Motivators and barriers for smoking cessation in people with multiple sclerosis: a qualitative study to inform the design of a tailored intervention

Abstract Background Tobacco smoking is a relevant determinant of multiple sclerosis (MS) onset, and smokers have increased risk for faster progression of MS compared to non-smokers. While the smoking prevalence is high in Germany, no smoking cessation programs have been developed specifically in MS...

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Main Authors: Alex M. Keller, Barbara von Glasenapp, Daniel Kotz, Claudia H. Marck, Christoph Heesen, Karin Riemann-Lorenz
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-20998-5
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author Alex M. Keller
Barbara von Glasenapp
Daniel Kotz
Claudia H. Marck
Christoph Heesen
Karin Riemann-Lorenz
author_facet Alex M. Keller
Barbara von Glasenapp
Daniel Kotz
Claudia H. Marck
Christoph Heesen
Karin Riemann-Lorenz
author_sort Alex M. Keller
collection DOAJ
description Abstract Background Tobacco smoking is a relevant determinant of multiple sclerosis (MS) onset, and smokers have increased risk for faster progression of MS compared to non-smokers. While the smoking prevalence is high in Germany, no smoking cessation programs have been developed specifically in MS populations to date, and only little is known about the motivators and barriers influencing smoking cessation in people with MS (pwMS) in Germany. This study aims to identify these factors to inform the design of a tailored smoking cessation intervention. Methods As part of a larger program of work, we conducted semi-structured interviews in people with MS (pwMS) to explore their needs, motivators and barriers regarding smoking cessation. We recruited via MS-websites and the email-newsletter of our institution at the University Medical Centre Hamburg-Eppendorf. Participants were eligible if they had a self-reported MS-diagnosis and currently smoked or quit smoking within the last two years but after their MS-diagnosis. Interviews were conducted online and via telephone during May and June 2023. Data were analysed using thematic analysis based on a realistic approach. Results Eight women and seven men participated in our interviews. Eleven were current, four were former smokers. Median time since diagnosis was 4 years (range: 1–26). Interviews identified MS-diagnosis, concerns about general health, and social factors as relevant motivators to stop smoking. Furthermore, worries about negative consequences when quitting (e.g. fear of missing out on social interactions or weight gain) were identified as a great barrier to smoking cessation. Knowledge about the connection between MS and smoking, and satisfaction with communication with MS clinicians were low. PwMS expressed a need for better conversations with neurologists and expert-led smoking cessation interventions. Additionally, we found that the wish for peer-exchange and the willingness to participate in smoking cessation programs was high. Conclusion Our results confirm findings of previous studies from other countries, identifying lack of knowledge, unsatisfactory communication with MS clinicians, and worries about negative consequences when quitting as barriers, and the MS-diagnosis as a motivator for smoking cessation. In a next step, we will use our findings for the development of an MS-specific online smoking cessation program.
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spelling doaj-art-64e3c30802d648e69303c02b49196d8d2025-08-20T02:31:39ZengBMCBMC Public Health1471-24582024-12-0124111410.1186/s12889-024-20998-5Motivators and barriers for smoking cessation in people with multiple sclerosis: a qualitative study to inform the design of a tailored interventionAlex M. Keller0Barbara von Glasenapp1Daniel Kotz2Claudia H. Marck3Christoph Heesen4Karin Riemann-Lorenz5Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg- EppendorfInstitute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg- EppendorfInstitute of General Practice, Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüsseldorfDisability and Health Unit, Centre for Health Policy, the Melbourne School of Population and Global Health, The University of MelbourneInstitute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg- EppendorfInstitute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg- EppendorfAbstract Background Tobacco smoking is a relevant determinant of multiple sclerosis (MS) onset, and smokers have increased risk for faster progression of MS compared to non-smokers. While the smoking prevalence is high in Germany, no smoking cessation programs have been developed specifically in MS populations to date, and only little is known about the motivators and barriers influencing smoking cessation in people with MS (pwMS) in Germany. This study aims to identify these factors to inform the design of a tailored smoking cessation intervention. Methods As part of a larger program of work, we conducted semi-structured interviews in people with MS (pwMS) to explore their needs, motivators and barriers regarding smoking cessation. We recruited via MS-websites and the email-newsletter of our institution at the University Medical Centre Hamburg-Eppendorf. Participants were eligible if they had a self-reported MS-diagnosis and currently smoked or quit smoking within the last two years but after their MS-diagnosis. Interviews were conducted online and via telephone during May and June 2023. Data were analysed using thematic analysis based on a realistic approach. Results Eight women and seven men participated in our interviews. Eleven were current, four were former smokers. Median time since diagnosis was 4 years (range: 1–26). Interviews identified MS-diagnosis, concerns about general health, and social factors as relevant motivators to stop smoking. Furthermore, worries about negative consequences when quitting (e.g. fear of missing out on social interactions or weight gain) were identified as a great barrier to smoking cessation. Knowledge about the connection between MS and smoking, and satisfaction with communication with MS clinicians were low. PwMS expressed a need for better conversations with neurologists and expert-led smoking cessation interventions. Additionally, we found that the wish for peer-exchange and the willingness to participate in smoking cessation programs was high. Conclusion Our results confirm findings of previous studies from other countries, identifying lack of knowledge, unsatisfactory communication with MS clinicians, and worries about negative consequences when quitting as barriers, and the MS-diagnosis as a motivator for smoking cessation. In a next step, we will use our findings for the development of an MS-specific online smoking cessation program.https://doi.org/10.1186/s12889-024-20998-5Multiple sclerosisSmoking cessationQualitative studyIntervention developmentHealth behaviour
spellingShingle Alex M. Keller
Barbara von Glasenapp
Daniel Kotz
Claudia H. Marck
Christoph Heesen
Karin Riemann-Lorenz
Motivators and barriers for smoking cessation in people with multiple sclerosis: a qualitative study to inform the design of a tailored intervention
BMC Public Health
Multiple sclerosis
Smoking cessation
Qualitative study
Intervention development
Health behaviour
title Motivators and barriers for smoking cessation in people with multiple sclerosis: a qualitative study to inform the design of a tailored intervention
title_full Motivators and barriers for smoking cessation in people with multiple sclerosis: a qualitative study to inform the design of a tailored intervention
title_fullStr Motivators and barriers for smoking cessation in people with multiple sclerosis: a qualitative study to inform the design of a tailored intervention
title_full_unstemmed Motivators and barriers for smoking cessation in people with multiple sclerosis: a qualitative study to inform the design of a tailored intervention
title_short Motivators and barriers for smoking cessation in people with multiple sclerosis: a qualitative study to inform the design of a tailored intervention
title_sort motivators and barriers for smoking cessation in people with multiple sclerosis a qualitative study to inform the design of a tailored intervention
topic Multiple sclerosis
Smoking cessation
Qualitative study
Intervention development
Health behaviour
url https://doi.org/10.1186/s12889-024-20998-5
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