An exploration of the smoking-related health beliefs of older people with chronic obstructive pulmonary disease

Irene Schofield, Susan Kerr, Debbie Tolson

Research output: Contribution to journalArticlepeer-review

33 Citations (Scopus)


AIM: To explore the smoking-related health beliefs of older people with chronic obstructive pulmonary disease (COPD).

BACKGROUND: Globally, smoking is a major cause of COPD and symptoms present typically mid to later life. Substantial numbers of people with COPD continue to smoke even though smoking cessation is known to slow the rate of disease progression and prevent further deterioration in lung function. There is evidence to suggest that, although older long-term smokers can successfully quit smoking with the help of specialist structured programmes, those with COPD find it more difficult to achieve sustained cessation. An understanding of the health beliefs of people with COPD will assist professionals to provide the most appropriate support with cessation attempts.

DESIGN: A secondary analysis of qualitative interview data.

METHODS: Twenty-two current and former smokers with COPD who used the outreach service of an inner city hospital in Scotland were interviewed in their own homes using semi-structured interviews which were transcribed verbatim. The main concepts of the Health Belief Model were used as an analysis framework.

FINDINGS: Interviews were carried out with 15 women and seven men with a median age of 68 years. Almost 90% lived in areas of the highest socio-economic deprivation according to DEPCAT scores. Almost two-thirds of the individuals in this study continued to smoke even though they largely perceived smoking as a threat to health. Individuals who continued to smoke cited various barriers to quitting smoking and all had, at some time, attempted smoking cessation. Over half were still attempting to quit. Cues to action came from external sources rather than increasing disease severity.

CONCLUSIONS: Cessation is challenging and knowledge of a person's health beliefs is a prerequisite to supporting behaviour change.

RELEVANCE TO CLINICAL PRACTICE: Findings emphasize the need for frontline health professionals to reflect on their current practice with a view to providing sustained encouragement and support towards smoking cessation and relapse prevention for people with COPD.

Original languageEnglish
Pages (from-to)1726-35
Number of pages10
JournalJournal of Clinical Nursing
Issue number9
Publication statusPublished - Sept 2007
Externally publishedYes


  • Aged
  • Aged, 80 and over
  • Attitude to Health
  • Causality
  • Disease Progression
  • Female
  • Health Behavior
  • Health Knowledge, Attitudes, Practice
  • Health Services Needs and Demand
  • Humans
  • Male
  • Middle Aged
  • Models, Psychological
  • Nursing Assessment
  • Nursing Methodology Research
  • Poverty Areas
  • Pulmonary Disease, Chronic Obstructive
  • Qualitative Research
  • Scotland
  • Smoking
  • Smoking Cessation
  • Social Support
  • Surveys and Questionnaires


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