Tobacco use and cessation among veterans recovering from stroke or TIA: a qualitative assessment and implications for rehabilitation.

OBJECTIVE

To understand factors associated with tobacco use and related tobacco cessation among veterans recovering from stroke/transient ischemic attack (TIA) that will facilitate design of a tailored intervention for rehabilitation services.

METHODS

Four focus groups were conducted with veterans who were smokers prior to an incident stroke or TIA along with their spouse or caregiver. Focus groups addressed tobacco use, cessation, and barriers to quitting during the recovery and maintenance periods. Focus group discussions were audiotaped, transcribed, and analyzed using an inductive qualitative method.

RESULTS

Twenty-eight veterans and spouses/caregivers participated. Five themes emerged from analysis: existing helpful resources for cessation, existing unhelpful resources, barriers and facilitators to cessation, desired resources for quitting, and association of stroke/TIA with tobacco use. Pharmacotherapy and support from medical providers were perceived as helpful whereas group programs and flyers were perceived as unhelpful. Barriers to quitting included boredom and lack of social support; facilitators included social support and the cost of tobacco products. Vocational and rehabilitation programs were highly desirable resources for quitting. Participants did not perceive their stroke/TIA to be associated with tobacco use.

CONCLUSIONS

Results identified several issues concerning tobacco use and cessation relevant to patients recovering from stroke/TIA. These results can inform the development of a tailored cessation intervention for integration into rehabilitation and recovery treatment plans for patients with stroke/TIA.