Smith, Charlie Albert;
(2021)
Investigating the acceptability, feasibility and implementation of e-cigarettes as a viable tobacco harm reduction intervention for smokers with mental health conditions.
Doctoral thesis (Ph.D), UCL (University College London).
Abstract
Over the past decade, smoking prevalence has steadily declined among the general population in England, yet remains disproportionately higher among the population of individuals with mental health conditions. E-cigarettes have become the most popular smoking cessation aids in England, and studies have suggested that they may support smokers with mental health conditions to quit. This thesis details a series of studies that aimed to explore the feasibility, acceptability and implementation of using e-cigarettes as a tobacco harm reduction (THR) intervention for smokers with mental health conditions. Study 1 was a cross-sectional quantitative study (n=40,295) which used data from the Health Survey for England (HSE). This study found that smokers and ex-smokers with mental health conditions were more likely to use e-cigarettes compared with individuals without mental health conditions. Study 2 (analysis 1) was a qualitative focus group study (n=36) which found that Mental Health Professionals (MHPs) experience challenges in addressing smoking with patients in mental health settings; lacking the capability (psychological), opportunity (physical and social) and motivation (automatic and reflective) to successfully address smoking with patients. Study 3 was a cross-sectional quantitative study (n=6,531) which used data from the Smoking Toolkit Study (STS). This study found that the majority of smokers in England held inaccurate harm perceptions of e-cigarettes and highlighted that this did not differ between smokers with and without mental health conditions. Study 2 (analysis 2) was a qualitative focus group study (n=39) which found that MHPs generally adopt a risk-averse approach when judging the safety and suitability of e-cigarettes, influenced by: perceived obscurity surrounding e-cigarettes and tobacco harm reduction; high exposure to adverse and unreliable information regarding e-cigarettes; and perceived analogies between e-cigarettes and conventional cigarettes. Study 4 was a qualitative interview study (n=14) which identified barriers and facilitators that impact smokers with mental health conditions’ perceptions and ability to engage in THR and e-cigarette use; enablement (psychological, physical, social and financial), health-related ambivalence, and patient agency. Together, these findings informed the development of a pilot RCT protocol which aims to explore the feasibility, acceptability and implementation of using e-cigarettes as a THR intervention for smokers with mental health conditions.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Investigating the acceptability, feasibility and implementation of e-cigarettes as a viable tobacco harm reduction intervention for smokers with mental health conditions |
| Event: | UCL (University College London) |
| Language: | English |
| Additional information: | Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10127507 |
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