What did we do?

Torbay Council Public Health worked with Hidden Voices Heard to understand what smoking means to those working in these types of jobs, and what might help or hinder them from stopping smoking.
 
We adopted a behavioural insights approach using a well-established process called Look, Listen, Learn. This approach builds on the evidence base and helps uncover what shapes real-world behaviour.
 
We began by reviewing existing research on smoking in coastal towns and among routine and manual workers (Look). We used what we found in the research to inform the conversations we had with local people (Listen). This used a behavioural science lens to explore habits, emotions, social norms, and the environment people are navigating day to day.
 
We heard from 16 people who live and work in Torbay and who smoke. We sought to understand:
– What smoking means to them
– Their experience, desire and approach to quitting
– Their perceptions of services and support
 
By integrating the wider evidence with lived experience, we were able to uncover hidden barriers, surface fresh insight, and identify what might support people to move from intention to action.

What did we learn?

1.The pain of quitting often feels greater than the desire to quit.

Many people who smoke have quit before – often multiple times – so the pain of quitting again is real and grounded in lived experience. This anticipation often outweighs the perceived risks of continuing smoking and deserves greater recognition in how services are designed and delivered. The ‘pain of quitting’ also affects those working in caring roles, who have had similar lived experiences of smoking and quitting. Without clear organisational support or policies, they may feel conflicted or hesitant to encourage others to stop because of the worry of the extra pain. The findings were clear – this is not a belief, it is a lived experience.

2. Belief in ability to control the habit…and then quit

The default behaviour is to quit on their own.

Many people had a strong belief in their ability to control their smoking and quit on their own- often shaped by lived experiences of stopping cold turkey in the past, such as during pregnancy or illness. Quitting without support was seen as the norm, and using willpower was viewed as a personal benchmark of success. Services need to acknowledge that this individual belief and social norm is strong, and to design support around this.

3. Trustworthy and relevant messages

Media and social media reports about the safety of vapes and their impact on health were considered more credible than the information provided by healthcare organisations. This meant many considered smoking to be an acceptable risk compared to the unknown risk of vaping. Additionally, many felt that the financial impact of smoking was increasingly of greater concern than the potential health impacts.