A qualitative approach exploring the experiences of smoking and quitting attempts in type 1 diabetes.

AIMS AND OBJECTIVES: To explore the experiences of smoking and quitting attempts in people with type 1 diabetes, including their perceptions of existing services for smoking cessation.

BACKGROUND: In the UK, approximately a fifth of the population with type 1 diabetes smoke and despite the adverse effects of smoking, these individuals continue with their smoking habits. There is limited information on the barriers and facilitators to quitting smoking in people with type 1 diabetes.

METHODS: This study adopted a qualitative study design using semi-structured individual interviews guided by PRIME theory. Participants (n = 12) were purposively sampled and recruited from two diabetes outpatient clinics in London (UK). Audio-recorded interviews were transcribed verbatim and analysed using the Framework method.

RESULTS: Most smokers with type 1 diabetes reported lack of motivation to stop smoking due to the addictive nature of cigarettes. Further barriers to quitting included self-image and habits associated with smoking, such as social activities. Generally, most reported limited awareness about the risks associated with smoking and diabetes. Moreover, the perceived negative attitude towards nicotine replacement therapy and pharmacotherapy impeded their willingness to alter their smoking habits. Nonetheless, these patients suggested that informative guidance from medical professionals and strategies to tackle cravings related to nicotine as helpful approaches to improve quitting attempts.

CONCLUSION: Internal and external factors influence quitting attempts among smokers with type 1 diabetes, with particular emphasis on self-image and societal norms. It is evident that existing strategies for smoking cessation recommended by the National Institute for Health and Care Excellence have either not been implemented or not well received by people with type 1 diabetes.

RELEVANCE TO CLINICAL PRACTICE: Strategies and resources, such as staff training, to increase delivery of smoking cessation support to patients with diabetes are needed.