From personal responsibility to prevention strategies: Perspectives of Spanish-speaking Latinx adults who smoke on multilevel factors related to smoking and cessation support.

Latinx individuals face significant tobacco-related disparities, particularly in cessation care. In particular, little is known about barriers and facilitators of quitting smoking among Spanish-preferring Latinx. This study examined the perspectives of Latinxs who smoke and have psychological distress regarding the factors influencing their smoking and quitting behaviors and experiences with cessation treatment. A cross-sectional, exploratory multi-method study included 18 Latinx adults who smoke and completed a questionnaire on demographics, tobacco use, and mental health, followed by a semi-structured interview. Participants' responses (N=18) were analyzed using a deductive-inductive thematic analyses approach organized with the Dedoose software. Participants' ages ranged from 24-61 years (M=39.63, SD=9.89); 68.5% were employed part-time or full-time, and 37.5% reported financial strain. Themes were organized according to the various levels of the Socioecological model: (1) Intrapersonal (psychological distress, addiction, health concerns, personal attributes); (2) Interpersonal (stigma, external pressures, social support); (3) Organizational (preferences related to treatment content, format, delivery and frequency), (4) Community (familismo), and (5) Social/Policy (second hand smoke reduction and prevention among youth). Participants had little to no experience with cessation treatment. Findings were generally consistent with the limited existent literature on smoking motivation and cessation among Spanish-preferring Latinxs and expand previous work by highlighting potential treatment targets in the development and/or adaptation of culturally relevant interventions for this group.