Stages of readiness to quit smoking: population prevalence and correlates.

We examined the population prevalence and correlates of stages in smokers' readiness to quit, using data from 1,048 smokers recruited in a self-weighting, multistage, systematic clustered area sample from 0.44% of South Australian dwellings, with an 89% response rate. Smokers in the precontemplation stage comprised 24.1% of the sample, smokers in the contemplation stage comprised 47.2%, and smokers in the preparation stage comprised 28.7%. No sociodemographic variables (i.e., age, sex, marital status, educational level) were found to be significant independent predictors of membership in the different stages. The five significant independent predictors of being in the precontemplation stage (vs. the contemplation stage) were (a) having a higher confidence of quitting, (b) seeing fewer health risks associated with smoking, (c) not having made an attempt to quit, (d) seeing quitting as more difficult, and (e) smoking 25 or more cigarettes a day. The two significant independent predictors of being in the contemplation stage (vs. the preparation stage) were (a) having lower confidence of quitting and (b) not having tried to quit. We discuss implications for the understanding of smoking behavior in populations and also consider how cessation campaigns might address the factors associated with different stages of readiness to quit.     

Value change and relapse following a decision to quit or reduce smoking

Ainslie (1975) suggested a model according to which values change subsequent to decision and in which the value of a smaller, immediately available, reward increases at a faster rate than that of a later reward. The rank orde between the two rewards may therefore become reversed, leading to impulsive behavior. The assumptions of this model as applied to addition are discussed. As an alternative, it is suggested that values and beliefs may be more indicative of stereotypical, biased thinking during the course of an attempt to quit. A study of 23 smokers who tried to quit or reduce smoking supported the latter view rather than the Ainslie model However, neither approach was successful in accounting of relapses. This may be because action is hard to predict from beliefs and values, and it may more suitably be accounted for by desires and emotional states, the latter most importantly because they affect the ability of self-monitoring.     

Perceived health: a test of incremental validity in relation to smoking outcome expectancies, motivation to smoke and desire to quit smoking

This study examined the role of perceived health in predicting theoretically-relevant aspects of smoking behavior among 161 young adult regular smokers (67 females; mean age = 21.9 years (SD = 7.2), cigarettes per day (M) = 12.2 (SD = 5.7)) recruited from the general community. Consistent with prediction, results indicated that relative to anxiety sensitivity, gender, number of cigarettes smoked per day and nicotine dependence, perceived physical health uniquely and significantly predicted expectancies for negative affect reduction and expectancies that smoking would lead to negative personal consequences. Additionally, perceived health incrementally predicted motivation to smoke to reduce negative affect. In contrast to expectation, perceived health was unrelated to motivation to quit smoking. Results are discussed in relation to the role of perceived health as a cognitive vulnerability factor for specific types of smoking patterns.     

Self-efficacy and social support as predictors of smoking after a quit attempt

Abstract

The current study examined self-efficacy and social support as predictors of maintenance after an attempt to stop smoking. As in previous studies, self-efficacy at the end of treatment was a significant predictor of reported smoking during the follow-up period. At 3 months after treatment the prediction from self-efficacy was weaker than a prediction from the level of post-treatment smoking. However at 10 months self-efficacy was the strongest predictive variable assessed in the study. In contrast, social support for the quit attempt was not a significant predictor of maintenance at any stage. The results provided qualified support for the contention that self-efficacy can often be a more powerful predictor than previous performance attainments, especially under conditions of greater situational change.     

Debunking myths about self-quitting. Evidence from 10 prospective studies of persons who attempt to quit smoking by themselves

This article examines data from 10 longterm prospective studies (N greater than 5,000) in relation to key issues about the self-quitting of smoking, especially those discussed by Schachter. When a single attempt to quit was evaluated, self-quitters' success rates were no better than those reported for formal treatment programs. Light smokers (20 or less cigarettes per day) were 2.2 times more likely to quit than heavy smokers. The cyclical nature of quitting was also examined. There was a moderate rate (mdn = 2.7%) of long-term quitting initiated after the early months (expected quitting window) of these studies, but also a high rate (mdn = 24%) of relapsing for persons abstinent for six months. The number of previous unsuccessful quit attempts was unrelated to success in quitting. Finally, there were few occasional smokers (slips) among successful long-term quitters. We argue that quitting smoking is a dynamic process, not a discrete event.     

A closer look at decisions to quit

Aspects of March and Simon’s (1958) subjective expected utility model and a prediction of Lee and Mitchell’s (1994) unfolding model of voluntary employee turnover were tested. A policy capturing simulation that varied high, moderate, and low levels of five job characteristics was used to model voluntary turnover decision processes for 532 nurses. Survey measures of these job characteristics obtained over the next 2 years were multiplied by weights derived from nurse simulations to yield turnover likelihood estimates. These estimates exhibited 80%, 127%, and 190% more predictive power (depending on turnover operationalization) than post-employment survey estimates of turnover intention, job satisfaction, and job availability. Groups of nurses with homogeneous voluntary turnover decision models were also identified, though no groups with homogeneous job perceptions were observed. Evidence suggested nurses responded to “shocks” as predicted. March and Simon’s model of voluntary turnover was supported and implications drawn for managing voluntary nursing turnover.     

How to be able to do things without really trying

Philosophical Studies -     

Early cessation success or failure among women attempting to quit smoking: trajectories and volatility of urge and negative mood during the first postcessation week

Aversive symptoms of abstinence from nicotine have been posited to lead to smoking relapse and research on temporal patterns of abstinence symptoms confirms this assumption. However, little is known about the association of symptom trajectories early after quitting with postcessation smoking or about the differential effects of tonic (background) versus phasic (temptation-related) symptom trajectories on smoking status. The current study examined trajectories of urge and negative mood among 300 women using the nicotine patch during the first postcessation week. Ecological momentary assessments collected randomly and during temptation episodes were analyzed using hierarchical linear modeling yielding four individual trajectory parameters: intercept (initial symptom level), linear slope (direction and rate of change), quadratic coefficient (curvature), and volatility (scatter). Early lapsers, who lapsed during the first postcessation week, exhibited more severe tonic urge and phasic negative mood immediately after quitting, and more volatile tonic and phasic urge compared to abstainers. Late lapsers, who were abstinent during the first week but lapsed by 1 month, exhibited more severe tonic urge immediately after quitting compared to abstainers. These results demonstrate the importance of early postcessation urge and negative affect and highlight the value of examining both tonic and phasic effects of abstinence from nicotine.     

Development of a telephone-based intervention for support persons to help smokers quit

This study represents the first step toward systematic behavioral treatment development and pilot testing of a novel approach to smoking cessation that utilizes adults interested in helping someone to stop smoking (i.e., support persons) as the agent of change. The counselor manual for a telephone-based intervention for support persons was developed based on a previous clinic-based intervention. Social cognitive theory served as the conceptual basis for the intervention. Ten adult non-smoking females completed the treatment protocol, consisting of six 20 - 30-min sessions and written materials. The support person was the sole recipient of the professional intervention. Feedback was obtained from 8 of the 10 participants and all 4 telephone counselors 1 week post-treatment (week 10). Results indicate that the telephone-based intervention was feasible and acceptable to participants. The intervention was refined based on participant and counselor feedback and will be subsequently tested in a randomized pilot trial.     

Volitional lifestyle in healthy elderly: its relevance to rest-activity cycle,nocturnal sleep,and daytime napping

Sleep-related problems are prevalent among the aged. The present study examined the influence of a mentally active or "volitional" lifestyle on the rest-activity cycle, nocturnal sleep, and daytime napping in the healthy elderly. 14 aged individuals with a high Volitional lifestyle (M = 74.1 yr. old) and 14 with a Low Volitional lifestyle (M = 73.0 yr. old) were screened by questionnaires including the Philadelphia Geriatric Center Morale scale and the Self-confidence scale. Their activity levels were monitored by a wrist actigraph system for 14 consecutive days. They were also asked to record daily sleep logs. The total times of nocturnal sleep and daytime napping did not differ between the groups. However, the acrophases of circadian (tau = 24 hr.) and circasemidian (tau = 12 hr.) activity cycles were more advanced in the Low Volitional group. In addition, the High Volitional group took a daytime nap with a better timing than did the Low Volitional group: the former started a nap during the phase in which their activity level was going down, whereas the latter when their activity level was going up. These results suggest that high volitional lifestyle may be related to better rest-activity cycle in the healthy elderly.     

Persuading people to stop smoking

Forty smokers attending a chest clinic were given a questionnaire designed to measure motivation to stop smoking. The effects of three variables on their smoking level were investigated: (1) advice from the chest physician to stop smoking; (2) subjection to a further ‘motivating’ interview by a psychologist: (3) the wearing of a white coat by the psychologist during his interview. The questionnaire proved a useful predictor of smoking reduction over a 3-month follow-up period. Advice from the chest physician had a significant effect in getting people to reduce smoking over 3 months but the extra ‘motivating’ interview was ineffective. Patients responded to the white coat by reducing their smoking level significantly, irrespective of whether the psychologist wearing the white coat was advising them to reduce smoking or not. These results suggest that the advice-giving role of the doctor could be used more effectively than it currently is in preventive medicine, and that the psychologist has an important role to play in measuring the successful parameters of such advice and hence improving its quality.     

Principal self-efficacy: relations with burnout, job satisfaction and motivation to quit

The purpose of this study was to explore relations between principals?? self-efficacy, burnout, job satisfaction and principals?? motivation to quit. Principal self-efficacy was measured by a recently developed multidimensional scale called the Norwegian Principal Self-Efficacy Scale. Burnout was measured by a modified version of the Maslach Burnout Inventory. Job satisfaction and motivation to quit were measured by two scales developed for the purpose of this study, respectively. Participant in the study were 1,818 principals from the population of Norwegian principals. Data was collected by means of an electronic questionnaire. Two structural equation models were tested which specified principal self-efficacy as an exogenous variable and burnout, job satisfaction and motivation to quit as endogenous variables. The data was analyzed by means of SEM analysis for latent variables using the AMOS 18 program. Both models had acceptable fit to data. The results revealed that principal self-efficacy was positively related to job satisfaction and motivation to quit and negatively related to burnout. Burnout and job satisfaction were negatively related. Burnout was positively related to motivation to quit whereas job satisfaction was negatively related. The study highlights important relations between self-efficacy, burnout, job satisfaction and motivation to quit and extends the literature on principal self-efficacy and its relation to other concepts. The results of the study are discussed together with limitations and suggestions for further research.