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Abstract
Background: This qualitative paper describes perceptions of smoking risk and ways of thinking about risk for 31 persons with a Severe Mental Illness (SMI). Research has shown that many people with SMI want to quit smoking, and, like many other disadvantaged groups, make many quit attempts.
Aim: The authors undertook a qualitative study to explore views and experiences about smoking and quitting, within a general context of what it means to them to live a healthy lifestyle.
Method: A purposive sample of former smokers, current smokers, and individuals who had never smoked was chosen to participate in a semi-structured interview. Questions targeted various lifestyle domains, narrowing to focus more specifically on smoking habits, attempts to quit, and thoughts about the future in relation to health and smoking. Techniques of grounded theory were used to categorize and interpret themes.
Results: The results indicate that many current smokers interpret and frame perceptions of health risks from smoking in relation to the perceived benefits of smoking on mental health stability, and, for a few, in terms of their survival luck thus far. Former smokers' retrospective accounts suggest that risk perceptions were shaped not just by information regarding health risks, but also by myriad events and experiences over time, such as a relative dying or starting a job. Individuals who had never smoked did not discuss a careful consideration of risk that resulted in their non-smoking status, but instead mentioned their negative experience with smoking and their disgust at the habit.
Conclusions: Identifying how risks are framed by members of a particular population may be useful for designing strategies to engage them into treatment. These data suggest a variety of strategies clinicians can use to motivate individuals with SMI to quit smoking.