Table 4.

Illustrative quotes (focus groups)

Theme	Quote
Barriers to lung cancer symptom presentation
Fixation on chest infections	“People tend to be fixated on a [chest] infection and they want their next rescue pack ready cos almost as if it’s inevitable; it’s going to happen in the next month or so”. (Focus group 4)
Difference in perception around healthcare professional approach to patients ’ smoking	“I think there is a gulf between what people believe their GP would say to them if they do actually talk about [smoking] as opposed to what that conversation actually is in reality….But certainly as far as the formal training coming out of public health, if they are doing that then there is, that’s not a lecture…But that’s what people fear is going to be what they’re going to be told”. (Focus group 3)
Potential format of an intervention to support earlier lung cancer diagnosis	Participant 2: “So what I’m saying is, you know them mobile buses… in the shopping area, where people go shops, or outside the hospital… So they set them up and people are walking past, and even though they can’t be bothered to go to the doctors, and they look and they think I’ll just pop in”. Participant 1: “Cos you wouldn’t hesitate you know, you’d just go in”. Participant 2: “You’re just a person, they don’t know and they’re just seeing what’s there, or what’s there or what’s the problem with you. If there’s no problem” . Participant 3: “People think you don’t want to think you’re, feel as if you’re wasting the doctor’s time”. (Focus group 1)
Intervention content
More specific symptom advice	Participant 1: “Yeah I think when you say ‘cough’ it’s a bit broad and it’s a bit…You know, you’ve had a cough for 2  weeks, off you go". Participant 3: “It’d be useful if it was a change in your regular cough”. (Focus group 4)
Messages to combat negative beliefs	“Positive messages, particularly around lung cancer because everybody, you know it’s like a death knell isn’t it? And actually it’s not, it doesn’t have to be. You know you’re talking here about early diagnosis which is a big deal isn’t it”. (Focus group 3)
Smoking cessation	“You’ve got to include [smoking cessation information] …I think it’s how you deliver the message…not in such a way you feel ashamed for smoking. I’ve noticed [ the nurse] has got a way of telling patients how to stop smoking, she does it in a, not in a ‘well you should stop smoking’, that kind of way. She’ll say ‘have you ever thought about giving it up. You know it would improve your chest a bit’. And I’ve seen [the nurse do it] more in a non-lecturey basis, more of a, ‘have you ever thought about it?’ Relaxed, warmer manner. So I’m not lecturing you, it’s your choice. You know it’s bad for you”. (Focus group 4)