Research to Prepare for Stop Smoking Wales

I.Background:

Stop Smoking Wales is the organisation funded by Welsh Government; with the mission to offer free and friendly support (including providing quitting guidance, advice and information) to those smokers who are intend to give up smoking across Wales since 2004. Stop Smoking Wales plays an important role in reducing bad impact on the health of smokers as well as people who suffer from second-hand smoking.

The organisation is about to launch a new campaign, which is aiming to encourage smokers to change their behaviours as well as raise the level of public awareness of smoking-related litter. In order to obtain an optimized social effort based on its aims, reasonable formulation of the campaign is necessary. Therefore, a further understanding regarding smoking-related behaviours and motivations is crucial in terms of formulate the campaign more reasonably.

According to the brief Stop Smoking Wales sent, the content of research should cover: profiles of smokers; smoking levels and related behaviours; motivations to smoke and quit; behaviour regarding litter related to smoke.

Objectives

The overall objective of the research is to identify the smoking-related behaviour and have an insight into their motivation. This has been splitted into the following sub-objectives:

1. To gain an updated profile of smokers;

2. To get information regarding smoking level and related behaviours of smokers.

3. To identify the motivations of smokers to smoke, quit and re-smoke.

4. To obtain the information on behaviour of smokers regarding smoking-related litter.

Detailed descriptions of each objective are shown below:

1. To gain an updated profile of smokers:

It would attempt to present a broad picture of smokers, including the number of people who smoke, the proportion of smokers at different gender, age, socio-economic classification etc. Not only would it give you an overall idea about smokers in Wales recently, but also be useful as a reference of evaluation to compare with the situation after the new campaign launches.

2. To get information regarding smoking level and related behaviours of smokers.

It would seek to gain information including how long the smokers have been smoking, how many cigarettes they smoke per day, when they smoke their cigarettes every day etc. It would be helpful for you to understand better on smokers’ behaviour patterns.

3. To identify the motivations of smokers to smoke, quit, and re-smoke; identify sources of help or advice on smoking.

The objective is to identify the deep motivation of smokers to smoke, as well as that to quit. As you know, there are a lot of smokers who tried to give up smoking but failed. You would notify that we have slightly adjusted the original objective. To identify the motivations of re-smokers would provide you a better insight where smokers need more support in the process of quitting. Identifying sources of help or advice on smoking would be valuable to the future formulation of the campaign in terms of choosing channels to publicity.

4. To obtain the information on behaviour of smokers regarding smoking-related litter and identify the reason why smokers choose to drop litter wherever it is.

It would investigate how smokers normally dispose smoking-related litter, such as cigarettes ends, packets and try to have an understanding in terms of the reason that people discard smoking-related litter. It would be indicate a clearer direction to scheme the part of the campaign, which is with the goal of increasing public awareness of smoking-related litter.

?.Research design

The proposed research will be consisted of three phases. The first phase is about to inspect the secondary data in order to cover the useful information we are seeking for. Given the basic information we get from the first stage, the second phase will use qualitative researches as a tool to assist us in acquiring deeper insight into the motivations and attitudes regarding smoking behaviour of smokers. Through phase two, we may be able to discover some unexpected motivations and attitudes of smokers. Based on the in-depth information we obtain in the second phase, we will be capable of forming questionnaires of quantitative research reasonably. The questionnaire would be used during the third phase to fulfil the overall objective of the research.

3.1 Desk research

3.1.1 Purpose

The secondary data will be gathered with the purpose to draw a general picture of characteristics of smokers in the last two years (2007, 2008).The data will help in providing a constructive indication that enables us to inform the next stages. The list of main directions of the desk research to where we are heading to explore are shown below:

* How many people are smoking?

* What is the proportion of smokers in terms of gender and age?

* Which areas of occupations are the adult smokers in? How much salary do they make per year?

* How many cigarettes do smokers have per day?

* When would smokers smoke their first cigarettes every day?

* Which are the age levels that smokers tend to smoke more?

* How old are they when smokers started smoking?

* Where do smokers usually smoke, indoors or outdoors?

* How many smokers intend to give up smoking, and how many smokers tried to give up (but failed)?

* How do smokers view on quitting smoking?

* What are the reasons for smokers to quit smoking and re-smoke?

* What are the sources of advice and help that smokers usually turn to or get?

* How smokers behave when they are with non-smokers and children?

3.1.2 Procedure

The source of external data would be mainly targeted the data provided by National Statistics Opinion Survey .All the data of targeted reports were collected for the usage of health and social care. Therefore, the data provided by the reports are considerably relevant to our objective of research. In addition, the targeted reports are all released before 2008,most of them are release in 2009,hopefully would provide us more current data to assist us in understanding the case better.

List of useful points and information of targeted reports related to our research:

* Welsh Health Survey, 2008.

According to the report of Welsh Health Survey,

a. We could obtain the proportion of current smokers, ex-smokers and non-smokers of adult (classified by age and sex):

b. We could obtain the locations where people usually smoked:

c. We could obtain the proportion of smokers who would like to give up smoking and the one of smokers who had tried to give up in the last year. We could obtain the main reason for smokers to quit also.

d. We could obtain the proportion of non-smokers who were bothered by second-hand indoors and outdoors.

* Smoking related behaviour and attitudes – 2008/09

According to the report,

a. We could obtain the proportion of smoking status by sex and socio-economic classification. The socio-economic classification includes managerial and professional occupations; intermediate occupations; routine and manual occupations.

b. We could obtain the number of cigarettes smokers smoked daily.

c. We could obtain the information about when smokers smoked their first cigarette every day.

d. We could obtain the proportion of different views on quitting smoking as well as the reasons of smokers to quit.

e. We could obtain the proportion of different sources of advice and help on smoking smokers got and used.

f. We could obtain the proportion of smokers who tried to give up smoking and the main reasons for them to smoke again.

g. We could obtain the behavior of smokers when they were with non-smokers and children.

* Statistics on Smoking, England – 2009

According to the report:

a. We could obtain information about the proportion of smoking among adults and children;

b. We could obtain information about age that smokers started to smoke.

* Smoking, drinking and drug use among young people in England – 2008

According to the report,

a. We could obtain the proportion of pupils who regularly smoked.

b. We could obtain information about influences of family attitudes and behaviour towards smoking on young people’s smoking attitudes and behaviour.

c. We could obtain the proportion of different levels of dependence on smoking of pupils.

d. We could obtain information about beliefs and attitudes to smoking among young people.

e. We could obtain the sources of helpful information that young smokers got.

It is noted that with the exception of the report of Welsh Health survey, all the data of the surveys were not covered in Wales. Therefore the data provided by the reports would not entirely indicate the local situation in Wales. However, they are still able to offer us a likely picture for the reason that we believe the situations in Wales and in England are similar, or not that different. The above data of reports have already evaluated by us to ensure that they met the standard: reliability, validity, currency.

When it comes to internal data, we would require to access to the database of Stop Smoking Wales, which would provide information we need of smokers that were helped to quit smoking by your organisation in the past two years. The data will be arranged and analysed to generate a report that based on the directions listed above.

3.2 Primary data

3.2.1 Qualitative researches

With all the constructive analysis we derive from the first phase, it would be easier to understand and summary common behaviour and attitudes towards smoking of smokers in general. The second phase primarily explores the motivations and attitudes to smoking-related issue. Different types of qualitative research would be adopted (if it is necessary, they would be intermixed used) with the purpose of interlinking and fulfilling the different sub-objectives of the research. Further details of each would be presented below

3.2.1.1 Group interview

1) Purpose: a. to explore the reasons, attitudes and motivations to smoking-related behaviour and littering behaviour;

b. to explore the reasons that smokers consider help/information/advice useful or unuseful;

c. to explore the ideas of smokers regarding how to change the smoking-related littering behaviour.

The group interview research will probe the following:

* Motivations for smokers to smoke at the first place (positive perception of smoking, family influences, friend influences etc.);

* Motivations for smokers to quit (financial reason, health reason, bad impact on children or non-smokers etc.);

* Reasons for smokers to re-smoke;

* The sources of help/advice/information on smoking, to what extend smokers consider it as useful and reasons to their opinions.

* The way smokers dispose smoking-related litter and their attitudes towards throwing the litter any where.

* Recommendations to improve smokers’ behaviour regarding smoking-related litter.

2) Population and sampling:

The target population of group interviews will be people aged 11-45, living in Wales. School registers, Postcode Address File are chosen as sample frame. To those students under 18, school registers would be useful. 80 students would be selected according to the list provided by school census based on the academic year of 2007, 2008 and 2009. To make the research more easily conducted, the selected students would be from two schools (middle school and high school, 40 of each). Students of different academic year will be selected randomly to make sure the selected students cover the age from 11 to 18.To those above 18, we will use Postcode Address File as the sampling frame.200 people would be selected randomly from the sample frame.

Selected people would be pre-screened their qualifications to take part in the interviews by a prepared questionnaire. The questionnaire would include: whether or not they are smokers, if they are not, the end of the pre-screening; if they are, information regarding demographic, socio-economic classifications, how long they’ve smoked, how many cigarettes they smoke per day, locations they smoke, have they tried to quit in the past 1 year, how they dispose smoking-related litter, will be asked to provided in order to help in screening. All the questionnaires would be done and collected on-line, to reduce possible uncomfortable feelings of giving true answers.

We propose fours groups (6 participants each group) with the following profiles based on the result of the pre-screening:

* Group 1: mixed gender; aged 11 to 18; smokers who tried to quit in the past 1 year.

* Group 2: mixed gender; aged 20 to 45; smokers who tried to quit in the past 1year; with managerial or professional occupations.

* Group 3: mixed gender, aged 20 to 45; smokers who tried to quit in the past 1 year; with intermediate occupations.

* Group 4: mixed gender; aged 20 to 45; smokers who tried to quit in the past 1 year; with routine or manual occupations.

Actually, the best scenario would be the participants in a single group with homogeneous profiles in gender, age and socio-economic classification. In that case, possible conflicts would be avoided and participants would feel more comfortable to open their mouths, what’s more important, we could obtain more reliable results from the research. However, given the limited budget, the above scenario is a relatively suitable one.

3) Procedure

A skilled moderator will in charge of the group interviews. Questions flow on topic guide generated for the interviews will be followed (but not exactly in the order as the flow, for the reason that the interviews on some level should be free-flowing.) The interviews will approximately last 2 hours. The process of interviews will be videoed with permissions of participants. Moderator will also make notes during the interviews.

4) Data analysis: The data of interviews from videotapes and notes the moderator makes during interviews, will be retrieved, organised and interpreted into meaningful units. Focus will be put on seeking the motivations of smokers to smoke and quit; how they dispose smoking-related litter and the advice they give on improving smokers’ behaviour regarding smoking-related litter.

3.2.1.2 Observation

1) Purpose: to see how smokers deal with smoking-related litter in real life through field observations. The observations would be classified as structured (observing how people would dispose cigarette ends after smoking), disguised (observations without informing respondents) and natural (the observed behaviour takes place in natural environment).

2) Data collection: observations would take place in a certain areas of different types of areas across Cardiff. Areas would be coded generally as 5 categories: places near schools, shopping malls, senior offices, factories, market. 8 areas (2 of each category) would be chosen as places of observation. The observations would be undertaken by an observer and they last for 3 days. A single observation lasts for 1 hour. During the observations progress, observers will mark down place the observation take place, targeted behaviour of smokers they encounter as well as field notes. When observation ends, observer is required to fill an observation form.

3) Data analysis: The collected data would be generated as a small report with showing percentages of smokers who inappropriately dispose smoking-related litter and likely relationship between ways of disposing the litter and socio-economic status.

3. 2. 2 Quantitative researches

In light of analysing reports generated at the two previous stages, we could start our last phase of the research. We are planning to conduct the quantitative research on Online Access Panel, which is a more cost-effective access to meet the need of saving budget comparing to face to face interviews and on phone. The way we contact the desired respondents could efficiently balance the budget and the number of respondents of the research. What’s more, finishing questionnaires on Online Access Panel makes respondents feel more private and comfortable so that they would be more likely to give true answers when being asked sensitive questions, for example: how smokers usually deal with smoking related litter.

1) Purpose: The objective of the phase is mainly to measure how smokers feel about the motivations, reasons and ideas on smoking-related behaviour and attitudes we explore at the second stage. Measurement and analyse would be done to identify how widespread these feelings.

2) Population and sampling: 200 interviews of different gender and different socio-economic classification will be carried out in order to obtain more subjective and reliable data which could also give us opportunity to see how smoking-related opinions and behaviours differ by gender and socio-economic classification.