"It Was All Tailored Around Me": Qualitative Evaluation of Clinical Effort Against Smoke Exposure in Cystic Fibrosis (CEASE-CF)

Abstract

Background: Our prior work revealed multilevel barriers to smoking cessation interventions among cystic fibrosis (CF) families and clinical providers. Here, we assess qualitatively the implementation of CEASE-CF, a multicomponent smoking cessation intervention tailored to the needs of CF caregivers and delivered by a tobacco treatment specialist (TTS) integrated into the CF care team (NCT04777344).

Methods: We conducted interviews with CF caregivers in the CEASE-CF intervention arm and with CF clinical care providers. Interviews were recorded and transcribed. Data analysis was completed by two independent coders using NVivo. Themes were generated using a content analysis approach with a constant comparative method.

Results: In 22 interviews with caregivers (n = 12) and providers (n = 10), four overarching themes emerged: (1) Increased caregiver awareness about the sources and harms of smoke exposure; (2) Increased caregiver self-efficacy for quitting; (3) Caregiver endorsement of the effectiveness of counseling by TTS; and (4) Provider endorsement of the integration of TTS in the CF care team.

Conclusion: CEASE-CF positively impacted caregivers by increasing their awareness of the sources and harms of smoke exposure, equipping them with tools to change habits, and enhancing their self-reported confidence and self-efficacy for quitting. Consistent and multifaceted cessation support provided by a trained TTS is practice-changing and can be successfully integrated in CF care delivery.

Keywords: cystic fibrosis; qualitative research; smoking cessation; tobacco.