 13 to 63 years, with a distribution of 25 males and five females. On average, they had been smoking for 18.15 years. The findings indicate that the social environment plays a significant role in smoking cessation, as participants acknowledged the influence of family support, supervision, and companionship. Negative emotions such as anxiety and depression were identified as barriers to quitting smoking. Additionally, individual motivations related to personal health concerns and family responsibilities emerged as key drivers for tobacco cessation. Participants also recognized the impact of government legislation and school regulations in preventing teenagers from initiating smoking habits. However, there was a notable lack of awareness regarding the availability and benefits of smoking cessation clinics. The present study underscores the intricate factors influencing Chinese individuals' desire to quit smoking. To develop effective strategies for disseminating information about smoking cessation clinics, implementation research should prioritize addressing social environmental factors, which serve as pivotal determinants.