title: Developing a Tailored Smoking Cessation Intervention for Rheumatoid Arthritis Patients.
abstract: OBJECTIVE
  Smoking is associated with an increased risk of comorbidities in rheumatoid arthritis (RA) and may reduce the efficacy of anti-rheumatic therapies. Smoking cessation is therefore an important goal in RA. Our previous qualitative research identified five RA-related barriers to smoking cessation: lack of support; limited knowledge of the relationship between smoking and RA; uncontrolled pain; inability to exercise; and using smoking as a coping strategy. The aim of this article is to describe the process of developing a smoking cessation intervention for RA patients based on these themes.
  
  
  METHODS
  A comprehensive review of the literature on smoking cessation was undertaken. A tailored smoking cessation programme was designed to address each RA-specific barrier. A meeting was convened with key staff of Arthritis New Zealand to develop a consensus on feasible design to deliver a smoking cessation programme based on existing best practice and smoking cessation resources, and tailored within existing Arthritis New Zealand service delivery frameworks.
  
  
  RESULTS
  A three-month intervention was designed to be delivered by trained arthritis educators, with the following key components: nicotine replacement therapy for eight weeks; a telephone or face-to-face interview with each patient to determine their individual specific RA-related barriers to smoking cessation; and individualized education and support activities which addressed these barriers. The intervention also included three follow-up telephone calls; a support website; and 12 weekly smoking cessation advice emails.
  
  
  CONCLUSIONS
  A RA-specific smoking cessation invention was developed, matching support to specific issues within each patient's experience. A pilot study is in progress to evaluate the programme's efficacy. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Pip
authors.initials: P
authors.lastname: Aimer
authors.affiliation: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Stamp
authors.affiliation: Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Simon
authors.initials: S
authors.lastname: Stebbings
authors.affiliation: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Vicky
authors.initials: V
authors.lastname: Cameron
authors.affiliation: Arthritis New Zealand, New Zealand.
authors.forename: Sandra
authors.initials: S
authors.lastname: Kirby
authors.affiliation: Arthritis New Zealand, New Zealand.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Croft
authors.affiliation: Department of Psychology, University of Otago, Dunedin, New Zealand.
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Treharne
mesh_terms: D001172:Arthritis, Rheumatoid / Q000523:psychology*; D006801:Humans; D012107:Research Design; D016540:Smoking Cessation / Q000379:methods*
keywords: Rheumatoid arthritis; complex intervention; evidence-based practice; qualitative research; smoking cessation