What factors are important in smoking cessation and relapse in women from deprived communities? A qualitative study in Southeast England

• Little research has been conducted to examine factors associated with smoking cessation and relapse in women.
• Barriers to smoking cessation included fear of weight gain and the loss of a coping mechanism for stressful situations.
• Hormonal fluctuation during the menstrual cycle was perceived as a reason for relapse.
• Motivating factors for smoking cessation included the effects of smoking on physical appearance, and oral hygiene.
• Feelings of guilt regarding exposing children to passive smoking acted as a motivator to quit.

ObjectivesWomen are relatively more susceptible to smoking-related diseases and find it more difficult to quit; however, little research exists on factors associated with smoking cessation and relapse in women. We examined attitudes towards and perceptions of factors associated with smoking cessation and relapse in women from deprived communities.Study designQualitative interview study.MethodsParticipants included eleven women, smokers and ex-smokers, from disadvantaged communities in East Sussex, England, who had used the National Health Service (NHS) stop smoking service. Data were collected through a focus group and semi-structured interviews, and subjected to thematic analysis.ResultsParticipants opined that it is more difficult for women to quit smoking than men. Women felt that postcessation weight gain was inevitable and acted as a barrier to quitting. Hormonal fluctuations during the menstrual cycle and greater levels of stress were perceived as obstacles to quitting and reasons for relapse. Conversely, the women cited effects of smoking on physical appearance, oral hygiene and guilt about exposing children to passive smoke as powerful motivators to quit; and highlighted the impact of public health campaigns that focused on these factors. Views diverged on whether quitting with someone close to you is a help or hindrance. Other themes including alcohol intake, daily routine and being in the presence of smokers emerged as situational triggers of relapse.ConclusionsInterventions that address women's concerns related to postcessation weight gain, hormonal fluctuations during the menstrual cycle and stress may aid with smoking cessation and reduce relapse. Public health campaigns should consider the impact of smoking on physical appearance and the effect of passive smoke on children.