Background: Smoking and poor medication adherence are both associated with increased morbidity, mortality and immense costs for the healthcare system. Numerous studies have investigated the barriers and facilitators of medication adherence among patients with chronic disease. However, the factors influencing adherence to medication targeted to reduce smoking remain unexplored. In order to achieve further reduction of smoking prevalence, improvement of medication adherence is essential. Thus, this study aims to uncover and understand adult smokers’ attitudes towards adherence to medication to reduce tobacco dependence.
Methods: A purposive approach was used to recruit smokers aged over 18 and motivated to quit using pharmacotherapy. In-depth semi-structured interviews were conducted with a diverse sample of eleven smokers who were engaged with a NHS Stop Smoking Program. Data were thematically analysed using PRIME theory .
Results: Smokers were active decision makers regarding their tobacco dependence medications. Adherence was influenced by smokers’ evaluations, plans, access to support and experiential learning, highlighting the need for tailored adherence support. Conflicting views about medication were held by all participants. Side effects, fear of dependency and inability to stop cravings influenced initiation and adherence. Electronic cigarettes were viewed negatively. Adherence was influenced by their unique psycho-social contexts including deep-rooted personal rejection and, fear of medicines. These attitudes influenced smokers’ beliefs, decisions about quitting and the role and use of medications in the quitting process.
Conclusions: Tobacco dependency is a unique treatment context with specific adherence issues. Lay perspectives of medications to support quit attempts differ from the medical viewpoint. Adherence to tobacco dependency regimens is a challenging goal, inhibited by many complex factors. There is a need for smoking cessation interventions to respond to individual medication beliefs and concerns to help to build a smoker’s confidence that an individual can take their tobacco dependency mediation as prescribed and maximise benefits.