Motivating Change: Social Support and Behavior Strategies in Smoking Cessation

This study examined the role of social support and behavioural interventions used during the last unsuccessful quit attempt for smokers’ intentions to benefits of quit smoking within the next six months, and identified smokers’ attributes associated with the use of social support and behavioural interventions. The analytic sample included 7,195 adult daily smokers who responded to the 2010–2011 Tobacco Use Supplement to the Current Population Survey, conducted in the United States, and indicated having a serious quit attempt in the past 12 months.

Smokers who relied on social support from friends and family had higher odds of intending to quit than those who did These associations were similar for both sexes, all age groups, and nicotine dependence levels. Both, relying on social support and the use of behavioural interventions were more common among smokers who were female, higher educated, residing in the Western US region, and those who used pharmacological aids for smoking cessation. Social support and behavioural interventions are associated with higher intentions to quit among attempters who relapsed and thus, may aid future smoking cessation.

Benefits of Social Support and Behavioural Interventions

Social support plays a critical role in one’s psychological and physical well-being. For example, interpersonal relationships can help an individual to deal with stress (Cohen & Wills, Reference Cohen and Wills1985; Villain, Sibon, Renou, Poli, & Swendsen, Reference Villain, Sibon, Renou, Poli and Swendsen2017), motivate behavioural changes, and help maintain new behaviours (Crookes et al., Reference Crookes, Shelton, Tehranifar, Aycinena, Gaffney and Koch2016; House, Landis, & Umberson, Reference House, Landis and Umberson1988; Sarkar, Taylor, Lai, Shegog, & Paxton, Reference Sarkar, Taylor, Lai, Shegog and Paxton2016; Villain et al., Reference Villain, Sibon, Renou, Poli and Swendsen2017). Specifically, having a supportive environment could help a smoker quit smoking and prevent smoking relapse (Creswell, Cheng, & Levine, Reference Creswell, Cheng and Levine2015; Patten et al., Reference Patten, Goggin, Harris, Richter, Williams and Decker2016; Sorensen, Emmons, Stoddard, Linnan, & Avrunin, Reference Sorensen, Emmons, Stoddard, Linnan and Avrunin2002). For example, daily smokers expecting to receive social support if they quit smoking report stronger intentions to quit smoking (Meijer, Gebhardt, Laar, Kawous, & Beijk, Reference Meijer, Gebhardt, Laar, Kawous and Beijk2016).

Study Goals

Supportive social environments for smoking cessation and evidence-based behavioural interventions for smoking cessation share similar features. In addition, disintegration of individual effects is problematic for those smokers who relied on social support as a part of an intervention or in addition to the intervention. Therefore, the impact of supportive social environments and interventions on quitting behaviours should be assessed simultaneously. We hypothesize that relying on social support and/or using behavioural interventions, even during a failed quit attempt, will help motivate smokers to improve their intentions to quit in the near future.

The overall goal of the study was to assess whether social support and behavioural interventions used during the last serious (unsuccessful) quit attempt were positively associated with smokers’ intentions to quit in the near future. The specific research goals were as follows:

  • Goal 1: Identify smokers’ characteristics associated with relying on social support and behavioural interventions while trying to quit smoking.
  • Goal 2: Identify specific behavioural interventions associated with the intentions to quit smoking.
  • Goal 3: Identify whether relying on support and/or using behavioural interventions during the last serious quit attempt are positively associated with smokers’ intentions to quit in the near future, and whether these associations differ across diverse groups of smokers with regards to age, sex, and/or nicotine dependence.

Study Behavioural Interventions

While evidence suggests that behavioural interventions are effective means for smoking cessation (Bully, Sánchez, Zabaleta-Del-Olmo, Pombo, & Grandes, Reference Bully, Sánchez, Zabaleta-Del-Olmo, Pombo and Grandes2015; Fiore et al., Reference Fiore, Jaen, Baker, Bailey, Benowitz and Curry2008), smokers attempting to quit do not often use behavioural interventions: less than 10% of attempters use these methods (Cokkinides, Ward, Jemal, & Thun, Reference Cokkinides, Ward, Jemal and Thun2005; Fiore et al., Reference Fiore, Novotny, Pierce, Giovino, Hatziandreu and Newcomb1990; Shiffman, Brockwell, Pillitteri, & Gitchell, Reference Shiffman, Brockwell, Pillitteri and Gitchell2008a, Reference Shiffman, Brockwell, Pillitteri and Gitchell2008b; Soulakova & Crockett, Reference Soulakova and Crockett2016.

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