Qualitative Study of Barriers and Facilitators to Cigarette Smoking After Spinal Cord Injury

Objective: Persons with spinal coid injury (SCI) have been shown to have rates of smoking as high as or higher than the general population. As those with SCI are at increased risk for negative health outcomes and early mortality, smoking can be especially dangerous. Our purpose was to assess barriers and facilitators of smoking cessation as defined by those with SCI. Method: Participants (N = 30) were identified through a state surveillance registry (n = 27) and volunteers from the statewide SCI Association (n = 3). All participants reported smoking cigarettes at some point postinjury. Both current smokers and former smokers were included. A semistructured focus group interview format included questions about health, personal, and policy factors related to smoking and smoking cessation after SCI. Groups discussions were recorded, transcribed, and coded into conceptual categories to identify themes and patterns and inferences were drawn about their meaning using NVivo software for data analysis. Results: We categorized preliminary results into two categories: barriers to smoking cessation and facilitators of smoking cessation. Within barriers to smoking cessation, themes included comorbid alcohol use, boredom, and the social environment that encourages smoking. Within facilitators of smoking cessation, themes included cost, health concerns, health care professionals, and social support that encourages quitting. Conclusions: These categories and themes identify the key barriers and facilitators of smoking cessation in this sample of persons with SCI. Future studies should further quantify specific facilitators and barriers within smoking-related studies and address these in intervention programs and studies of smoking cessation.