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A descriptive qualitative study of what informs and influences smoking behaviours in community dwelling persons with severe and persistent mental illness Grant, Lyle George

Abstract

Smoking establishes poor health trajectories and is the leading preventable cause of death in Canada. Individuals with severe and persistent mental illness (SPMI) have a prevalence of smoking 2 to 3 times that of the general population. While many are motivated to stop smoking, the quit rate in this group is low and their unique reasons for smoking not fully understood. Current understanding of tobacco use among those with SPMI largely comes from quantitative studies that have used pre-determined frameworks for understanding factors that affect and influence smoking behaviours. Little is known about the perspectives of those with SPMI. In this descriptive qualitative study semi-structured interviews were conducted with thirteen community dwelling persons with SPMI to explore what informs and influences their smoking behaviours. The findings provide an understanding of the importance of smoking to the lives of those with SPMI. For most of the participants, smoking began as an anticipated positive enhancement of their self-esteem and/or identity, but evolved into a stigma with associated negative consequences. Participants perceived smoking as affecting their image, influencing social relations, and helping them adjust to mood changes. Participants revealed the complex ways in which they experienced smoking both as a group and as individuals, and in so doing illustrated the various agents that shape individual health choices around smoking. This study presents unique perspectives from participants' about their motivations for smoking, how they view themselves in relation to smoking, and what factors are important in influencing their personal behaviours around smoking. This study offers important opportunity for increased understanding and contains various recommendations for further inquiry and study.

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