title: Understanding recruitment and retention in the NHS community pharmacy stop smoking service: perceptions of smoking cessation advisers.
abstract: To understand views of pharmacy advisers about smoker recruitment and retention in the National Health Service community pharmacy stop smoking programme.
  
  
  
  Thematic framework analysis of semistructured, in-depth interviews applying the Theoretical Domains Framework and COM-B behaviour change model. We aimed to identify aspects of adviser behaviour that might be modified to increase numbers joining and completing the programme.
  
  
  
  25 stop smoking advisers (13 pharmacists and 12 support staff).
  
  
  
  29 community pharmacies in 3 inner east London boroughs.
  
  
  
  Advisers had preconceived ideas about smokers likely to join or drop out and made judgements about smokers' readiness to quit. Actively recruiting smokers was accorded low priority due in part to perceived insufficient remuneration to the pharmacy and anticipated challenging interactions with smokers. Suggestions to improve smoker recruitment and retention included developing a more holistic and supportive approach using patient-centred communication. Training counter assistants were seen to be important as was flexibility to extend the programme duration to fit better with smokers' needs.
  
  
  
  Cessation advisers feel they lack the interpersonal skills necessary to engage well with smokers and help them to quit. Addressing advisers' behaviours about active engagement and follow-up of clients, together with regular skills training including staff not formally trained as cessation advisers, could potentially boost numbers recruited and retained in the stop smoking programme. Adjustments to the pharmacy remuneration structure to incentivise recruitment and to allow personalisation of the programme for individual smokers should also be considered.
authors.affiliation: Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Ratna
authors.initials: R
authors.lastname: Sohanpal
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Rivas
authors.affiliation: Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Liz
authors.initials: L
authors.lastname: Steed
authors.affiliation: University of Oxford, Oxford, UK.
authors.forename: Virginia
authors.initials: V
authors.lastname: MacNeill
authors.affiliation: Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Valerie
authors.initials: V
authors.lastname: Kuan
authors.affiliation: Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Edwards
authors.affiliation: Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Griffiths
authors.affiliation: Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Sandra
authors.initials: S
authors.lastname: Eldridge
authors.affiliation: Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Taylor
authors.affiliation: Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Walton
mesh_terms: D000488:Allied Health Personnel; D001291:Attitude of Health Personnel; D003157:Community Pharmacy Services; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D010352:Patient Dropouts; D018579:Patient Selection; D010465:Perception; D010595:Pharmacists; D036301:Qualitative Research; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation; D013222:State Medicine; D006113:United Kingdom
keywords: Communication; Community Pharmacies; Health Behaviour; Patient recruitment; QUALITATIVE RESEARCH; Smoking cessation