Decision-Making on Nicotine Replacement Therapy Use and Product Selection: An Explorative Qualitative Study Among Chinese Americans Who Smoke

Chinese Americans who smoke have low use of nicotine replacement therapy (NRT). This study explored perceptions of NRT and decision-making around product choice among Chinese American smokers who received NRT. From September 2023 to January 2024, we conducted in-depth phone interviews with 20 participants recruited in New York City from a WeChat-based cessation pilot trial and a community-based cessation program, both providing free nicotine patches, gum, or lozenges. Participants (aged 26-72; 85% male; 60% current smoking) included 12 consistent NRT users (≥2 weeks), four trial users (<2 weeks), and four non-users. Five participants (25%) had never heard of NRT before program enrollment, and 14 (70%) had never used it previously. Consistent users generally viewed NRT as helpful in reducing cravings. Others reported barriers, including culturally rooted skepticism toward pharmacotherapy, preference for unassisted quitting, lack of readiness to quit, prior negative experiences, and unpleasant taste or side effects. Product choice was influenced by lay knowledge, ease of integrating NRT into daily routines, perceived effectiveness, and taste and side effects. Cessation programs addressing cultural beliefs, reframing willpower, engaging individuals not ready, and providing diverse NRT options with guidance on side effect management and routine integration may increase NRT use among this population.