ThinkQuit V1.0
Research type
Research Study
Full title
The Think Quit Study: A study to co-produce & pilot test a behaviourally-informed intervention to empower nurses to address smoking & promote smoking cessation with hospital patients in Cwm Taf Morgannwg
IRAS ID
342275
Contact name
Jessica Baillie
Contact email
Sponsor organisation
Cwm Taf Morgannwg University Health Board
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
"Research summary"
Background: In Wales, hospital patients who smoke can be supported by the Help Me Quit in hospital service. Smokers are up to three times more likely to successfully quit if supported by the service. Nurses play a critical role in identifying smokers, promoting smoking cessation and referring patients to services. However, they report barriers such as lack of knowledge, confidence, time, training, perceived patient motivation to quit and a supportive work culture.Research question: What are the factors influencing secondary care nurse discussions about smoking and referral to smoking cessation services?
Design: A three phase study based on behavioural science theory to (1) gather insight about factors affecting nurse behaviours, (2) co-produce a behaviourally-informed intervention with nurses and (3) pilot test the intervention in practice.
Participants: Nurses working in secondary care settings in Cwm Taf Morgannwg University Health Board. Interviews with up to 10 patients who are smokers and have recently had a hospital stay.
Outcomes: Factors affecting nurse behaviour regarding discussing smoking and referring patients to Help Me Quit in Hospital. Secondary outcomes include feasibility, acceptability and usability of the intervention and rates of recording and referring smokers in secondary care.
Dissemination: Two reports will be prepared for the funder. Reports will also be disseminated via NHS nursing and public health channels. Three open-access peer-reviewed articles will be submitted for wider dissemination.
"Summary of results"
General Information
Study title: Co-producing and refining a behaviourally-informed intervention to empower nurses to address smoking and promote smoking cessation with hospital patients in Wales (The ‘Think Quit’ Study).Who carried out the research? The study was funded by the Burdett Trust for Nursing and sponsored by Cwm Taf Morgannwg University Health Board.
Public involvement: Two public involvement representatives were part of the team and helped us understand the real-world impact of smoking discussions on patients, reviewed documentation, and identified which aspects of the intervention were most important.
Where and when the study took place: The study was undertaken in Cwm Taf Morgannwg University Health Board between June 2024 and August 2025.
Why the research was needed
Smoking is the biggest cause of preventable death worldwide. When someone is in hospital, it is a good chance for nurses and other healthcare staff to talk about quitting smoking and offer support. However, nurses can face challenges that make these conversations difficult, and we need to understand these better.What were the main questions studied?
The study objectives were:
1. To explore the experiences of nurses, including barriers and facilitators, to discussing smoking and making referrals to smoking cessation services.
2. To prioritise and co-produce an intervention to support nurses to discuss smoking and make patient referrals to Help Me Quit.
3. To refine the intervention with key stakeholders.What happened during the study and who participated?
Nurses from three district general hospitals within Cwm Taf Morgannwg University Health Board were invited to complete a survey and take part in focus groups.In total, 110 nurses completed the survey and 21 nurses took part in focus groups or individual interviews. The data were analysed to identify nurses’ experiences of the barriers and facilitators to discussing smoking and referring patients to the smoking cessation service.
A series of in-person and online workshops were then held with nurses and other key stakeholders to identify, prioritise, and refine an intervention to empower nurses to discuss smoking and make referrals to the smoking cessation service.
What were the results of the study?
Overall, nurses viewed smoking cessation intervention as part of their role, but:
• Pressured clinical environments, competing demands, and patient acuity made conversations difficult.
• Previous negative patient reactions deterred future discussions about smoking.
• Nurses reported limited time and knowledge about how to make referrals, and a lack of belief that referrals would result in patients quitting smoking.
• The absence of feedback on referrals undermined nurses’ confidence that referrals were beneficial.The co-production workshops prioritised developing an intervention that provides feedback on patient referrals to the smoking cessation service. This feedback intervention was co-developed and refined with nurses and has now been implemented within Cwm Taf Morgannwg University Health Board.
How has this study helped patients and researchers?
This study co-produced and refined a behaviourally-informed intervention to support nurses working within Cwm Taf Morgannwg University Health Board to discuss smoking cessation and refer patients to the smoking cessation service. Launching this intervention aims to empower nurses and support efforts to reduce smoking rates within the Health Board.Where can I learn more about this study?
The barriers and facilitators identified in discussing smoking and making referrals have been published here: https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Flink.springer.com%252Farticle%252F10.1186%252Fs12912-025-03597-6%2FNBTI%2FcNXBAQ%2FAQ%2F69082be0-d470-4907-8f9b-6d718063d13a%2F1%2FuE2ZZw70cQ&data=05%7C02%7CWales.REC7%40wales.nhs.uk%7C13bb81ce71184cb150d308de34080794%7Cbb5628b8e3284082a856433c9edc8fae%7C0%7C0%7C639005406273237739%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=mE1npdZLjUegrgA%2BzUwsHxmhtA%2Bry8Ds632QhbGGqpg%3D&reserved=0The strategies the research team used to recruit nurses as research participants have been explored in this article: https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Fpubmed.ncbi.nlm.nih.gov%252F41306109%252F%2FNBTI%2FcNXBAQ%2FAQ%2F69082be0-d470-4907-8f9b-6d718063d13a%2F2%2Fx_4-Shs9KY&data=05%7C02%7CWales.REC7%40wales.nhs.uk%7C13bb81ce71184cb150d308de34080794%7Cbb5628b8e3284082a856433c9edc8fae%7C0%7C0%7C639005406273261077%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=RX%2BA0a1h3oCSOzNwPnjbwCjYOL6p8rUqdqL2dEWO%2FCE%3D&reserved=0
REC name
Wales REC 7
REC reference
24/WA/0157
Date of REC Opinion
21 May 2024
REC opinion
Further Information Favourable Opinion