title: Experiences of COPD patients with existing smoking cessation programs and their preferences for improvement - a qualitative analysis.
abstract: BACKGROUND
  Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD). For current smokers who are diagnosed with COPD, their first treatment option is to stop smoking. Motivation is necessary for long-term smoking cessation; therefore, when designing smoking cessation programs, the patients' needs and preferences should be considered. We focused on COPD patients' experiences with existing smoking cessation programs and evaluated their preferences for the improvement of these programs.
  
  
  METHODS
  We conducted 18 guideline-based interviews with COPD patients between April and June 2014 in Germany. Each patient with COPD, who was a current or past smoker and had made at least one attempt to quit smoking in the past 5 years, was included in the study. We audiotaped, verbatim transcribed, and evaluated the interviews, using content analysis.
  
  
  RESULTS
  The patients had broad and different experiences with pharmaceutical, behavioral, and alternative approaches that supported or negatively influenced the smoking cessation process. Pharmaceuticals were viewed as an expensive alternative with many side effects although they helped to stop cravings for a few moments. Furthermore, the bad structure and impersonal content of the seminars for smoking cessation negatively influenced group cohesion, and therefore degrading the patients' motivation to stop smoking. Alternative methods, such as acupuncture and hypnosis were mostly ineffective in smoking cessation, but in some cases, served as motivational strategies.
  
  
  CONCLUSIONS
  Negative experiences with smoking cessation were explained by the patients' lack of motivation or resolution. Other negative experiences, such as the structure of seminars for smoking cessation and the high price of pharmaceuticals should be addressed through policy changes to increase the patients' motivation to quit smoking.
authors: Center for Health Economics Research Hannover (CHERH), Leibniz University of Hannover, Otto-Brenner-Str. 1, 30159 Hannover, Germany ; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.
authors: I
authors: I
authors: Aumann
authors: Center for Health Economics Research Hannover (CHERH), Leibniz University of Hannover, Otto-Brenner-Str. 1, 30159 Hannover, Germany.
authors: L
authors: L
authors: Tedja
authors: Center for Health Economics Research Hannover (CHERH), Leibniz University of Hannover, Otto-Brenner-Str. 1, 30159 Hannover, Germany ; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany.
authors: J M Graf
authors: JM
authors: von der Schulenburg
keywords: COPD; Chronic obstructive pulmonary disease; Preferences; Qualitative interviews; Smoking cessation