A randomized trial of a self-help smoking cessation intervention in a nonvolunteer female population: testing the limits of the public health model.

Reaching nonvolunteer female smokers with effective smoking cessation programs is a critical public health challenge. Smokers (N = 2,786) among 15,004 female members of a health maintenance organization who completed a routine needs assessment were invited into the "UCLA Preventive Health Behavior Study," consisting of five telephone interviews over 2 years assessing health practices. Participants (N = 1,396) were randomized into experimental or control conditions of an unsolicited, mailed, self-help smoking cessation program. Subjects were not alerted to the link between the program and the health study. Smoking status was assessed at 1, 6, 12, and 18 months. Across all subjects, point prevalence at 18 months was 18.62, and continuous abstinence was 2.71%. No difference was found between treatment and control groups regarding smoking status or readiness to stop smoking--raising questions about the value of mailing cessation materials to nonvolunteers. Quit rates increased over the 18-month follow-up; those still smoking at 18 months reported increased readiness to quit. Predictors at each follow-up point were examined multivariately.     

A randomized trial comparing the effects of self-help materials and proactive telephone counseling on teen smoking cessation.

We conducted a 2-arm randomized trial to test the efficacy of self-help materials with or without proactive telephone counseling to increase cessation among teen smokers. Teen smokers (N = 402) recruited from 11 shopping malls and 1 amusement park in the southeastern United States were randomized to 1 of 2 groups: written self-help material plus video; or written self-help material, video, and telephone counseling. Cessation rates based on 7-day point-prevalent abstinence for the self-help and counseling arms were 11% and 16%, respectively (p = .25), at 4 months postbaseline and 19% and 21%, respectively (p = .80), at 8 months postbaseline. Sustained abstinence, reflecting 7-day abstinence at both time points, in the self-help and counseling arms was 7% and 9% (p = .59). Results suggest that minimal self-help cessation approaches that target youth have comparable success to that shown among adult smokers. However, refinements in telephone-counseling approaches may be needed to achieve the success observed in adult populations.     

Attributions in the New Zealand Sports Pages

Abstract

Foot-in-the-door (FITD) and door-in-the face (DITF) techniques were compared in a telephone survey that also sought to assess how legitimate the source of the request seemed to the respondents. Calls were made to 120 Americans by an interviewer from a fictitious private consulting firm, using a source name designed to have low perceived legitimacy. It had been expected from previous research that only the FITD technique would successfully produce compliance under these circumstances, and that the FITD compilers would also yield higher ratings of the source's legitimacy than either the DITF or a control. This prediction was confirmed, but some evidence suggested that the source legitimacy question in the procedure also affected the compliance level of DITF subjects.     

Self-Inference and the Foot-in-the-Door Technique Quantity of Behavior and Attitudinal Mediation

The purpose of this investigation was to test two aspects of the self-perception theory account of the foot-in-the-door (FITD) phenomenon. The first aspect tested was the claim that the greater the quantity of behavior associated with the initial request, the greater the likelihood of compliance with the later request. Quantity of behavior was operation-alized as (a) request size and (b) active versus passive execution, that is, whether the target person actually carried out the request or simply agreed to do so. The second aspect tested was the claim that changes in self-perception mediate the FITD effect. A field experiment was conducted to address these concerns. The results showed that a self-inference explanation is viable; however, a strict self-perception account fails because neither request size nor execution showed any correspondence to attitudinal measures or to compliance with the second request. Implications for a self-inference explanation are discussed.     

The effect of the two feet-in-the-door technique on tobacco deprivation

The ‘Foot-in-the-door’ (FITD) is a well-known compliance technique that increases compliance with a request. Many investigations on this paradigm have generally used prosocial requests to test the effect of the technique. A new evaluation of the effect of the FITD technique was carried out on tobacco deprivation. A two feet-in-the-door technique in which the target request was preceded by two small target requests was used to encourage students to stop smoking for 24 h. The results were compared with two single foot-in-the- door procedures in which the final request was only preceded by one small request, as well as with a control condition using only a 24 h stop-smoking request. Results showed that the single FITD and the two feet-in-the-door procedures were effective to increase verbal compliance (accepting to stop smoking) but only the two feet-in-the-door technique significantly increased behavioural compliance (not smoking for 24 h) with the request.     

SEQUENTIAL-REQUEST PERSUASIVE STRATEGIES

Meta-analysis of the foot-in-the-door (FITD) and door-in-the-face (DITF) literatures showed both effects to be small (r = .17, .15 respectively), even under optimal conditions. Both require aprosocial topic in order to work. The amount of time between the first and second requests plays a different role in the operation of each of the two strategies. DITF was effective only when the delay between requests was brief. Effectiveness of FITD was unrelated to delay, but did depend on whether or not an incentive was provided with the first request. The positive relationship between effort and FITD predicted by self-perception theory was not found. Self-perception theory and reciprocal concessions theory, the theoretical perspectives usually applied to FITD and DITF respectively are examined in light of the findings and it is concluded that both are flawed seriously. Directions for future research are suggested.     

Claw-in-the-door: pigeons,like humans,display the foot-in-the-door effect

Animal Cognition - People are more likely to comply with a large request when it is preceded by another, smaller request, and this is known as the “foot-in-the-door” (FITD). The FITD...     

Answering the Call for Prosocial Behavior

Abstract

Prosocial behavior toward strangers was investigated via responses to wrong-number messages on telephone answering machines. Two hundred forty anonymous participants were randomly selected from the telephone directory of a midsized, midwestern community. Each participant received a message that was intended for someone else. The importance and urgency of the message were varied—low, medium, high, and high with a prod (a direct request for help). Overall, the findings revealed a higher than anticipated prosocial response. The number of return calls increased as a function of the urgency and importance of the misdirected message.     

A comparative analysis of teenagers who smoke different cigarette brands

This study analyzed and compared the survey responses of teenagers who smoke different cigarette brands. It was found that teen Marlboro and Camel smokers perceived themselves as having more stress in their lives as compared with teen Newport smokers. On average, Marlboro smokers were depressed or sad more often than were Camel or Newport smokers. Camel smokers were generally less interested in a peer stop-smoking program than were Newport or Marlboro smokers. Finally, these teen smokers, regardless of cigarette brand, had similar opinions about quitting. Given the differences across brands, more flexible approaches may be needed to address teenage smoking.     

Correspondence programs for smoking cessation and weight control: a comparison of two strategies in the Minnesota Heart Health Program

Mailed invitations to participate in weight loss and/or smoking cessation correspondence programs to 31,400 households in a suburban community. Two programs were offered to randomized subsets of households, a 6-month correspondence program costing +5 and the same program for free but requiring a +60 deposit to be refunded based on success in weight loss or smoking cessation. Overall, sign-up included 1,304 people for weight loss and 142 for smoking cessation. The +5 program was about 5 times as popular as the incentive program. Validated weight change after 6 months averaged about 4 lb for the +5 program and 8 lb for the incentive program. Corresponding rates of smoking cessation were about 9% and 20%, respectively. We conclude that correspondence programs for the promotion of weight control and smoking cessation are potentially cost-effective methods for reaching individuals in the community at large, many of whom would not be interested in clinic-based programs. Issues meriting further research include recruitment, especially of smokers, and evaluation of the relative trade-offs in recruitment success versus efficacy of differing treatment approaches.     

Depression vulnerability moderates the effects of cognitive behavior therapy in a randomized controlled trial for smoking cessation

Several clinical trials have tested the hypothesis that smoking cessation treatments with a mood management component derived from cognitive behavior therapy (CBT) for depression would be specifically effective for depression-vulnerable smokers, with mixed results. This trial addressed methodological concerns with some of the previous studies to clarify whether depression vulnerability does in fact moderate CBT smoking cessation outcome. The study compared 8-session group CBT with a time-matched comparison group condition in a sample of 100 cigarette smokers randomized to treatment condition. Each treatment group was led by one of 7 American University clinical psychology graduate students; therapists were crossed with treatment conditions. Outcome (7-day point prevalence abstinence) was evaluated 1 month and 3 months after quit date. Baseline self-reported depression vulnerability (sample median split on the Depression Proneness Inventory) moderated treatment response, such that more depression-prone smokers fared better in CBT whereas less depression-prone smokers fared better in the comparison condition. These results may have implications for determining when to use CBT components in smoking cessation programs.     

The Value and Vulnerability of Perceived Religious Involvement

Abstract

The relation between sequential request influence strategies and social power was examined, using a social impact theory model of perception. It was predicted that a door-in-the-face (DITF) scenario would suggest a greater difference in power between a giver and seeker than a foot-in-the-door (FITD) scenario would. Two judgment studies using American students at two different universities measured the perceived power of two individuals, the favor giver and the favor seeker, in either the DITF or the FITD. In both studies, the subjects perceived a significantly greater power difference between the giver and the seeker in the DITF strategy than they did in the FITD.     

Interest in Participating in Smoking Cessation Treatment Among Latino Primary Care Patients

Smoking is the leading preventable cause of disease and death for U.S. Latinos. This study identified correlates of interest in participating in a smoking cessation program among urban Latinos seen in community clinics. Interviews were completed with 141 current smokers. Participants were predominantly Spanish-speaking (93%) males (66%), who were on average 37.6 years old and smoked 8.7 cigarettes per day. Over two-thirds (63%) of participants were “definitely interested” in participating in a smoking cessation program. Participants who smoked more cigarettes per day and reported greater nicotine dependence, depression, and readiness to quit were more likely to be interested, while those employed fulltime were less likely to report high interest. Treatment preferences were consistent with Clinical Practice Guidelines recommending counseling, social support, and pharmacotherapy. Results support recommendations that healthcare providers intervene with all Latino smokers, including light smokers and those who do not report initial interest in smoking cessation.     

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.     

Mindlessness Revisited: Sequential Request Techniques Foster Compliance by Draining Self-control Resources

The present research extends previous findings suggesting that sequential request techniques, such as the Foot-in-the-Door (FITD) or Door-in-the-Face (DITF) technique, are primarily effective under conditions conducive of mindlessness. We forward that this mindlessness may be the product of the influence technique itself. More specifically, based on the notion of self-control as a limited resource, we hypothesize that actively responding to the initial request-phase of a FITD-compliance gaining procedure drains the target of his/her self-regulatory resources, thus creating the mindlessness so often observed in social influence settings. This resource depletion opens the door for compliance with the target request. The results were in line with these expectations. More specifically, we observed that active responding to an initial request of a FITD technique reduced the availability of self-regulatory resources. This state of resource depletion mediated the effect of the technique on behavioral compliance. In addition, the results of this study ruled out the alternate explanation that the effects were attributable to mood or a general tendency for acquiescence.     

Putting It on the Line: Telephone Counseling for Adolescent Smokers

Adolescent smokers need cessation help, but the question of how best to intervene remains unanswered. This article describes the empirically validated protocol of an established, well‐utilized adolescent telephone counseling program for smoking cessation, tailored to adolescent developmental needs and shown to increase clients' 6‐month prolonged abstinence rate significantly. Clinical issues addressed include client assessment, motivation, self‐efficacy, familial and social support, planning, coping, relapse‐sensitive call scheduling, and self‐image. Counselor training considerations are also discussed.     

A National Evaluation of Community-Based Youth Cessation Programs: End of Program and Twelve-Month Outcomes

Most youth cessation treatment research consists of efficacy studies in which treatments are evaluated under optimal conditions of delivery. Less is known about the effectiveness of youth cessation treatments delivered in real-world, community based settings. A national sample of 41 community-based youth cessation programs participated in a longitudinal evaluation to identify site, program, and participant characteristics associated with successful cessation. Validated quit rates were comparable to those in randomized controlled trials; 7-day abstinence at the end of program averaged 14% and 30-day abstinence at 12 months averaged 12%. Multivariate GEE models explored predictors of smoking cessation at the end of the programs and at 12 months. Results showed correlates of both short- and long-term cessation. Findings point to the importance of both individual and community-level variables, including motivation, opportunities for and encouragement to engage in activities outside of academics, having youth participate in treatment before they become highly dependent smokers, and community norms and ordinances that discourage youth purchase, use and possession of tobacco. Providing evidence-based treatment to youth in community-based settings results in successful cessation.     

助推戒烟的行为干预策略

烟草危害是人类所面临的重大公共健康挑战之一。传统的控烟策略主要依赖健康宣教、烟草税和控烟条例等手段,但是较少考虑到吸烟行为的“非理性因素”及其心理机制,因此仍不能有效帮助吸烟者成功戒烟。行为科学的发展为助推吸烟者成功戒烟提供了新视角。以实施主体和干预的影响机制为划分标准,可将助推戒烟的行为干预策略分为由政府和公共健康服务部门执行的情境型干预策略和认知型干预策略以及吸烟者可自主执行的情境型和认知型干预策略,一方面便于吸烟者和相关部门选取可执行的戒烟行为干预策略,另一方面为进一步开发和验证助推戒烟的行为干预策略提供参考。虽然基于行为科学的助推干预策略已经取得了一定的进展,未来研究仍有必要进一步在真实世界中验证和评估戒烟助推干预策略的效果。未来也有必要进一步将行为改变技术融入到数字化的戒烟服务或应用小程序中去以提升其效果。未来也需要考察如何应用戒烟助推干预策略防止电子烟产品的负面影响并减少这类策略的误用和滥用。