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Aim: To investigate why some patients with chronic obstructive pulmonary disease (COPD) have difficulty quitting smoking and to develop a theoretical model that describes their perspectives on these difficulties. Methods: Grounded theory method was used from the selection of participants to the analyses of semi-structured interviews with 14 patients with COPD. Four additional interviews were conducted to ensure relevance. Results: The analysis resulted in a theoretical model that illustrates the process of ‘Patients with COPD trying to quit smoking’. The model illuminates factors related to the decision to try to quit smoking, including pressure-filled mental states and constructive or destructive pressure-relief strategies. The constructive strategies lead either to success in quitting or to continuing to try to quit. The destructive strategies can lead to losing hope and becoming resigned to continuing to smoke. Conclusion: The theoretical model ‘Patients trying to quit smoking’ contributes to a better understanding of the pressure-filled mental states and destructive strategies experienced by some patients with COPD in the process of trying to quit. This better understanding can help nurses individualise counselling. Moreover, patients’ own awareness of these states and strategies may facilitate their efforts to quit. The information in the model can also be used as a supplement to methods such as motivational interviewing (MI). Published by arrangement with John Wiley & Sons.

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