Keller Alex M, von Glasenapp Barbara, Kotz Daniel, Marck Claudia H, Heesen Christoph, Riemann-Lorenz Karin
Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Centre Hamburg- Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
BMC Public Health. 2024 Dec 17;24(1):3402. doi: 10.1186/s12889-024-20998-5.
Tobacco smoking is a relevant determinant of multiple sclerosis (MS) onset, and smokers have increased risk for faster progression of MS compared to non-smokers. While the smoking prevalence is high in Germany, no smoking cessation programs have been developed specifically in MS populations to date, and only little is known about the motivators and barriers influencing smoking cessation in people with MS (pwMS) in Germany. This study aims to identify these factors to inform the design of a tailored smoking cessation intervention.
As part of a larger program of work, we conducted semi-structured interviews in people with MS (pwMS) to explore their needs, motivators and barriers regarding smoking cessation. We recruited via MS-websites and the email-newsletter of our institution at the University Medical Centre Hamburg-Eppendorf. Participants were eligible if they had a self-reported MS-diagnosis and currently smoked or quit smoking within the last two years but after their MS-diagnosis. Interviews were conducted online and via telephone during May and June 2023. Data were analysed using thematic analysis based on a realistic approach.
Eight women and seven men participated in our interviews. Eleven were current, four were former smokers. Median time since diagnosis was 4 years (range: 1-26). Interviews identified MS-diagnosis, concerns about general health, and social factors as relevant motivators to stop smoking. Furthermore, worries about negative consequences when quitting (e.g. fear of missing out on social interactions or weight gain) were identified as a great barrier to smoking cessation. Knowledge about the connection between MS and smoking, and satisfaction with communication with MS clinicians were low. PwMS expressed a need for better conversations with neurologists and expert-led smoking cessation interventions. Additionally, we found that the wish for peer-exchange and the willingness to participate in smoking cessation programs was high.
Our results confirm findings of previous studies from other countries, identifying lack of knowledge, unsatisfactory communication with MS clinicians, and worries about negative consequences when quitting as barriers, and the MS-diagnosis as a motivator for smoking cessation. In a next step, we will use our findings for the development of an MS-specific online smoking cessation program.
吸烟是多发性硬化症（MS）发病的一个相关决定因素，与不吸烟者相比，吸烟者患MS快速进展的风险更高。虽然德国的吸烟率很高，但迄今为止尚未专门针对MS人群制定戒烟计划，对于影响德国MS患者（pwMS）戒烟的动机和障碍知之甚少。本研究旨在确定这些因素，为量身定制的戒烟干预措施的设计提供依据。
作为一项更大规模工作项目的一部分，我们对MS患者（pwMS）进行了半结构化访谈，以探讨他们在戒烟方面的需求、动机和障碍。我们通过MS相关网站以及我们位于汉堡-埃彭多夫大学医学中心的机构的电子邮件通讯招募参与者。如果参与者自我报告患有MS诊断，并且目前吸烟或在过去两年内（但在MS诊断之后）戒烟，则符合入选条件。访谈于2023年5月和6月通过在线和电话方式进行。基于现实方法，使用主题分析法对数据进行了分析。
八名女性和七名男性参与了我们的访谈。十一名为当前吸烟者，四名是曾经吸烟者。自诊断以来的中位时间为4年（范围：1 - 26年）。访谈确定MS诊断、对总体健康的担忧以及社会因素是戒烟的相关动机。此外，对戒烟时负面后果的担忧（例如害怕错过社交互动或体重增加）被确定为戒烟的一大障碍。关于MS与吸烟之间联系的知识以及对与MS临床医生沟通的满意度较低。pwMS表示需要与神经科医生进行更好的沟通以及由专家主导的戒烟干预措施。此外，我们发现同伴交流的愿望以及参与戒烟计划的意愿很高。
我们的结果证实了其他国家先前研究的结果，确定知识缺乏、与MS临床医生的沟通不令人满意以及对戒烟时负面后果的担忧是障碍，而MS诊断是戒烟的动机。下一步，我们将利用我们的研究结果来开发一个针对MS的在线戒烟计划。
