Self-efficacy and motivation to quit during participation in a smoking cessation program
ABSTRACT The associations between failure to quit and posttreatment self-efficacy and motivation were examined among 600 African American smokers enrolled in a randomized trial testing the efficacy of bupropion for smoking cessation. Participants also received brief motivational counseling and were followed for 6 months. Baseline levels of self-efficacy and motivation for all participants were high (8.2 and 8.5 on a 10-point scale, respectively). Longitudinal analyses indicated that smokers who failed to quit were less likely than quitters to report high self-efficacy and motivation from posttreatment to follow-up. However, examination of mean self-efficacy and motivation scores at posttreatment and follow-up revealed that smokers continued to sustain high self-efficacy and motivation. Mean self-efficacy and motivation scores differed by less than 1 point from baseline levels, even though the majority of participants failed to quit smoking. Results suggest that unsuccessful participation in a smoking cessation program does not meaningfully reduce smokers' self-efficacy and motivation to quit.
- SourceAvailable from: James M Davis
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- "The Interactive Learning for Smokers (ILS) intervention combined elements of the American Lung Association’s Freedom from Smoking program  and The Mayo Clinic’s Nicotine Dependence Center program  and was constructed to help participants develop individualized smoking cessation strategies to manage relapse challenges related to smoking triggers, social situations, strong emotions, stressful situations, relapse-related thoughts, urges and withdrawal symptoms–areas also targeted in MTS. ILS participants were asked to practice thirty minutes of silent non-directed walking per day throughout the intervention, and to further match MTS, were instructed to use non-directed walking for relaxation, stress reduction and as a strategy for managing urges and withdrawal symptoms. "
ABSTRACT: We report results of a pilot study designed to test a novel smoking cessation intervention, Mindfulness Training for Smokers (MTS), in smokers age 18-29 years with regular episodes of binge drinking. Mindfulness is a cognitive skill of applying close moment-to-moment attention to experience with a mental posture of acceptance and non-reactivity. The MTS intervention consisted of six weekly classes that provided instruction on how to use mindfulness to manage known precursors of smoking relapse including smoking triggers, strong emotions, stressful situations, addictive thoughts, urges, and withdrawal symptoms. The MTS intervention was compared to Interactive Learning for Smokers (ILS), a time/intensity matched control group using daily non-directed walking instead of mindfulness meditation. Recruitment was conducted primarily at local technical colleges. Primary outcome measures included biochemically-confirmed smoking abstinence and reduction in alcohol use at the end of treatment (2-weeks post-quit attempt). The sample (N = 55) was 70.9% male, with a mean age of 21.9 years, and a mean of 11.76 alcoholic drinks consumed per week. Intent-to-treat analysis showed biochemically-confirmed 7-day point prevalence abstinence rates at 2-weeks post-quit for MTS = 20.0% and ILS = 4.0%, p = .08. Secondary analysis showed number of drinks per week in the first 2-weeks post-quit correlated with smoking relapse at 2-weeks post-quit (p < .01). This pilot study demonstrated that Mindfulness Training for Smokers shows promise for smoking cessation and alcohol use reduction in treating young adult smokers with alcohol abuse. Results suggest the need for a study with larger sample size and methods that reduce attrition.Trial registration: NCT01679236.BMC Complementary and Alternative Medicine 09/2013; 13(1):215. DOI:10.1186/1472-6882-13-215 · 2.02 Impact Factor
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- "Three published studies have examined associations between measures of motivation to quit and quit attempts prospectively in population samples in the absence of interventions (Borland et al., 2010; West et al., 2001; Zhou et al., 2009). Many other studies have examined the predictive validity of measures of motivation to stop in clinical samples or in the context of interventions studies (for example: Biener and Abrams, 1991; Boardman et al., 2005; Crittenden et al., 1994; Hughes et al., 2005; Ong et al., 2005; Sciamanna et al., 2000). Others have examined the predictive value of measures of " stage of change " which incorporates past quitting behavior and so conflates motivation and previous action (Cancer Prevention Research Center, 2012; DiClemente et al., 1991). "
ABSTRACT: Background: Many different measures of motivation to stop smoking exist but it would be desirable to have a brief version that is standard for use in population surveys and for evaluations of interventions to promote cessation. The aim of this study was to assess the predictive validity and accuracy of the single-item Motivation To Stop Scale (MTSS). Methods: This study is part of the "Smoking Toolkit Study;" a monthly survey of representative samples of the English population. We used data from 2483 respondents to the surveys from November 2008 to January 2011, who were smokers, used the MTSS, and were followed up 6 months later to provide information on quit attempts since baseline. The MTSS consists of one item with seven response categories ranging from 1 (lowest) to level 7 (highest level of motivation to stop smoking). Results: A total of 692 smokers (27.9% (95% CI=26.1-29.6)) made an attempt to quit smoking between baseline and 6-month follow-up. The odds of quit attempts increased linearly with increasing level of motivation at baseline (p<0.001) and were 6.8 (95% CI=4.7-9.9) times higher for the highest level of motivation compared with the lowest. The accuracy of the MTSS for discriminating between smokers who did and did not attempt to quit was ROC(AUC)=0.67 (95% CI=0.65-0.70). Conclusions: The MTSS provides strong and accurate prediction of quit attempts and is a candidate for a standard single-item measure of motivation to stop smoking. Further research should assess the external validity of this measure in different smoking populations.Drug and alcohol dependence 08/2012; 128(1-2). DOI:10.1016/j.drugalcdep.2012.07.012 · 3.42 Impact Factor
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- "Baseline variables include socio-demographic characteristics (gender, age, education, employment), smoking characteristics (cigarettes smoked per day, number of years smoking, number of prior quit attempts), level of nicotine dependence using the Severity of Dependence Scale , and single item measures of motivation and confidence to quit [28-30]. The primary outcome measure is the occurrence of any quit attempt defined as a serious quit attempt of at least 24 hours  by 6-month follow-up. The secondary outcome is biochemically verified 7-day point-prevalence abstinence at 6-month follow-up [32,33]. "
ABSTRACT: Background Although the current Clinical Practice Guideline recommend Motivational Interviewing for use with smokers not ready to quit, the strength of evidence for its use is rated as not optimal. The purpose of the present study is to address key methodological limitations of previous studies by ensuring fidelity in the delivery of the Motivational Interviewing intervention, using an attention-matched control condition, and focusing on unmotivated smokers whom meta-analyses have indicated may benefit most from Motivational Interviewing. It is hypothesized that MI will be more effective at inducing quit attempts and smoking cessation at 6-month follow-up than brief advice to quit and an intensity-matched health education condition. Methods/Design A sample of adult community resident smokers (N = 255) who report low motivation and readiness to quit are being randomized using a 2:2:1 treatment allocation to Motivational Interviewing, Health Education, or Brief Advice. Over 6 months, participants in Motivational Interviewing and Health Education receive 4 individual counseling sessions and participants in Brief Advice receive one brief in-person individual session at baseline. Rigorous monitoring and independent verification of fidelity will assure the counseling approaches are distinct and delivered as planned. Participants complete surveys at baseline, week 12 and 6-month follow-up to assess demographics, smoking characteristics, and smoking outcomes. Participants who decide to quit are provided with a self-help guide to quitting, help with a quit plan, and free pharmacotherapy. The primary outcome is self-report of one or more quit attempts lasting at least 24 hours between randomization and 6-month follow-up. The secondary outcome is biochemically confirmed 7-day point prevalence cessation at 6-month follow-up. Hypothesized mediators of the presumed treatment effect on quit attempts are greater perceived autonomy support and autonomous motivation. Use of pharmacotherapy is a hypothesized mediator of Motivational Interviewing’s effect on cessation. Discussion This trial will provide the most rigorous evaluation to date of Motivational Interviewing’s efficacy for encouraging unmotivated smokers to make a quit attempt. It will also provide effect-size estimates of MI’s impact on smoking cessation to inform future clinical trials and inform the Clinical Practice Guideline. Trial registration ClinicalTrials.gov NCT01188018BMC Public Health 06/2012; 12(1):456. DOI:10.1186/1471-2458-12-456 · 2.26 Impact Factor