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A process evaluation of 'We Can Quit': a community-based smoking cessation intervention targeting women from areas of socio-disadvantage in Ireland

Darker, Catherine D.; Burke, Emma; Castello, Stefania; O'Sullivan, Karin; O'Connell, Nicola; Vance, Joanne; Reynolds, Caitriona; Buggy, Aine; Dougall, Nadine; Loudon, Kirsty; Williams, Pauline; Dobbie, Fiona; Bauld, Linda; Hayes, Catherine B.


Catherine D. Darker

Emma Burke

Stefania Castello

Karin O'Sullivan

Nicola O'Connell

Joanne Vance

Caitriona Reynolds

Aine Buggy

Kirsty Loudon

Pauline Williams

Fiona Dobbie

Linda Bauld

Catherine B. Hayes


Background: Smoking poses a serious risk of early preventable death and disease especially for women living with socio-economic disadvantage (SED). A smoking cessation programme, ‘We Can Quit’, was developed in Ireland tailored to SED women. This includes group-based support delivered by trained lay local community facilitators (CFs) and free nicotine replacement therapy (NRT). The intervention was pilot tested in a cluster randomised controlled trial, ‘We Can Quit 2’. This paper reports on the WCQ2 process evaluation which assessed feasibility and acceptability of the programme and trial processes.

Methods: Embedded qualitative design using the UK Medical Research Council’s process evaluation framework. Semi-structured interviews with trial participants (N=21) and CFs (N=8). Thematic analysis was utilised.

Results: Peer-modelling, a non-judgemental environment, CFs facilitation of group support were viewed as acceptable programme related factors. Some participants expressed concerns about NRT side effects. Provision of free NRT was welcomed and accepted by participants, although structural barriers made access challenging. Pharmacists took on a role that became larger than originally envisaged – and the majority provided additional support to women in their quit attempts between group meetings which augmented and supplemented the intervention sessions provided by the CFs. Participants reported good acceptance of repeated measures for data collection, but mixed acceptability of provision of saliva samples. Low literacy affected the feasibility of some women to fully engage with programme and trial-related materials. This was despite efforts made by intervention developers and the trial team to make materials (e.g., participant intervention booklet; consent forms and participant information leaflets) accessible while also meeting requirements under 2018 European General Data Protection Regulation legislation. Hypothetical scenarios of direct (e.g., researcher present during programme delivery) and indirect (e.g., audio recordings of programme sessions) observational fidelity assessments for a future definitive trial (DT) were acceptable.

Conclusions: Intervention and trial-related processes were generally feasible and acceptable to participants and CFs. Any future DT will need to take further steps to mitigate structural barriers to accessing free NRT; and the established problem of low literacy and low educational attainment in SED areas, while continuing to comply within the contemporary legislative research environment.


Darker, C. D., Burke, E., Castello, S., O'Sullivan, K., O'Connell, N., Vance, J., …Hayes, C. B. (2022). A process evaluation of 'We Can Quit': a community-based smoking cessation intervention targeting women from areas of socio-disadvantage in Ireland. BMC Public Health, 22(1), Article 1528.

Journal Article Type Article
Acceptance Date Jul 28, 2022
Online Publication Date Aug 10, 2022
Publication Date 2022
Deposit Date Jul 28, 2022
Publicly Available Date Jul 28, 2022
Journal BMC Public Health
Publisher BMC
Peer Reviewed Peer Reviewed
Volume 22
Issue 1
Article Number 1528
Keywords smoking cessation, behavioural intervention, NRT, deprivation, women, trials, qualitative, process evaluation
Public URL


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