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Table 4 Relapse prevention interventions for abstinent/lapsed and relapsed smokers

From: Relapse prevention in UK Stop Smoking Services: a qualitative study of health professionals' views and beliefs

Support for abstinent/lapsed smokers
Content
Behavioural counselling & pharmacotherapy
"We run a group, so they can come in for a series of sessions which cover general healthy lifestyle, like healthy eating, getting advice, and stress reduction". 6.
"Well everything that is involved in behavioural support, going through every situation they may encounter, preparing themselves for that, looking at tactics to cope with situations....if they've got anything in particular they're worried about, we will approach it in a practical but relaxed manner". 2
"We work with people, whatever their issues/triggers are, we would deal with, it doesn't matter what it is, if its debt management, crisis resolution, if in quitting smoking they've got problems that need dealing with, we would deal with it". 5
"I would strongly recommend that (pharmacotherapy) because as I said, a lot of patients reported that they actually relapsed right after they are not provided with medications". 3
"I think it (pharmacotherapy) would be fantastic".5
Telephone follow up
"We do telephone follow-ups, say between six and twelve months, just to ask them how they are getting on, and to let them know they can access the service again and again, at any point they need". 18
"The problem you have there is if you are going to phone everybody, you have to have the manpower, the resources to do that, from a resource point of view, I wouldn't have time to phone everybody at the moment". 13
"It would be very hard for us to that, to phone everyone up would be ideal but impossible at the moment".15
Social activities
"We do use interventions such as diversion therapy, by getting people into community groups and community support....we don't send them home to continue sorting out themselves, we get them out in the community, get them busy and get them involved in things, they need to be busy and out there and feeling useful... we get them to go to care homes and just you know, do peoples' hair and make them cups of tea, its just engaging them with whatever involves them". 5
Uptake
"I think the picture is actually, people poorly attend relapse prevention. Because they feel once they've actually reached the quit, they don't need any help...a lot of smokers don't want you chasing them up, a lot of them are fed up if you do contact them". 6
"We used to, a couple of times a year, we'd put on like an open session, and invite everybody who'd been to the group in the last year, we'd put on a bit of food and make it a social event, and do some stuff about staying quit, but very few people attended, so it tended to be a waste of our time, so we didn't continue it". 16
Support for relapsed smokers
Content
Rolling groups
"We don't have any formal relapse groups, but there are no barriers to re-entry of the service, for example in my 12 week group, drop-in group, people can come along who have relapsed and re-join the group again". 12
"We have a rolling group that is open for anybody who wants to come back in at any time". 14
Recycling
"Yes, it's a new quit attempt isn't it? (For relapsed smokers). You would go over the reasons for relapse and then you need to go through the whole process of another quit attempt". 16
Uptake
"A lot of people would rather, even though you've built up a rapport, struggle than bother you, so they think, oh no, I've failed now, they may have had one, two cigarettes, they don't contact you, so that tends to be a problem.". 8
"I think, when you, from my experience as an ex-smoker, if you're trying to give up, and you've slipped up, and then somebody is ringing you, you think Oh God no, it's that woman again, and feel really bad". 13
"The trouble is when people do relapse there's sort of, they're embarrassed to come back". 15