Enhancing engagement with stop smoking services among lower socioeconomic groups across the UK: a qualitative study using the behaviour change wheel

Smith, Pamela, Dahlby, Lucia, Plotnikova, Evgeniya, Williams, Rebecca-Bell, Thorley, Rebecca, Murray, Rachael, Dobbie, Fiona, Langley, Tessa, Bogdanovica, Ilze, Brain, Katherine ORCID: https://orcid.org/0000-0001-9296-9748 and Jayes, Leah 2025. Enhancing engagement with stop smoking services among lower socioeconomic groups across the UK: a qualitative study using the behaviour change wheel. Nicotine & Tobacco Research , ntaf256. 10.1093/ntr/ntaf256

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Abstract

Introduction Individuals who use a stop smoking service (SSS) in the UK are three times more likely to quit. Uptake of SSS is limited among lower socioeconomic (LSE) groups and efforts are needed to understand how to improve the appeal, acceptability and accessibility of SSS. Methods Semi-structured interviews with 114 participants from the four UK devolved nations who had a current or recent smoking history, and who had previously accessed or may potentially access a SSS. Participants were recruited via Facebook, third sector organisations and a market research company. Telephone-based interviews were analysed using thematic analysis. The Behaviour Change Wheel was used to develop the interview topic guide, inform thematic analysis and identify strategies to increase engagement with SSS. Results Barriers included low awareness and understanding regarding the availability and content of SSS, a lack of free time to access SSS and negative beliefs regarding the efficacy of SSS support. Facilitators included more frequent and continued flexible support delivered using a range of modes, access to free NRT and rapport with the advisor. Intervention functions were identified to address these barriers and facilitators via educational efforts to raise awareness of SSS, environmental restructuring to provide a flexible approach to delivery, and community champions to encourage and enable SSS engagement in the target population. Conclusions Providing further community-based efforts along with a more holistic approach to delivering behavioural support and NRT has strong potential to maximise SSS reach, engagement and acceptability. Implications The current study provides insights into the barriers and facilitators to engaging with and accessing SSS amongst LSE groups and indicates that interventions to increase capability, motivation and opportunity are required. Recommendations from this work for tailoring UK SSS for LSE groups can be used to inform future tobacco control policy including engagement strategies at a local and national level.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: https://creativecommons.org/licenses/by/4.0/, Start Date: 2025-12-19
Publisher:	Oxford University Press
ISSN:	1462-2203
Date of First Compliant Deposit:	7 January 2026
Date of Acceptance:	14 December 2025
Last Modified:	07 Jan 2026 14:45
URI:	https://orca.cardiff.ac.uk/id/eprint/183682

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