title: Views and Preferences for Nicotine Products as an Alternative to Smoking: A Focus Group Study of People Living with Mental Disorders.
abstract: Aims and Background: People living with mental disorders experience a disproportionately higher burden of tobacco-related disease than the general population. Long-term substitution with less harmful nicotine products could reduce the tobacco-related harm among this population. This study investigated the views and preferences of people with mental health disorders about different nicotine products and their use as long-term substitutes for cigarettes.Methods: Semi-structured focus group discussion followed by a brief questionnaire. The discussion transcripts were analysed for content and themes and quantitative data summarised with descriptive statistics.Results: Twenty-nine participants took part in four focus groups. Vaping devices were the most acceptable nicotine products discussed; however preferences for nicotine products were individual and varied along aesthetic, pragmatic, sensory and symbolic dimensions. The concept of tobacco harm reduction was unfamiliar to participants, however they generally agreed with the logic of replacing cigarettes with less harmful nicotine products. Barriers to activating tobacco harm reduction included the symbolism of smoking and quitting; the importance placed on health; the consumer appeal of alternatives; and cost implications.Discussion and Conclusions: Engaging this population in tobacco harm reduction options will require communication that challenges black and white thinking (a conceptual framework in which smoking cigarettes or quitting all nicotine are the only legitimate options) as in practice this serves to support the continuance of smoking. Consumers should be encouraged to trial a range of nicotine products to find the most acceptable alternative to smoking that reduces health harms. Providing incentives to switch to nicotine products could help overcome barriers to using less harmful nicotine products among mental health consumers.
authors.affiliation: Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, QLD 4018, Australia. c.meurk@uq.edu.au.|School of Public Health, The University of Queensland, Herston, QLD 4006, Australia. c.meurk@uq.edu.au.
authors.forename: Carla
authors.initials: C
authors.lastname: Meurk
authors.affiliation: School of Dentistry, The University of Queensland, Herston, QLD 4006, Australia. p.ford1@uq.edu.au.
authors.forename: Pauline
authors.initials: P
authors.lastname: Ford
authors.affiliation: School of Public Health, The University of Queensland, Herston, QLD 4006, Australia. r.ratika@uq.edu.au.
authors.forename: Ratika
authors.initials: R
authors.lastname: Sharma
authors.affiliation: School of Public Health, The University of Queensland, Herston, QLD 4006, Australia. l.fitzgerald@sph.uq.edu.au.
authors.forename: Lisa
authors.initials: L
authors.lastname: Fitzgerald
authors.affiliation: School of Public Health, The University of Queensland, Herston, QLD 4006, Australia. c.gartner@uq.edu.au.|UQ Centre for Clinical Research, The University of Queensland, Herston, QLD 4006, Australia. c.gartner@uq.edu.au.
authors.forename: Coral
authors.initials: C
authors.lastname: Gartner
mesh_terms: D000328:Adult; D000368:Aged; D066300:Electronic Nicotine Delivery Systems / Q000523:psychology; D017144:Focus Groups; D040261:Harm Reduction; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology*; D061485:Tobacco Use Cessation Devices; D000072137:Vaping
keywords: consumer preferences; nicotine products; people living with mental illness; qualitative research; tobacco harm reduction