Table 4 Need for smoking cessation among habitual smokers in Japan (N = 16)

Empowerment from experts

Attitude of trying

to understand

It was nice to be able to talk one-on-one. I talked directly with the psychologist and the public health nurse, and because of that, I was able to keep going to them. They were very accommodating.

I went to the wrong clinic (not right for me). The mood there was very cold. They looked at me like I had weak willpower, and even told me that they would find out if I smoked (causes of failure).

Symptoms relief

When I was taking varenicline, I strangely didn’t enjoy smoking. I thought, “I’m going to quit,” and I kept taking the drug for a while. I didn’t smoke for a while.

Smoking is always on my mind, and I can’t stop thinking about it. It would be helpful if something could distract me or something to ease my mind, such as an exercise or an idea.

Praise for efforts

The nurse and doctor were very complimentary about my continued abstinence of smoking. They encouraged me to increase the number of days without smoking and not quit smoking at once.

The nurses and doctors may have been just doing their jobs, but they were very kind and supportive to me. That made me think, “I have to do my best.”

Visualize accomplishments

My lung capacity was measured every time I went to the clinic. I could see that my lungs were recovering slowly, and seeing the results made me want to continue to abstain from smoking.

It is more encouraging to be told that my lung function numbers have improved, or to be told how many days I have been able to quit smoking than to say “I quit for three days” on my own.

Peer interaction

Express weaknesses

I know I’m an addict, I know I shouldn’t smoke, I know it’s tough to not keep smoking, I know I want to quit, but I can’t. So I need a comrade I can say so, I can do it with, or no enemies.

I tried varenicline and everything else. I’m stuck in my current state with the feeling that the next time I have to do it will be on my own, and it’ll be too hard.

Forward together

I want to continue to abstain from smoking with other colleagues. And short term goals, like let’s all work together, I think it’s easier to succeed than trying in solitude.

I wish there was some kind of self-help group. Even if we don’t know who they are or where they are from, we can meet them and work together. I think just not smoking while we talk is an even effect.

Mutual acceptance

It’s normal to make mistakes of smoking again. It does not suddenly come to zero, but just the fact that I smoke less often makes a difference from before. I want you to look at it with an open mind.

When people are not acknowledged, their self-esteem decreases. It is very reassuring to have someone who is willing to confront me for putting up with or suffering from not smoking.

Social commitment

Public understanding

I feel persecuted by the media and all things they say about passive smoking. They don’t understand the suffering smokers endure. I’ve switched to heated cigarettes, and it has eased the guilt for me.

I may be being paranoid, but I thought people would think I had bad manners or that I couldn’t control myself. Smoking is seen as a terrible bad thing in the world, and it’s hard to shrug it off.

Ideal environment

I would love to be transferred to an environment where I can’t legally smoke, or where everyone around me doesn’t smoke. Then, I can’t smoke either and will eventually quit.

I haven’t been told I have lung cancer yet, so when the doctor tells me I’m going to die, I’ll change. Besides, if they don’t sell me cigarettes, I could quit.

Political involvement

If the government wants to reduce the number of smokers, their voices are not being heard. The law is also vague. Stores sell a lot of them. I don’t see they want us to stop or not.

They are taxing us so much, eliminating most of the smoking areas, but leaving a few, that’s the anger, why don’t they just abolish it all together? Why do they treat smokers so badly?

Recovery of confidence

Realize one’s

own efficacy

If there is a cigarette in front of me, I know I wouldn’t feel normal, unfortunately. If I’m drunk and invited to have one, I’ll smoke “just one.” In short, I have to keep bounding myself no to smoke.

I wonder if I can really quit, since I have started smoking again many times before. I’m just going to keep going through the days of not smoking until I die.

Free from bondage

The guilt I feel when I smoke, the weird feelings when I don’t, the guilt I feel when I start smoking again, not just the cigarettes, all of that would be gone, and I would be free.

While I wasn’t smoking, the thought of wanting to smoke kept coming, I kept thinking about cigarettes at all hours. I’ll never be able to stop smoking. I want to be free from smoking.

Compassion for neighbors

The most important thing is not to start smoking. Quitting in the middle is the hardest thing. I don’t want my children to smoke. I think Taspo system (which is a card identifying adults) is a good idea.

Compared to before, when smokers smoked at their office desks, they now smoke in a limited number of places, opportunities for people to passively smoke have dramatically decreased, a very good thing.