A focus group pilot study of tobacco smoking among psychosocial rehabilitation clients

Objective: The study explored the perceived advantages and disadvantages of tobacco smoking and quitting among clients in psychosocial rehabilitation programs. Deeper understanding of such perceptions may be useful in creatin g maximally effective cessation and prevention interventions for this popul ation. Methods: Five focus groups of six to ten persons were formed with a total of 40 clients from two programs. Participants included smokers and no nsmokers-including former smokers and smokers who explicitly were not inter ested in quitting smoking. The semistructured, researcher-facilitated discu ssions covered pros and cons of smoking and not smoking, barriers to and fa cilitators of abstinence, and other issues. Audiotapes of the group discuss ions were transcribed and analyzed qualitatively. Results: Participants emp hasized their reasons for smoking, reasons for quitting or wanting to quit, views on smoking-related health concerns, perceived social costs and benef its of smoking, and strategies for quitting and maintaining abstinence. Man y similarities between the focus groups' views and those of the general pop ulation were noted, along with some issues that are specific to having a me ntal illness or attending a psychosocial rehabilitation program, such as co ping with psychiatric symptoms and limited access to information, support, and other coping methods. All of these views influenced participants' motiv ations and perceived readiness to smoke or to abstain, or to struggle betwe en the two alternatives. Conclusions: Issues and needs that are specific to smokers who use mental health services must be addressed in the developmen t of smoking prevention and cessation interventions in psychosocial rehabil itation and other mental health programs. The importance of messages about smoking that clients receive from program rules, program staff, and other s ources is highlighted, as is the possibility that the regulation of affect and stress provided by tobacco use is especially important for people exper iencing psychiatric symptoms.