"What else is there to do?"--A qualitative study of the barriers to soldiers stopping smoking.
OBJECTIVE
To investigate the impact of Army life on soldiers' motivation for stopping smoking.


METHODS
A two stage study using a questionnaire to identify smokers in a British Army infantry battalion of 560 soldiers based in the United Kingdom with either a low or high intention to quit smoking, followed by semi-structured interviews of a purposive sample of 18 respondents.


RESULTS
31.3% of soldiers were current smokers. In addition to recognised barriers to stopping smoking, the interview data revealed structural and cultural barriers, some of which are unique to the Army. Structural barriers included an increased opportunity to smoke in terms of time, place, and cost. Cultural barriers included peer pressure, the smoking norm, and a lack of discouragement from the 'regimental family'. These barriers to stopping smoking often arise from established British Army values and standards. For example, the need for punctuality requires early arrival at destinations, which in turn, provides an increased time opportunity to smoke. Other attitudes that the Army wishes to encourage, such as building teamwork and interdependence, can also be enhanced through smoking.


CONCLUSIONS
Whilst the numerous, previously identified barriers to stopping smoking exist within and outside the armed forces, specific additional barriers arise from the structure and culture of the Army. Changes in the structure of daily life within the Army may reduce the barriers to stop smoking. Army clinicians also play an important part in soldiers' stopping smoking and an increased understanding of the specific barriers to stopping smoking may help them to support soldiers more effectively.
Owers
R C
RC
Queen Elizabeth Memorial Health Centre, St Michael's Avenue, Tidworth, Wiltshire SP9 7EA. russellowers@doctors.org.uk
Ballard
K D
KD
D001294:Attitude to Health; D003469:Culture; D006801:Humans; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D009042:Motivation; D036301:Qualitative Research; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires; D006113:United Kingdom