Table 4 Attitudes towards the reduction programme – illustrative quotes from pharmacists

“I think people don’t come at the moment because they think that they’re going to be pressurised… you know and a lot of finger pointing…so I think it is a good idea to have a programme that… allows very heavy smokers…to reduce first, before they quit, and that might help them more. ” PH01

“I think there is definitely a place for it…it would be able to help a lot more people than I was presently because the stop smoking services is very strict really… whereas at least with [the reduction programme] they can approach it gradually” PH06

“I think it’s quite important to establish that when you set out with a reduction scheme, you’re on…what I think is dodgy grounds because the patients thinks… “well I can reduce…and they don’t, they don’t see that final goal as quickly, whilst the cessation scheme is more likely… I think just as long as…it’s set out from the beginning that you’re going to reduce to quit, then I think…it can be valuable part of the NHS.“ PH15

“With the Self Help… I think it just depends on the person…how much enthusiasm they’ve got for it…if they’ve got… to do it themselves and make their own decisions, I don’t think that motivated them at all“ PH04

“I think it’s the smoke free period without a doubt [that is the best approach]. The timer method is only suitable for, very small proportion of the population. And even then, it doesn’t actually deter people, it might actually work the opposite way, and people may be used to then smoking every hour. Or every hour and a half, they make it the habit, that, ‘Oh God… I need to smoke now.” PH07

“When you are helping the person, behavioural support, it was more satisfying than…just tell them to go… do it themselves…”PH10

“I think, the one to be left on their own to do everything would have been…not appropriate, I think they really needed the support.”PH12

“It was a very thin line between ‘I am giving you support now,’ where ‘I’m not giving you support now.’ Now where do you stop, giving that support…You can even sit down with the guy and say, yeah try here, try here, do this, like we do with NRT product. But you can’t give him support…it’s a very thin line between, now I’m giving him support… and kind of messing with the study, where does my role stop, where can I say, nope, I can’t give you any more support past this point.” PH16