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.     

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.     

Differences in psychosocial factors and fat consumption between stages of change for fat reduction

Abstract

Differences in fat consumption and psychosocial factors between subjects in different trans-theoretical stages of change for fat reduction were studied. Data on fat consumption, self-rated fat intake, attitudes, social support and self-efficacy were collected among a sample of 507 adults. Analysis of variance with Scheffe's multiple-comparison test was used to study differences in these factors between stages of change. Attitudes and social support were most positive among subjects in preparation and action. Self-efficacy expectations were lowest among subjects in contemplation and preparation. Fat consumption was highest among precontemplators hut no substantial differences between other stages were found. It is concluded that subjects in different stages of change differ in psychosocial factors that are regarded as important determinants of behavioral change. Based on these differences it is recommended to develop stage-tailored nutrition education. A majority of subjects in maintenance consumed more fat than is recommended. Therefore, it is suggested that the usually applied staging algorithms might need adjustment for a valid application in nutrition research.     

Mediation analysis of decisional balance,sun avoidance and sunscreen use in the precontemplation and preparation stages for sun protection

Objective: Mediation analyses of sun protection were conducted testing structural equation models using longitudinal data with three waves. An effect was said to be mediated if the standardised path between processes of change, decisional balance and sun protection outcomes was significant.

Design: Longitudinal models of sun protection using data from individuals in the precontemplation (N = 964) and preparation (N = 463) stages who participated of an expert system intervention.

Main outcome measures: Nine processes of change for sun protection, decisional balance constructs of sun protection (pros and cons), sun avoidance behaviour and sunscreen use.

Results: With the exception of two processes in the preparation stage, processes of change predicted the pros (r = .126–.614), and the pros predicted the outcomes (r = .181–.272). Three models with the cons as mediator in the preparation stage, and none in the precontemplation stage, showed a mediated relationship between processes and outcomes.

Conclusion: In general, mediation analyses found both the process of change-to-pros and pros-to-behaviour paths significant for both precontemplation and preparation stages, and for both sun avoidance and sunscreen use outcomes. Findings provide support for the importance of assessing the role of underlying risk cognitions in improving sun protection adherence.     

Are most precontemplators contemplating smoking cessation? Assessing the validity of the stages of change.

OBJECTIVE: To assess the validity of the stages of change (SOC) algorithm for current smokers. DESIGN: This study was a mail-based, cross-sectional survey study of 242 adult smokers. MAIN OUTCOME MEASURES: The main outcome measures were the SOC algorithm and a variety of alternative questionnaire items measuring motivation to quit smoking. RESULTS AND CONCLUSION: The results revealed that the SOC algorithm systematically underestimated motivation to quit smoking relative to a variety of other measures. Further, the stages of change do not appear to be qualitatively distinct categories. More than half the precontemplators were contemplating cessation, and many precontemplators intended to quit. Most contemplators were not merely contemplating cessation but rather were trying to quit currently. In summary, there is a divergence between the concepts underlying the SOC - precontemplation, contemplation, and preparation - and the operational definitions of these concepts.     

Quitting smoking: The importance of non-smoker identity in predicting smoking behaviour and responses to a smoking ban

Objective: We examined how ‘smoker’ and ‘non-smoker’ self- and group-identities and socio-economic status (SES) may predict smoking behaviour and responses to antismoking measures (i.e. the Dutch smoking ban in hospitality venues). We validated a measure of responses to the smoking ban.

Design: Longitudinal online survey study with one-year follow-up (N = 623 at T1 in 2011; N = 188 at T2 in 2012) among daily smokers.

Main outcome measures: Intention to quit, quit attempts and ‘rejecting’, ‘victimizing’, ‘socially conscious smoking’ and ‘active quitting’ responses to the smoking ban.

Results: Non-smoker identities are more important than smoker identities in predicting intention to quit, quit attempts and responses to the smoking ban, even when controlling for other important predictors such as nicotine dependence. Smokers with stronger non-smoker identities had stronger intentions to quit, were more likely to attempt to quit between measurements, and showed less negative and more positive responses to the smoking ban. The association between non-smoker self-identity and intention to quit was stronger among smokers with lower than higher SES.

Conclusion: Antismoking measures might be more effective if they would focus also on the identity of smokers, and help smokers to increase identification with non-smoking and non-smokers.     

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.     

Matched and mismatched interventions with young adult smokers: testing a stage theory.

This experiment tested the transtheoretical model (J.O. Prochaska & C.C. DiClemente, 1983) of smoking cessation by matching or mismatching interventions to smokers in a particular stage. The interventions were tested against a no-intervention condition with 92 college-aged daily smokers in the precontemplation stage of change. The stage-matched intervention asked smokers to think more about quitting smoking; the stage-mismatched intervention provided action-oriented activities typically used for those ready to quit smoking. The results failed to support the value of matching interventions to a smoker's stage of change. Instead, more smokers who received the action intervention tried to quit smoking. Matching interventions to an individual's current stage may be less important than the transtheoretical model suggests.     

Stages of Change in Smoking Cessation: A Comparison of Expectancies Among Precontemplators and Contemplators

Previous research has shown that smokers progress through a series of stages of change as they attempt to quit their habit. This study evaluated smokers in the precontemplation and contemplation stages in order to explore how we can effectively facilitate positive stage transition. Precontemplators (n = 71) and contemplators (n = 30) were compared in terms of two types of expectancies: self-efficacy beliefs and response outcome expectancies. Stage of change was defined according to both categorical and continuous dimensions, each of which led to different results. The findings are discussed in terms of their potential applications to smoking cessation programs and their implications regarding the stage model of change.     

The effectiveness of smoking cessation programs: Determinants and outcomes

Abstract

In this review, smoking cessation is discussed from a stress and coping perspective. Nicotine has been found to produce potentially reinforcing effects. Smoking cessation is best characterized as a process with various stages, of which the stage of relapse remains a major area for intervention research. Mood and expectancies appear to be major determinants of behavior in this stage. Social support apparently still needs conceptual refinement before it may be applied effectively in interventions. Effects of multicomponent treatment has been found to be increased when combined with nicotine replacement therapy. Notwithstanding the sometimes modest quit rates, smoking cessation has been found to be cost-effective among high-risk groups, both from an economical and health perspective. New research should focus on emotional and cognitive processes involved in cessation, in particularly self-efficacy expectations. While public policies may be most efficient in reducing the number of smokers in our society, an increasing number of smokers will be confronted with the addictive character of their smoking.     

Factors Influencing Olympic Performance: Interviews with Atlanta and Negano US Olympians

To gain a better understanding of factors perceived to have positively and/or negatively influenced Olympic athlete performance and to examine differences in performance factors cited by athletes who met or exceeded performance expectations and athletes who failed to meet expectations, 8 Atlanta and 7 Nagano Olympians were interviewed. Interviews were conducted via telephone, tape recorded, transcribed, and content analyzed by three investigators. Major factors perceived to have positively influenced performance included mental skills and preparation, attitude towards the Olympics, support services and support facilitation, multifaceted preparation, physical preparation, and coaching. Major factors perceived to have negatively influenced performance included departing from normal routine, media distractions, coach issues, overtraining, and injury. The two groups, those who met or exceeded expectations and those who did not meet expectations, differed on only a few positive performance factors, including attitude towards the games, Olympic housing, and team unity. Negative factors that differed between the groups included team selection, coaching, lack of support, and team issues.     

尼古丁依赖对男性吸烟者感知戒烟行为控制的预测：社会支持与抱怨批评的作用

考察尼古丁依赖对男性吸烟者感知戒烟行为控制的预测及他人戒烟社会支持和抱怨批评的调节作用。对326名男性吸烟者进行问卷调查,结果显示：（1）尼古丁依赖显著负向预测感知行为控制;（2）社会支持和抱怨批评共同调节两者关系;在高社会支持且低抱怨批评、高抱怨批评且低社会支持的条件下,尼古丁依赖的预测作用不显著。结果说明,高社会支持在尼古丁依赖削弱感知行为控制过程中起缓冲作用,而高抱怨批评削弱社会支持的缓冲作用。     

Self-efficacy moderates the relationship between stress appraisal and quality of life among rescue workers

Abstract

Rescue workers are frequently exposed to highly stressful situations during their everyday work activity. Stress and coping theory emphasizes the interaction between primary and secondary appraisal in determining coping responses to stressful events and quality of life. According to Social Cognitive Theory, stress reactions depend on self-appraisal of coping capabilities.

The present study investigated whether self-efficacy moderates the relationship between stress appraisal and professional quality of life. A self-administered questionnaire was submitted to a sample of 451 Italian rescue workers (firefighters, paramedics, and medical technicians), including the Professional Quality of Life Scale, which measures three dimensions of emergency workers' quality of working life: compassion fatigue, burnout, and compassion satisfaction. Multiple regression analyses indicated that the relationship between stress appraisal and professional quality of life was significant only among rescue workers with low levels of self-efficacy but not among those with higher levels of self-efficacy. These results confirmed the expectations based on Social Cognitive Theory that self-efficacy buffers the impact of perceived stressful encounters on professional quality of life. Results suggest the usefulness of interventions aimed at increasing rescue workers' psychosocial skills.     

Cognitive factors in the explanation of the mismatch between confidence and competence in performing basic life support

Abstract

The main approach to rectifying the well documented poor basic life support (BLS) skills of doctors and nurses, based on a Skills Model, has met with only partial success. This study compares the utility of a Skills Model with one that incorporates a cognitive component in predicting BLS skills. Outcome-expectancy, self-efficacy, training and experience of BLS, and BLS ability were assessed in 53 trained nurses. Ability was unrelated to training or experience of BLS. Nurses who scored highest on the BLS skills assessment perceived the procedure as significantly more successful than those with lower scores. Self-efficacy was unrelated to ability, but was related to status: senior nurses were significantly more confident but no more competent in performing BLS than junior nurses. Nurses who had attended more arrests, while more confident, were no more competent than those who had attended fewer. Assessment of BLS skills reduced self-efficacy beliefs. A model for predicting the relationship between self-assessed ability and objectively assessed skill is outlined.     

Insomniacs' perceived lack of control over sleep

Abstract

It is widely assumed that insomniacs have poor self-efficacy for sleep and it is known that successful treatment is usually accompanied by improved self-efficacy. However, there has been little detailed investigation of insomniacs perceived lack of control over sleep. Insomniacs' perceived control over sleep itself is affected more than their perceived control over pre-sleep mental activity or physical tension. It was hypothesised that insomniacs would diverge from controls more in their sense that sleep was out of their control than that sleep was under their control, though this was not supported by the data. Also, there was no clear support for the idea that insomniacs' dissatisfaction with their control over sleep was the product of excessive aspirations for control. One factor that seems likely to contribute to insomniacs' lack of perceived control over sleep is that they do not have as lawful a pattern of expectations of sleep, based on their recent pattern of sleep, as normal sleepers do. Insomniacs, like non-insomniacs, were most likely to attribute poor sleep to external stresses and an over-active mind. Insomniacs showed a wide range of heightened emotional reactions to poor sleep. The implications of the results for self-regulation approaches to the treatment of insomnia 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.     

The role of risk perception in explaining parental sunscreen use

Objective: This study assessed: (1) whether risk perceptions about skin cancer were related to parent's use of sunscreen on their children; (2) which combination of assessments susceptibility and severity best explain parental sunscreen protection behaviours and (3) whether risk perceptions influence behaviour directly through intentions or through attitudes, subjective norms and self-efficacy.

Design: Two longitudinal studies assessed sunscreen protection behaviours of parents for their toddlers (N?=?391) and young children (N?=?436).

Main outcome measure: Parent's use of sunscreen on their children.

Results: Risk perceptions correlated with future sunscreen protection behaviours of parents but were lower than those of attitude, social influence and self-efficacy. Treating susceptibility and severity as an additive function resulted in the best model fit. Risk perceptions were related with future intention and future sunscreen protection behaviour, but the effects were mediated through attitude, social influence and self-efficacy.

Conclusions: Our path analyses suggest treating susceptibility and severity as an additive function. A multiplicative model without main effects – although often used – had the poorest fit. Risk perceptions influence behaviour by influencing attitudinal and self-efficacy beliefs. Addressing risk perceptions in health communication programs is relevant when the purpose is to increase awareness and to influence attitudes and self-efficacy.     

Smoking cessation: social comparison level predicts success for adult smokers.

The affiliation preferences of 151 adult heavy smokers who joined smoking cessation groups were assessed at the 1st group session and were then used to predict their smoking status 6 and 12 months later. Those who preferred to be in groups with other smokers who were having relatively little trouble quitting were more likely to be successful than were those who preferred others who were having more difficulty quitting. This prospective effect was mediated by psychological distancing from the image of the typical smoker: Preference for others who were doing well was associated with a decrease in perceived similarity to the typical smoker, which, in turn, was associated with successful cessation. Implications of these findings for cessation groups and social comparison theory are discussed.     

Self-efficacy conception of anxiety

Abstract

In social cognitive theory, perceived self-efficacy to exercise control over potential threats plays a central role in anxiety arousal. Threat is a relational property reflecting the match between perceived coping capabilities and potentially hurtful aspects of the environment. People who believe they can exercise control over potential threats do not engage in apprehensive thinking and are not perturbed by them. But those who believe they cannot manage threatening events that might occur experience high levels of anxiety arousal. Experimental analyses of the microrelation between perceived self-efficacy and anxiety arousal reveal that perceived coping inefficacy is accompanied by high levels of subjective distress, autonomic arousal and catecholamine secretion. Environmental events are not always completely under personal control and most human activities contain some potential risks. The exercise of control over anxiety arousal, therefore, requires not only development of behavioral coping efficacy but also efficacy in controlling dysfunctional apprehensive cognitions. It is not frightful cognitions per se but the perceived self-inefficacy to turn them off that is the major source of anxiety arousal. Analyses of the causal structure of self-protective behavior show that anxiety arousal and avoidant behavior are mainly co-effects of perceived coping inefficacy.     

Lifestyle differences between smokers,ex-smokers and non-smokers,and implications for their health

Abstract

Much evidence has been published in order to demonstrate that smoking cessation leads to a decrease in morbidity and mortality. Using data from the Health and Lifestyle Survey respondents were divided into three groups: smokers, ex-smokers and non-smokers and lifestyle characteristics such as diet and exercise were compared. Smokers were more likely to eat chips (French fries), fried food, butter and less likely to eat fresh fruit in winter, green vegetables and margarine high in polyunsaturated fats. Non-smokers were more likely than smokers and ex-smokers to take part in keepfit, jogging and swimming. Non-smokers in smoking households were more likely than non-smokers in non-smoking households to eat fried food, chips and butter and less likely to eat fruit in winter or margarine high in polyunsaturated fats. Results suggest that part of the assumed health benefits of smoking cessation are due to ex-smokers having a healthier diet than that of smokers.