Dependent behaviours and beliefs: a qualitative study of older long-term smokers with arterial disease

Aims. To examine the reasons for continuing to smoke provided by a sample of long-term older smokers who have arterial disease (a smoking-related condition) and the implications of those beliefs for current smoking behaviour and future smoking intent.
Design. Qualitative semi-structured interview study with face-to-face interviews using 'life grids'.
Setting and participants. Twenty-two long-term older smokers, with arterial disease, who were participants of a larger qualitative study of Life Course Influences on Patterns of Persistent Smoking.
Measurement. Qualitative semi-structured interviews explored how respondents' described their relationship to smoking, using life grids to capture changes in patterns of cigarette usage across the life course.
Findings. Older smokers with arterial disease defined their relationship to smoking in either dependent terms or functional terms (to fulfil specific purposes). The two types of relationship appeared to be associated more with different degrees of control smokers described exercising over their habit than with their levels and patterns of usage. Some older smokers with arterial disease who showed dependent patterns of behaviour did not believe they were dependent, and some who showed non-dependent patterns of usage did not think of themselves as smokers even though they smoked. The immediate, functional and material benefits which these smokers attributed to smoking appeared to outweigh anticipated immediate and/or long term health-related benefits of quitting.
Conclusions. How smokers define their relationship to cigarettes does not necessarily correspond to levels and patterns of usage.