“Let’s break it into smaller steps”: the possible role of social workers in improving the access of vulnerable smokers to smoking cessation support.

Abstract

Background: Smokers with a lower socioeconomic status or migration background experience multiple barriers to accessing smoking cessation support. Previous studies suggest that social workers could play a significant role in reducing these barriers. The aim of this study is to explore what role(s) social workers can play in improving access to smoking cessation support and their readiness to fulfill these roles. Methods: In 2022 and 2023, semi-structured interviews as well as participatory learning and action sessions were conducted in the Netherlands amongst smokers with a lower SES or a migration background, smoking cessation support providers, social workers and external experts in multiple living labs, in the Netherlands. Interviews were coded using a combination of deductive and inductive coding; data were analyzed thematically. Results: Important barriers for accessing smoking cessation support as reported by interview participants included difficulties in perceiving, seeking, reaching and engaging with the support, as well as concerns related to the appropriateness, approachability, intensity and affordability of smoking cessation support. To overcome these barriers social workers could motivate this group of smokers to quit smoking, proactively refer them to smoking cessation support and provide individual or group support. Social workers feel capable of addressing smoking cessation but lack organizational support, hindering their motivation to discuss it. When social workers feel capable, have the opportunity and motivation to fulfill these roles, this does not necessarily lead to performing this behavior. Conclusion: Participants agree on multiple roles social workers could fulfill to reduce the barriers smokers with a lower SES or migration background experience in accessing smoking cessation support. To fulfill these roles, it is recommended to gradually integrate cessation support into their daily responsibilities through the provision of concrete and small practical assignments, allowing social workers’ capabilities, opportunities and motivation regarding the uptake of these roles to increase.