Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, Kansas, United States of America.
Oregon Research Institute, Eugene, Oregon, United States of America.
PLoS One. 2021 May 11;16(5):e0251128. doi: 10.1371/journal.pone.0251128. eCollection 2021.
While firefighters currently have low smoking rates, rates of smokeless tobacco (SLT) use among this population are remarkably high and substantially greater than similar occupational groups, and the general population. This study explored determinants associated with SLT use, barriers to cessation, and motivators for SLT cessation in the fire service. Key informant interviews were conducted in 23 career firefighters who were current (n = 14) and former (n = 9) SLT users from across the U.S. Discussions were recorded and independently coded according to questions and themes. Major themes that developed among firefighters regarding SLT use determinants included positive perceptions of SLT products, social influences from their peers and family members, acceptability of SLT use in the fire service, and a coping resource for job stress. Firefighters discussed several barriers to SLT cessation, including intrapersonal barriers such as SLT use habits and its dependency, concerns about withdrawal symptoms; and social-environmental barriers including lack of support from health and other services providers, and lack of enforcement of existing tobacco policies regarding SLT use. Firefighters also mentioned both internal and external motivators for cessation. Internal motivators included self-motivation and their health concerns while external motivators included friends and family support, incentives or rewards, and price of SLT products. Findings provide unique perspectives from firefighters on factors that influence SLT use and barriers and motivators to SLT cessation. These are insufficiently assessed and considered by the fire service organizations and their health care providers. Thus, the organizations must understand these issues in order to mitigate barriers and motivate the personnel to quit using SLT. Information gained from firefighters who were current and former SLT users can be used to develop an effective, culturally-tailored intervention that is acceptable to fire service personnel.
虽然消防员目前的吸烟率较低，但该人群中使用无烟烟草（SLT）的比例却高得惊人，且远高于类似职业群体和普通人群。本研究探讨了与 SLT 使用相关的决定因素、戒烟障碍以及促使消防员停止使用 SLT 的因素。我们对来自美国各地的 23 名在职（n=14）和前职（n=9）SLT 用户的 23 名职业消防员进行了关键知情人访谈。讨论内容根据问题和主题进行了独立编码和记录。消防员在 SLT 使用决定因素方面提出的主要主题包括对 SLT 产品的正面看法、来自同事和家庭成员的社会影响、SLT 在消防服务中的可接受性以及工作压力的应对资源。消防员讨论了 SLT 戒烟的几个障碍，包括内在障碍，如 SLT 使用习惯及其依赖性，以及对戒断症状的担忧；以及社会环境障碍，包括缺乏来自健康和其他服务提供者的支持，以及缺乏对 SLT 使用的现有烟草政策的执行。消防员还提到了戒烟的内部和外部动机。内部动机包括自我激励和对健康的关注，而外部动机包括朋友和家人的支持、激励或奖励以及 SLT 产品的价格。研究结果从消防员的角度提供了对影响 SLT 使用的因素以及戒烟的障碍和动机的独特看法。这些因素在消防服务组织及其医疗保健提供者中没有得到充分的评估和考虑。因此，这些组织必须了解这些问题，以减轻障碍并促使人员停止使用 SLT。从当前和前 SLT 用户的消防员那里获得的信息可以用于开发一种有效的、文化上适宜的干预措施，以满足消防人员的需求。
