Successful Interventions to Promote Smoking Cessation - Dissertation Example

Successful Interventions to Promote Smoking Cessation Introduction Human behaviour is one of the most complex aspects that influence individual habits, perception, and actions. These habits, perception and actions play a crucial role in defining their health conditions and the extent to which they can prevent diseases. It is with this view that health professionals today are turning their focus on theoretical models that provide a deeper understanding of human behaviour and how it can be changed for better. These models not only help in understanding the underlying causes of diseases but it also provides a framework for inducing behavioural changes that can contribute to reducing health problems in future. The models are applied to promote self-control, adopt preventive actions, and influencing behaviour to reduce the health risks posed by bad habits or compulsive destructive activities (). Smoking habit is one such health hazard that has resulted in health problems all over the world. Studies have established that cigarette smoking is responsible for 90 percent of all lung cancer cases over the world (Siemiatycki, Krewski, Franco, and Kaiserman, 1995). More recent studies have claimed that health problems related to smoking have claimed the lives of over 393,000 Americans in the year 2011 alone (ALA, 2012). Smoking is also responsible for 80 to 90 percent of deaths due to emphysema and chronic bronchitis (ALA, 2012). The health implications of smoking are staggering, yet people continue to indulge in it. Such compulsive behavioural problems form the root cause for growing health problems in the society. The academic theories in this context provide a number of frameworks and models for behavioural change and these have been adopted by health professionals for decades. However, the effectiveness of these models is defined by the extent to which they have reported success or failure in different cases. A number of studies have focused on finding an effective framework that can help in changing individual health behaviour. Most of these studies have asserted that multiple approaches to treating such problems are the most effective way in dealing with such conditions. Among the various frameworks available, the social cognitive model has been termed as a highly effective intervention strategy that has produced successful results in most cases. The paper provides an in-depth evaluation of this model and its role in promoting smoking cessation through a critical analysis of the model and its application. Social cognitive model – overview and application The social cognitive model refers to the framework that explains the cognitive indicators of human behaviour and how it can be controlled to produce positive health behavioural changes (French, Vedhara, and Kaptein, 2010). The theories supported by the social cognitive model focus on inducing positive health behavioural changes to reduce risks posed by individual habits. These theories include the social cognitive theory, the theory of reasoned action, the theory of planned behaviour, the health belief model, protection-motivation theory and information-motivation-behavioural skills model (French et al., 2010). The social cognitive model is widely applied by health professionals to predict individual behaviour, explain behavioural patterns and induce behavioural changes. Such behavioural changes involve adopting healthier lifestyles, indulging in exercises and physical activity and adhering to medication. The intervention strategies used by health professionals vary from one situation to another. For people seeking to change their health related habits and behavior, the two most important factors that need to present are motivation and the will power to change. The person concerned needs to make a conscious choice to change. Once the individual has made up his mind to change his behavior, he must take steps to ensure that his thoughts are put into action and care must be taken to ensure that he doesn’t rescind and go back to his previous habits. Will power and determination is very important for people to follow through on their promise to change. A number of health problems are brought on by smoking, alcohol consumption, substance abuse, unhealthy eating habits and unprotected sexual contact. People have the ability to think and decide the manner in which they want to lead their life. A number of health problems caused by a bad lifestyle can be corrected by the individuals themselves through self-regulation. People can adopt a healthier lifestyle by being more active, eating healthy, avoiding high calorie food and drinks, and exercising on a regular basis. There is an assumption that when people realize that their behavior poses a health risk, they will be more open to change their habits and lifestyle for a healthier alternative. This is based on the belief that people are rational in their decision making when faced with a health risk. But over the years, a number of studies have shown a perceived health risk does not necessarily ensure that people will change their health related behavior (Schwarzer, 2008). Motivation to Change People need motivation to undergo the process of changing their health related behavior. Motivation will help them in making up their mind to change and resolve to achieve the goal. The three important factors that influence this process are risk perception, outcome expectancies and perceived self-efficacy. The starting point of foregoing an unhealthy lifestyle and taking up a healthier one is becoming aware of a health risk brought on by their behavior. If people are not made aware of the health risks posed by their habits, they will not have the motivation and will power to make a change. However, it must be remembered that just frightening people about adverse health conditions alone will not result in desired behavior change. A perceived health risk is just the starting point to motivate people to change. As the process of change progresses, other considerations acquire more importance. People need to be informed about the adverse impact their habits and lifestyle has on their physical and mental health. They need to understand the different negative consequences of their behavior on their health and overall quality of life. The knowledge of the detrimental effects will provide the motivation to change. But it must be remembered that this alone will not lead to behavioral change but will help people in making a conscious choice to start the process of change. All the good and bad outcomes that will result from continuing the behavior need to be identified and discussed elaborately. This will help the individual to make the right decision (Schwarzer, 2008). Self-Regulatory Processes Once people have decided to make a change, they need to have a plan of action in place. They need to stick to the plan and not go back to their earlier behavior even if they face difficulties. The two most important things in this process are to set the goal and take steps to achieve the goal. This is not always an easy and smooth process. It requires a lot of will power and self-regulation to stick to the behavioral change. It needs to be understood that people may be tempted to go back to their old ways when faced with challenges, but a strong will and determination will enable them to stay on the right path. Individual behaviour change is driven by goals and objectives that begins with initiation, planning, maintenance, relapse management and disengagement (Schwarzer, 2008). The plan for bringing about the behavioral change needs to be comprehensive and needs to be well defined. It should provide the individual a plan of action under different scenarios. This will reduce the chances of a relapse in difficult situations. Self-belief also plays a very important role in this process. It is only when people have a strong belief that they can change, will they take the initiative to start the process of change. They must also possess the determination and self-regulation to follow through on this behavioral change and attain the desired end result. Each individual has different mechanisms that drive their motivation and actions. The main goal of behavioral change can be broken down to smaller goals and checks can be put in place to avoid digression from the correct path. People also have their own unique and individual ways to overcome challenges in achieving their goal. It is also critical for people to receive support and assistance from those around them in order to successfully make the behavioral change. We can conclude that the process of health related behavioral change involves motivation, goal setting and self-regulating mechanisms to achieve and sustain the change (Simmons-Morton, McLeroy, and Wendel, 2012). The degree of change in behavior and lifestyle varies from individual to individual over the course of their lifetime. For example, some people who have quit smoking at a young age may give it an occasional try after they become adults while others remain non-smokers for the rest of their lives. After the initial try, a few people may indulge in smoking from time to time while others may never hold a cigarette again. Some of them may become regular smokers while others may stop smoking. People who have started to smoke again regularly may try to quit for a second time while others just continue smoking. Some people may be successful in kicking the habit again while others may not be able to do so (Schwarzer, 2001). Critical analysis and literary perspectives The application of the social cognitive model in promoting smoking cessation has been widely researched by many. The findings of these research studies have claimed that individual behaviour is not guided by reinforcements but behavioural changes are induced by self realization and conviction that the individual can change their habits with community support (Bandura, 1977). The social cognitive theory proposes that “the most important prerequisite for behaviour change is a person’s sense of self-efficacy or the conviction that one is able successfully to execute the behaviour required to produce the desired outcome” (NAS, 2001). It has been argued that people may realize that their specific behaviours can be detrimental to their health and their conditions can definitely improve if they change their habits, but this behavioural change is not possible unless the individual has the conviction that he or she can change. Health related behaviours can thus be changed only through conviction and self-efficacy beliefs that promote positive thoughts and actions among individuals (Kaplan et al., 1994). Self-control and regulation is another parameter supported by the social cognitive theories and this is translated to individual will power to change (Compass et al., 1999). The process of self-regulation involves cognitive processes that include initiation of change, modulation of thoughts, physiological responses, redirecting emotions and behaviours, and termination of specific habits. While self-regulation is an important factor guiding the adoption of healthy habits and preparing one-self for change, it can varies from individual to individual. A breakdown of self-regulation can have negative impacts in terms of adopting risky behaviours that include smoking or poor diet management (Sutton, 2004). It has been evidenced that the factors behind the initiation of smoking habits is largely psychosocial in nature. Parents, siblings, and society approve this habit and individuals adopt the glamorous image portrayed by their heroes on the big screen. Studies analyzing this trend have observed that among the most effective interventions for non-smoking is social reinforcement, rather than statutory warnings that aim to increase the awareness of the dangers related to smoking (Leventhal and Mora, 2005). Cigarettes are sold at low prices and readily available across all stores. Thus, societal factors also contribute immensely to the promotion of smoking habits. These observations have contributed to an improved understanding of various factors that have promoted smoking habits among individuals and why it is adopted by people from different demographic profiles. This understanding is important to analyze the mental conditions that define smoking behaviour and the role played by social cognitive models in promoting smoking cessation. However, this alone is not enough in ensuring the success of social cognitive intervention techniques (Goodman et al., 2001). The choice of intervention techniques must be based on the target audience. Some intervention techniques address those who are at risk of adopting the smoking habit. This type of preventive measure may or may not be effective in most cases (Westmaas, Gil-Rivas, and Silver, 2006). It was evidenced that the efforts of COMMIT (Community Intervention Trial for Smoking Cessation) to increase smoking cessation among heavy smokers met with mixed outcomes. While the cessation rates were high among moderate and light smokers, the heavy smokers did not show much change in behaviour (COMMIT, 1995). On the basis of these observations, the socio cognitive models have been criticized by practitioners and academicians. One of the arguments against the application of these intervention techniques is the assumption that individuals have a futuristic thought process and they are capable of weighing the pros and cons of their actions in light of possible consequences (Sutton, 2002). Health practitioners realize the individual decisions are based on their understanding of the situation and the perceptions that they have developed over the years on the issue. It is hardly rational to think that people will realize the consequences before taking up a particular habit like smoking. Young adults tend to be influenced by the peer pressure and fashionable trend attached to smoking rather than think of the possible heart diseases and lung cancer that they may have later on account of smoking. Thus, the social cognitive models of intervention approaches focus “more on adherence to treatment and metabolic control than on family behaviour variables or family processes themselves” that are the primary triggers behind adopting specific behaviours (NAS, 2001). Among other criticisms facing social cognitive models is its failure to consider affective influences on behaviour. A number of studies in this direction have observed the impact of affective influences like regret on the behavioural outcomes. These studies have concluded that the affective influences prove a strong determinant of individual behaviour and its outcomes on change process (Steptoe, 2010). It has often been found that though people are well aware of the negative impacts of smoking and they would like to quit smoking, they have been unsuccessful in their efforts. This is mostly on account of the fact that most of these individual possess low self-belief and are less optimistic in their efforts (Conner and Norman, 2009). The authors in their work observed that the smoking behaviour of people who want to quit are strongly guided by self-evaluative outcome expectations such as being, ashamed, feelings of regret, and being happy about quitting smoking. The stronger these self-evaluative outcome expectations were, the stronger were the chances of quitting smoking. Conclusion The discussion and analysis of the social cognitive model has asserted the role that self-efficacy and regulatory beliefs can have on reducing the instances of smoking. Health care professionals have found it an effective intervention mechanism to promote cessation of smoking. The theory assumes that human behaviour is rational and it can be controlled though positive beliefs and the will power of the individual undergoing treatment. Clinical based intervention strategies adopt a combination of both social cognitive models and medications for effective cessation of smoking. In practical context changing negative health behaviour requires a lot of self-discipline and control in order to achieve positive results. Behavioural changes can be induced only through a change in individual attitudes that shape behavioural patterns. Changes in health behaviour is thus dependant on individual motivation levels to change their habits, think rationally before adopting new behaviour, and the motivation to resist temptation. The model hence applies to “all health compromising and health enhancing behaviours and could even be adjusted to apply to behaviour change more generally” (Schwarzer, 2001). Health behaviour management efforts should broadly focus on social aspects and community initiatives that help in creating awareness of the negative impacts and consequences of smoking. References ALA. (2012). Smoking. Retrieved on Nov 29 2012 from http://www.lung.org/stop-smoking/about-smoking/health-effects/smoking.html Bandura, A. (1977). Self efficacy: Toward a unifying theory of behaviour change. Psychological review. Issue 84, pp 191-215. COMMIT.(1995). Community intervention trial for smoking cessation (COMMIT). I. Cohort results from a four year community intervention. American Journal of Public Health. 85:183–192. 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