The influence of self‐efficacy on the effects of framed health messages

Health promoting messages can be framed in terms of the gains that are associated with healthy behaviour, or the losses that are associated with unhealthy behaviour. In this study, we examined the influence of self‐efficacy to quit smoking on the effects of gain framed and loss framed anti‐smoking messages in a randomized controlled trial among 539 adult smokers. Participants with a high self‐efficacy to quit smoking reported higher levels of motivation to quit smoking after receiving a loss framed message than after receiving a gain framed message or no message. For these participants receiving a gain framed message did not result in a higher motivation to quit smoking than receiving no message. For participants with a low self‐efficacy to quit smoking there were no differences in motivation to quit smoking between the gain framed message condition, loss framed message condition and control condition. Our results suggest that self‐efficacy can moderate the effects of message framing on persuasion. Copyright © 2008 John Wiley & Sons, Ltd.     

Specifying the determinants of the initiation and maintenance of behavior change: an examination of self-efficacy, satisfaction, and smoking cessation.

Using data from smokers (N = 591) who enrolled in an 8-week smoking cessation program and were then followed for 15 months, the authors tested the thesis that self-efficacy guides the decision to initiate smoking cessation but that satisfaction with the outcomes afforded by quitting guides the decision to maintain cessation. Measures of self-efficacy and satisfaction assessed at the end of the program, 2 months, and 9 months were used to predict quit status at 2, 9, and 15 months, respectively. At each point, participants were categorized as either initiators or maintainers on the basis of their pattern of cessation behavior. Across time, self-efficacy predicted future quit status for initiators, whereas satisfaction generally predicted future quit status for maintainers. Implications for models of behavior change and behavioral interventions are discussed.     

Worry about health in smoking behaviour change

Many smokers and ex-smokers worry about their health. Given that worry keeps attention focused on the threat, it was expected that worrying about health in smokers would motivate them to quit and in ex-smokers may prevent relapse. Furthermore, worry was expected to influence the process of smoking cessation in interaction with self-efficacy, which is a measure of control over smoking, and with disengagement beliefs, which distorts the threatening meaning of potential motivating information. In the present study 380 smokers and 324 ex-smokers were recruited to join a prospective study with a follow-up of eight months. At T1, smoking/quitting behavior, worry and the other psychological constructs were assessed. At T2 quitting activity in smokers and relapse in ex-smokers were assessed. As expected, smokers who worried about the health effects of smoking reported higher quitting activity at T2. The three-way interactions between worry, self-efficacy and disengagement beliefs in the prospective prediction of quitting activity and relapse were significant: Among smokers with high self-efficacy combined with strong disengagement beliefs, worry led to more quitting activity. Among ex-smokers with low self-efficacy combined with strong disengagement beliefs, worry led to more relapse. The present results suggest new ways of approaching the stimulation of quitting and the prevention of relapse.     

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.     

A national survey of older smokers: treatment needs of a growing population

Examined smoking and quitting patterns among 289 smokers ages 50 to 74 years who took part in a nationwide survey of American Association of Retired Persons members. Respondents were predominantly chronic, heavy smokers. They had smoked for an average of 45 years, more than one third smoked 25 or more cigarettes per day, and more than two thirds showed evidence of high nicotine addiction. Nonetheless, most were interested in quitting smoking and reported plans to quit in the next year. Concerns about missing or craving cigarettes; losing a pleasure; and being nervous, tense, or irritable after quitting were the most common barriers to quitting reported. These problems were rated as more serious by heavier, longer term smokers and by smokers with lower quitting self-efficacy. The variables most strongly associated with "contemplating" quitting were beliefs in quitting health benefits, recent attempts to quit or cut down, prior attempts to quit, and high self-efficacy. Limitations of these findings are discussed along with implications for the design of treatments geared to the special needs of older smokers.     

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.     

Can genetic risk information enhance motivation for smoking cessation? An analogue study.

Protection motivation theory and the extended parallel processing model are used to predict the motivational impact of information regarding a genetic susceptibility to heart disease. One hundred ninety-eight smokers read 1 of 3 vignettes: gene positive, gene negative, or standard smoking risk information. Analyses examined whether the impact of type of risk information was moderated by smokers' self-efficacy (SE) levels. Key outcomes were intention to quit and intention to attend an information session about quitting. There were significant main effects of SE and of receiving gene-positive risk information on intentions to quit. There was a significant Risk x SE interaction on intentions to attend an information session. SE was not associated with intentions to attend the information session for smokers in the gene-positive group. Intentions to attend the session were negatively associated with SE for smokers in the lower risk groups. Implications for using genetic risk information to motivate smoking cessation are discussed.     

不确定性容忍度对风险偏好的影响及其情景依赖性

研究以经营店面为背景设计决策材料,采用2(不确定性容忍度:高/低)×2(损益背景:损失/获益)×2(选项描述框架:积极/消极)×3(损益概率:高/中/低)混合实验设计,探讨不同任务情景下个体不确定性容忍度对风险偏好的影响。结果发现,不确定性容忍度主效应显著,高容忍度者比低容忍度者更冒险。不确定性容忍度与损益背景交互作用显著：在损失背景下,高容忍度者比低容忍度者更冒险,在获益背景下无此效应。不确定性容忍度与选项描述框架交互作用显著：在积极框架下,高容忍度者比低容忍度者更冒险,在消极框架下无此效应。这表明,不确定性容忍度对风险偏好产生影响,但这种影响会受到损益背景和选项描述框架的调节,具有情景依赖性。     

THE RELATION BETWEEN BEHAVIORAL INTENTIONS AND BELIEFS: A PROBABILISTIC MODEL1

Based on mathematical probability theory, a model of the relationship between beliefs and behavioral intention was proposed and tested. In Experiment 1, subjects indicated their beliefs about the consequences of smoking cigarettes as well as their intention to smoke cigarettes. When combined according to the proposed model the average correlation between predicted and obtained behavioral intention was .78 (p<.01). In Experiment 2, implications of the model for changing behavioral intentions were examined. Subjects were presented a hypothetical election campaign between two candidates. Intentions to vote for a given candidate were measured prior to and after presentation of information about some of the candidates' political views. Using the proposed model of intention, the predicted and observed changes in voting intentions were correlated .72 (p<.01). Implications of the model for theories of social behavior and persuasion were discussed.     

Investigating the Big Five Personality Factors and Smoking: Implications for Assessment

Global personality dispositions may be important for understanding population-based individual differences in smoking outcomes, yet few studies have been executed using measures of these global dispositional constructs from the contemporary field of personality. This study explored whether the Big Five personality factors (Extraversion, Neuroticism, Agreeableness, Conscientiousness, and Intellect) were concurrently associated with key smoking (e.g., nicotine dependence, smoking rate, age at first cigarette) and cessation (e.g., self-efficacy to quit, motivation to quit, number of prior quit attempts, length of most recent quit) variables in a sample of regular smokers (n = 130). Of the 35 correlations computed, only 2 were significant: Intellect was positively correlated with motivation to quit and number of 24-hr quit attempts in the last year. These results have implications for using trait variables to study individual differences in smokers.     

Situational correlates of abstinence self-efficacy

Little is known about the situations that are associated with changes in self-efficacy during an attempt to quit smoking. In this study, 214 smokers used palmtop computers to record momentary self-efficacy ratings and situational context during a quit attempt. Higher urge to smoke and negative affect were associated with reduced self-efficacy. Although alcohol and coffee consumption are associated with heightened lapse risk, they were unrelated to abstinence self-efficacy. Individuals with low baseline self-efficacy generally reported lower self-efficacy across situations, but these differences were more pronounced under conditions of high urge and negative affect. These results suggest that self-efficacy may be reactive to affect-motivational states during a quit attempt. Whether these influences represent cognitive biases or objective risk assessments is not known.     

Self-efficacy expectations with regard to different tasks in smoking cessation

Abstract

Self-efficacy expectations are important psychological determinants of smoking cessation. The present study aimed at exploring different sorts of self-efficacy. The following self-efficacy scales were composed: Emotional self-efficacy, Social self-efficacy, Skill self-efficacy, Relapse self-efficacy and Try self-efficacy. In a sample of 752 smokers with low motivation to quit, two subsequent self-report measurements of self-efficacy were conducted. Firstly, we investigated to what extent potential sources of self-efficacy - quitting history and smoking behavior -were related to the types of self-efficacy. The explained variance in self-efficacy scores ranged from 4.4% to 23.1%, and in all five types of self-efficacy, smoking behaviour explained a higher percentage of self-efficacy than quitting history. The number of past quit attempts was only related to Relapse self-efficacy. Secondly, we investigated to what extent the different types of self-efficacy at T1 were predictive of quitting behavior measured at T2. The results showed that only Skill self-efficacy was predictive of quitting activity between Tl and T2. Point prevalence quitting at T2 was predicted by Skill self-efficacy and Relapse self-efficacy. The latter type of self-efficacy, however, was a negative predictor of quitting. The different types of self-efficacy can be mapped on two dimensions: The extent to which the means to accomplish a certain task are specified in the questionnaire item; and the phase of behavior change to which the self-efficacy tasks are relevant. Based on the findings from the predictive validity, it is concluded that the more clearly the means to accomplish the task are specified, the more valid the self-efficacy judgements are.     

Cultural Differences in Attitudes Toward Smoking: Developing Messages Using the Theory of Reasoned Action1

The theory of reasoned action was used to identify the culturally appropriate beliefs of Hispanic smokers that might be targeted in an anti-smoking campaign. In-depth interviews were conducted with 263 Hispanics and 150 non-Hispanic whites. Intentions to quit smoking were predicted most strongly by the attitudinal rather than the normative component of the model. A pattern of cultural differences between the two ethnic groups was identified. Family-related consequences and concerns about bad smell contributed more to Hispanic attitudes toward quitting than to those of non-Hispanic whites, while the effects of withdrawal from cigarettes contributed more to non-Hispanic whites'attitudes than to Hispanics'. The bad smell of cigarettes, improving relationships with the family, weight gain, breathing more easily, and having a better taste in the mouth were the consequences of smoking and quitting that most strongly discriminated between those Hispanics intending and not intending to quit. These results should be used in the creation of culturally appropriate anti-smoking messages for this group.     

Anxiety sensitivity: association with intensity of retrospectively-rated smoking-related withdrawal symptoms and motivation to quit

The present cross-sectional study evaluated the associations between anxiety sensitivity, intensity of retrospectively-rated nicotine withdrawal symptoms, and motivation to quit smoking. Participants were 127 young adult (mean age 20.4 years (SD 4.6)) regular smokers (mean cigarettes per day 10.2 (SD 5.1)). Anxiety sensitivity predicted intensity of retrospectively rated withdrawal symptoms during the first week of the most recent quit attempt as well as concurrent and lifetime indices of motivation to quit smoking even after controlling for theoretically-relevant smoking (e.g. nicotine dependence) and affect (e.g. panic attack history) factors. These results are discussed in relation to better understanding panic-related vulnerability factors in smoking cessation.     

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.     

Do Threatening Messages Change Intentions to Give Up Tobacco Smoking? The Role of Argument Framing and Pictures of a Healthy Mouth Versus an Unhealthy Mouth1

Do preventive‐behavior framing and outcomes of action framing moderate behavioral intention to stop smoking when health messages are illustrated by pictures? We manipulated arguments about preventive action (presence or absence), as well as arguments about the outcome of action (gain or loss), and the pictures that illustrated outcome action (healthy or unhealthy mouths). Behavioral intention was higher when pictures of unhealthy mouths were presented, regardless of framing, and when pictures of healthy mouths illustrated the presence of preventive action. Applications of this study on tobacco risk health campaigns based on text and pictures are discussed.     

Demonstration of an Integrated Treatment for Smoking Cessation and Anxiety Symptoms in People With HIV: A Clinical Case Study

Despite high rates of co-occurring tobacco use and anxiety symptoms and disorders among persons with HIV, evidence-based interventions for these individuals are not yet available. The present study sought to evaluate an integrated treatment model addressing smoking cessation and anxiety sypmtoms among HIV-positive smokers. Treatment was an 8-week intervention integrating a standard smoking cessation protocol (i.e., cognitive-behavioral therapy [CBT], nicotine replacement therapy) with CBT for anxiety. Inclusion criteria were 18–65 years of age, ≥ 10 cigarettes/day, State–Trait Anxiety Inventory [STAI-T] score of > 39, and moderate motivation (i.e., ≥ 5 out of 10 on a 10-point Likert scale) to quit smoking. Primary outcomes included scores on the Anxiety Sensitivity Index (ASI) and cigarettes smoked per day. Self-reported abstinence was biochemically verified by carbon monoxide breath analysis. Three male participants (mean age 49.3, SD = 9.1) completed through 2-month follow-up. At baseline all participants reported smoking an average of 20 cigarettes per day. Two participants quit smoking and maintained abstinence by the 2-month follow-up, and demonstrated a reduction in ASI scores. Participant 3 continued to smoke but at a reduced rate. Participants’ response to cognitive and behavioral strategies (e.g., creating balanced thoughts, interoceptive exposures) will be discussed. Clinical lessons learned include use of a flexible approach to cognitive restructuring, use of imaginal and in vivo exposures in session to better prepare patients for homework practice, and flexibility in delivering the treatment in an individual or group format. This clinical presentation provides preliminary support for the feasibility and initial effectiveness of an integrated treatment to reduce anxiety symptoms and aid in smoking cessation in anxious, HIV-positive smokers.     

Adolescents' Cognitive Appraisals of Cigarette Smoking: An Application of the Protection Motivation Theory1

High-school students (N = 690) provided their cognitive appraisals of protection motivation theory (PMT; Prentice-Dunn & Rogers, 1986) factors in the context of cigarette smoking. A logistic regression analysis revealed that PMT predicted adolescents' current smoking behavior. Cognitions, including greater personal vulnerability to smoking-related diseases, minimizing the severity of the consequences of smoking, perceiving adolescent male smokers to be popular and mature, and perceiving limited health benefits for not smoking were found to be significant predictors of current smoking behavior. Intending to quit smoking in the near future was related to smoking occasionally, as opposed to regularly, and to perceiving the long-term risks of smoking to be severe. Possible applications for intervention programs are discussed.     

Relative contributions of protection motivation theory components in predicting exercise intentions and behavior

A factorial design was employed to test the relative effectiveness of the four cognitive appraisal processes (severity, vulnerability, response efficacy, and self-efficacy) contained in the revised protection motivation theory (PMT). One hundred sixty undergraduate women read persuasive appeals for increasing exercise, which varied on these four dimensions. As predicted, both the vulnerability and self-efficacy variables enhanced intentions to exercise along with similar effects on self-reported exercising. Intentions were predictive of self-reported changes in behavior. The obtained interaction between vulnerability, self-efficacy, and response efficacy suggests that individuals employed a "precaution strategy": They intended to adopt the recommended behavior even though they held weak beliefs about its effectiveness and were not convinced of their at-risk status. These findings are compared to others obtained using the PMT, and the issue of main and interactive effects produced by the model is also addressed.     

Children's affective,behavioral, and cognitive responses to social comparison

Relative outcomes in social commerce with peers are potent determinants of cognitions and behavior in young children. Although there has been considerable attention given to the behavioral consequences of social comparisons following the receipt of rewards, there has been less concern with cognitive or affective consequences. Additionally, little is known about the accrued effects of multiple social comparison experiences that may be consistent or inconsistent with one another. In the present study, young children received a constant level of reward but the amount they saw a peer receive was varied. There were two sequences of reward distribution, and in a given sequence children received either the same number of rewards as the peer (=), more (+), or fewer (?). In a 3 × 3 factorial design all possible combinations occurred. A negative inequality in reward distribution, no matter where it fell in a sequence, made children sad and inclined children to distribute fewer rewards to peers. When a sequence contained an initial experience of positive inequality, children decreased subsequent levels of self-reward. Experiencing a comparison that revealed a negative inequality in reward distribution also disrupted children's accuracy in appraising the overall distribution of rewards: even when an initial negative inequality was completely offset by an equivalent experience of positive inequality, children inaccurately concluded that they had received fewer rewards than their peers.