Abstract
INTRODUCTION: Individuals who use a stop smoking service (SSS) in the UK are three times more likely to quit. Uptake of SSS is limited among lower socioeconomic (LSE) groups and efforts are needed to understand how to improve the appeal, acceptability, and accessibility of SSS. METHODS: Semi-structured interviews with 114 participants from the four UK devolved nations who had a current or recent smoking history and who had previously accessed or may potentially access a SSS. Participants were recruited via Facebook, third sector organizations, and a market research company. Telephone-based interviews were analyzed using thematic analysis. The Behaviour Change Wheel was used to develop the interview topic guide, inform thematic analysis, and identify strategies to increase engagement with SSS. RESULTS: Barriers included low awareness and understanding regarding the availability and content of SSS, a lack of free time to access SSS and negative beliefs regarding the efficacy of SSS support. Facilitators included more frequent and continued flexible support delivered using a range of modes, access to free Nicotine Replacement Therapy (NRT), and rapport with the advisor. Intervention functions were identified to address these barriers and facilitators via educational efforts to raise awareness of SSS, environmental restructuring to provide a flexible approach to delivery, and community champions to encourage and enable SSS engagement in the target population. CONCLUSIONS: Providing further community-based efforts along with a more holistic approach to delivering behavioural support and NRT has strong potential to maximize SSS reach, engagement, and acceptability. IMPLICATIONS: The current study provides insights into the barriers and facilitators to engaging with and accessing SSS among LSE groups and indicates that interventions to increase capability, motivation, and opportunity are required. Recommendations from this work for tailoring UK SSS for LSE groups can be used to inform future tobacco control policy including engagement strategies at a local and national level.