Is contemplation a separate stage of change to precontemplation?

Connectedness Based on Shared Engagement Predicts Remote Biochemically Verified Quit Status Within Smoking Cessation Treatment Groups on Facebook

INTRODUCTION

Engagement with online content and online social network integration are associated with smoking behavior change, but less is known about social dynamics of shared engagement between participants in group-based social media interventions.

METHODS

Participants were 251 young adult smokers aged 18 to 25 assigned to one of 29 secret Facebook groups tailored to their readiness to quit smoking ("pre-contemplation," "contemplation," and "preparation"). Groups varied in size and were randomly assigned to receive monetary incentives for engagement. All groups received daily posts for 90 days and were assessed for remote biochemically verified smoking abstinence at the end of the intervention. Across 29 groups, we examined associations between group features (group size, incentive condition, readiness to quit) with how connected members were within the group based on shared engagement with the same content (measured by density). At the individual level, we examined associations between 7-day biochemically verified smoking abstinence and how connected an individual was within the group (measured by degree centrality).

RESULTS

After adjusting for comment volume, being in a contemplation group (vs. pre-contemplation group) was associated with a decrease in comment-based density. Individual degree centrality was significantly associated with biochemically verified smoking abstinence for both comments and likes.

CONCLUSIONS

Future group-based social media interventions for smoking cessation may want to focus on promoting connected engagement between participants, rather than simply quantity of engagement.

IMPLICATIONS

Participants in a smoking cessation intervention delivered through Facebook groups were more likely to have biochemically verified smoking abstinence if they were more connected to the rest of the group via shared engagement. Promoting shared engagement between participants may be more likely to promote behavior change than volume of engagement alone.

Prevalence and factors associated with difficulty and intention to quit smoking in Switzerland

BACKGROUND

Recent data indicate a slight decrease in the prevalence of smoking in Switzerland, but little is known regarding the intention and difficulty to quit smoking among current smokers. Hence, we aimed to quantify the difficulty and intention to quit smoking among current smokers in Switzerland.

METHODS

Cross-sectional study including 607 female and 658 male smokers. Difficulty, intention and motivation to quit smoking were assessed by questionnaire.

RESULTS

90% of women and 85% of men reported being "very difficult" or "difficult" to quit smoking. Almost three quarters of smokers (73% of women and 71% of men) intended to quit; however, less than 20% of them were in the preparation stage and 40% were in the precontemplation stage. On multivariate analysis, difficulty to quit was lower among men (Odds ratio and 95% [confidence interval]: 0.51 [0.35-0.74]) and increased with nicotine dependence and number of previous quitting attempts (OR=3.14 [1.75-5.63] for 6+ attempts compared to none). Intention to quit decreased with increasing age (OR=0.48 [0.30-0.75] for ≥65 years compared to <45 years) and increased with nicotine dependence, the number of previous quitting attempts (OR=4.35 [2.76-6.83] for 6+ attempts compared to none) and among non-cigarette smokers (OR=0.51 [0.28-0.92]). Motivation to quit was inversely associated with nicotine dependence and positively associated with the number of previous quitting attempts and personal history of lung disease.

CONCLUSION

Over two thirds of Swiss smokers want to quit. However, only a small fraction wishes to do so in the short term. Nicotine dependence, previous attempts to quit or previous history of lung disease are independently associated with difficulty and intention to quit.

The influence of having a quit date on prediction of smoking cessation outcome

The aim of this study was to explore whether factors predicting making a quit attempt are uniform within the preparation stage of the transtheoretical model (TTM). Participants were 283 smokers, all planning to quit in the next 30 days (preparation stage), who used a computer-generated tailored advice programme. Evidence of differences in prediction of making a quit attempt was found between smokers with and without a quit date, with the predictive power of a multivariate model markedly higher among those with a set date. In particular, one aspect of pros of smoking (smoking helps you feel better when things are bad) was predictive of progression among those with a quit date, but not among those without. The results suggest that factors predicting stage progression are not uniform within the preparation stage. The results complement other recent research that has questioned the stage definitions used in the TTM and provide evidence in support of an alternative stage boundary defined by the commitment of setting a quit date.