Table 2 Identified facilitators and barriers and possible interventions informed by the literature, COM-B [17] and TDF [18]
COM-B sub-components | Â | Facilitators and barriers identified | TDF | Intervention function | Possible intervention |
|---|---|---|---|---|---|
1. Psychological capability | a* | Health knowledge confusion over harm-reduction and need to have factual evidence that NNDDs are safer than cigarettes | Knowledge and beliefs about consequences | Increase availability of knowledge of comparative health implications | ‘Try before you buy’ outlet with face to face trained staff |
Disseminate evidence of harm reduction | Explanatory email/leaflet/library/TV advert on harm reduction [27,28,29] | ||||
| Â | b | Satisfaction | Emotion (positive affect) | Trial to experience sensations | Hygiene safe trial and report site [30] |
| Â | Â | Good sensations similar to cigarette smoking | Â | Â | Â |
2. Physical capability | a* | Cost | Beliefs about capabilities | Make current cost details available to enable goal planning | Helpline—email link. A link with monthly updated information since prices are going downward [17, 31, 32] |
|  | b* | Availability/access | Self confidence/self efficacy | Easy access to reduce self-consciousness | Universal retail outlet—High St. easy access; trained staff [25, 33, 34] |
| Â | c | Duration Need provision to increase length of smoking time for the HTP Include a limitation on E-cigs | Modification of design | Longer tobacco sticks for HTP trial and time limiter on E-cigs [35] | |
3. Opportunity social | a* | Social acceptability | Social influences (norms and conformity) | To reinforce idea of being with the in crowd?? Modelling | Self-experienced |
Encouragement as self-perception improves—no bad smell. Others moving on to this form of NNDD | Social/professional role and identity | Progressing toward perceived desired identity | Share experiences | ||
4. Opportunity physical | a | Convenience Possibility of short period using an NNDD for a specific number of puffs (E-cigs) | Environmental context and resources | Modelling convenience use—short burst of NNDD nearby as allowed. Disgruntled cigarette smoker returning from a lesser further away place | Separate NNDD users from cigarette smokers and have some nicer place for NNDD users [18, 37] |
5. Motivation reflective | a* | Renewed optimism Simply by coming into contact with the products. Learning of their existence | Goals and Intentions (implementation intention/intrinsic motivation) | Facilitate experience Hear about others’ experience | More information points for guidance for cigarette smokers to trial such products [21] |
6. Motivation automatic | a | Intention to continue smoking cigarettes | Beliefs about consequences | Negative health consequence feedback | Education and information sharing of health consequences |
|  | Health derogation | Absence of social influence to change behaviour | New interest; social expansion—identity modelling | Promotion of an interest combining social-interaction [38, 39] |