Preferences, experiences and needs regarding tobacco cessation expressed among patients with rheumatoid arthritis: a qualitative study

Background: Smoking presents significant challenges for individuals with rheumatoid arthritis (RA) yet understanding of their smoking habits and perceptions remains limited. This study explores preferences regarding tobacco cessation strategies, barriers to success in cessation, and perceived needs in this population. Methods: We conducted qualitative semi-structured interviews with 16 people with RA (9 past and 7 current tobacco users). Data were analyzed to identify common themes and patterns related to smoking behaviors and perceptions. Results: Most participants did not alter their smoking habits after developing RA, and common triggers for smoking included alcohol consumption, coffee, stress, and RA symptoms. Few used non-combustible tobacco products, but many attempted nicotine replacement methods. Participants generally perceived smoking as having no role in RA development, although they recognized its negative health impacts, including respiratory and cardiovascular issues. Despite advice from healthcare providers, many participants were not ready to quit smoking, citing addiction, past failures, and challenges in replacing smoking with other activities as major barriers. Motivations and facilitators for quitting included family needs and support, health concerns, and financial savings. Successful quitters identified the need for strong personal commitment, use of medical aids, behavioral changes, and social support. Effective cessation programs should include education about health impacts and medication use, interactive discussions, support groups, and flexible formats, participants said. Conclusions: Smoking behaviors in individuals with RA are influenced by multiple factors, including stress, RA symptoms, and addiction. Effective cessation programs should address these specific challenges by incorporating personalized education, behavioral support, and flexible formats. Understanding these dynamics can improve targeted interventions to support RA patients in quitting smoking and managing their health more effectively.