Chool of Public Overall health, University of Sydney, Sydney, New South Wales, Australia 3 Cancer Screening and Prevention, Cancer Institute NSW, Eveleigh, New South Wales, Australia four Prevention Research Collaboration, College of Public Wellness, University of Sydney, Sydney, PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/21330118 New South Wales, Australia Correspondence to Andrea L Smith; andrea.smithsydney.edu.auINTRODUCTION Smoking cessation researchers, advocates and healthcare practitioners have tended to emphasise that the odds of quitting effectively is usually enhanced by using pharmacotherapies such as nicotine-replacement therapy (NRT), bupropion and varenicline1 or behavioural support including guidance from a healthcare professional2 or from a phone quitline.six Having said that, rather than utilizing 1 or extra of those forms of assistance, it appears most quit attempts are unassisted7 and most long-term and recent ex-smokers quit with no pharmacological or qualified help.8 Researchers have identified a number of issues relating for the choice to work with help. They commonly conclude that failure to make use of help might be explained by treatmentrelated 
challenges such as cost and access, and patient-related challenges including lack of awareness or know-how about help, including misperceptions about the effectiveness and security of pharmacotherapy or concerns about addiction.92Smith AL, et al. BMJ Open 2015;5:e007301. doi:ten.1136bmjopen-2014-Open Access The policy and practice response to the low uptake of cessation assistance has typically focused on improving awareness of, access to, use of help and in certain, pharmacotherapy. NRT, bupropion and varenicline are often supplied free-of-charge or heavily subsidised by the government or overall health insurance corporations.135 NRT is on general sale in pharmacies and supermarkets, and is broadly promoted by way of direct-to-consumer advertising.16 17 Clinical practice guidelines in the UK, USA and Australia advise clinicians to propose NRT to all nicotine-dependent (10 cigarettes per day) smokers.180 Specialist stop-smoking clinics, and committed telephone and on the web quit solutions give smokers with tailored help and assistance.213 These products and solutions haven’t had the population-wide effect that could possibly have already been expected from clinical trial final results,16 24 25 leading some researchers to suggest that patient-related barriers which include misperceptions about effectiveness and security are a higher impediment than treatment-related barriers.26 Little interest, nonetheless, has been given to how and why smokers quit unassisted.8 27 If we can clarify how the process of unassisted quitting comes about and what it can be about unassisted quitting that appeals to smokers, we may perhaps be improved placed to support all smokers to quit, MedChemExpress SC1 whether or not or not they wish to use help. We carried out a qualitative study to know why half to two-thirds of smokers decide to quit unassisted rather than use smoking cessation assistance. Smoking cessation researchers have lately highlighted the importance of gaining the smokers’ perspective28 29 and suggested qualitative analysis could provide the indicates of doing so.30 While several qualitative research have examined non-use of help in at-risk or disadvantaged subpopulations,313 only several have looked at smokers in general.26 34 Cook-Shimanek et al30 report that couple of studies have examined explicit self-reported reasons of why smokers don’t use NRT; to our knowledge, none has examined explicit, self-reported factors of why s.