Table 2.
Thematic framework informed by the COM-B (capability, opportunity, motivation, and behaviour) model and Theoretical Domains Framework for two behaviours: using NRT per se (B1) and engaging with information and support on NRT use (B2)
| COM-B | Using NRT per se (B1) | Engaging with information and support with NRT use (B2) |
|---|---|---|
| B | 1. B1: Using NRT per se—from imitation to termination 1.1 Product selection and initiation of NRT use 1.1.1 Formal health care channels - GP recommendations or prescription - Recommendations in pharmacies - Stop smoking programmes - Samples from healthcare professionals 1.1.2 Informal channels - Word of mouth - Internet, TV and other advertisements - Samples from acquaintances 1.2 Selection criteria for NRT type 1.2.1 Convenience 1.2.2 Level of addiction and NRT strength 1.2.3 Prior experience 1.2.4 Cost, flavour and other criteria 1.2.5 Spontaneous and unguided selection 1.3 Experience of purchasing NRT 1.4 Past NRT use 1.4.1 Using individual NRT 1.4.2 Using multiple NRT products 1.4.3 Adhering to guidelines and recommendations 1.4.4 Experiencing side effects 1.5 Termination of NRT use |
13. B2: engaging with information and support on NRT use 13.1 Using NRT without any support 13.2 Reliance on one’s experience and understanding of addiction 13.3 Engaging with patient information leaflets 13.3.1 Reading the leaflet 13.3.2 Selective reading 13.3.3 Ignoring the leaflet 13.4 Engaging with healthcare professionals 13.4.1 GPs 13.4.2 Cessation advisers 13.4.3 Pharmacists and pharmacy staff 13.5 Accessing informal sources of support and information 13.5.1 Friends and family 13.5.2 Internet 13.5.3 TV and other ads 13.6 Engaging with display and packaging of NRT |
| C Phys | 2. Physical skills in taking NRT 2.1 Techniques and application methods 2.2 Practice and experimentation with NRT use |
Not identified as a theme |
| C Psy | 3. Knowledge related to NRT use 3.1 Factual knowledge about NRT 3.1.1 Types of NRT 3.1.2 Combination NRT 3.1.3 Mechanisms of action and ingredients 3.1.4 Effectiveness 3.1.5 Safety and side effects 3.2 Procedural knowledge about NRT use 3.2.1 Knowledge of techniques and application methods 3.2.2 Regimen of NRT use 3.3 Misconceptions and factual errors |
14. Knowledge of sources of information and support with NRT use |
| 4. Memory and attention to take NRT 4.1 Remembering about NRT use 4.2 Competing tasks and attention to NRT |
15. Memory and attention for information and support on NRT use 15.1 Focus on potential harm and side effects 15.2 Limited attention and recollection of advice |
|
| 5. Behaviour regulation in NRT use 5.1 Mental stamina to endure negative sensations 5.2 Monitoring and scheduling NRT use 5.3 Planning and preparing for obtaining NRT |
Not identified as a theme | |
| O Phys | 6. Physical opportunity for NRT use 6.1 Views on NRT products in general 6.1.1 Range of NRT products 6.1.2 NRT product design 6.1.3 NRT cost and availability 6.2 Views on individual NRT products 6.3 NRT regimen 6.3.1 Dose recommendations 6.3.2 Combination NRT 6.3.3 Cognitive complexity of NRT regimen 6.3.4 Impracticality, convenience and high effort 6.4 Views on medications and pharmaceutical companies |
16. Physical opportunity for engagement with information and support 16.1 Pharmacy setting 16.2 Display and packaging of NRT 16.3 Views and preferences on current printed resources on NRT use 16.3.1 Accessibility of guidelines 16.3.2 Patient leaflets 16.3.3 Other written resources 16.4 Digital support with NRT use 16.4.1 Online resources 16.4.2 Smartphone apps |
| O Soc | 7. Social opportunity and perceived norms impacting on NRT use 7.1 Role models in relation to NRT use 7.2 Use of NRT products in public |
17. Social opportunity 17.1 Not being offered support from healthcare professionals 17.2 Views and preference regarding face-to-face support 17.2.1 Accessibility of support 17.2.2 Dissatisfaction with past support 17.2.3 Detailed consultation 17.2.4 Signposting 17.2.5 Support in the pharmacy 17.2.6 Anonymous support 17.3 Peer testimonials and demonstrations |
| M Ref | 8. Beliefs about capabilities to use NRT | Not identified as a theme |
| 9. Beliefs about consequences of using NRT and other medications 9.1 NRT effectiveness 9.2 NRT safety concerns 9.2.1 NRT and addiction 9.2.2 Overdosing and dual use with cigarettes 9.2.3 Side effects 9.2.4 Other concerns 9.3 Views on smoking and quitting that could impact on NRT use 9.3.1 Quitting requires commitment and willpower 9.3.2 Smoking as a habit and learned gestures |
18. Beliefs about consequences of engaging with information and support on NRT use 18.1 Value of accessing support 18.1.1 Face-to-face support 18.1.2 Self-help resources 18.1.3 Reliance on one’s experience and knowledge 18.2 Burden of commitment to face-to-face support 18.3 Right timing and frame of mind needed for commitment to quitting |
|
| 1. Identity related to NRT use | Not identified as a theme | |
| M Aut | 2. Emotions: anxiety related to NRT use | 19. Emotions: shame and embarrassment to engage with support |
| 3. Routines and habits in NRT use | ||
| – | 20. Reaction to NRT facts and recommendations 20.1 Shock and surprise 20.2 “aha” moment—re-assessing one’s prior knowledge and experiences with NRT 20.3 Feeling encouraged 20.4 Ambivalence |
|
B = behaviour; C Phys = capability (physical); C Psych = capability (psychological); O Soc = opportunity (social); O Phy = opportunity (physical); M Ref = motivation (reflective), M Au = motivation (automatic), GP = in the UK general practitioner (e.g. primary care physician in the US)