Determinants of physical activity promotion by smoking cessation advisors as an aid for quitting: Support for the Transtheoretical Model

doi:10.1016/j.pec.2009.05.004

Patient Education and Counseling

Volume 78, Issue 1, January 2010, Pages 53-56

https://doi.org/10.1016/j.pec.2009.05.004 Get rights and content

Abstract

Objectives

Physical activity (PA) can reduce cigarette cravings and aid quitting but little is known about its promotion by smoking cessation advisors. This study aimed to: (1) determine the extent to which smoking cessation advisors promote PA; and (2) examine the relationship between PA promotion as a cessation aid and advisor characteristics and cognitions, within the Transtheoretical Model (TM) framework.

Methods

Self-report surveys assessing PA promotion, TM variables, advisors’ own PA levels and demographics were completed by 170 advisors in England and Scotland.

Results

Advisors reported spending 29 min promoting PA over a 6/7-week clinic. Those in later stages of readiness for promoting PA as a cessation aid and those spending more time promoting PA held more positive beliefs regarding pros and cons, self-efficacy, outcome efficacy and importance of PA within smoking cessation. Time spent promoting PA and stage of readiness were strongly associated. There was a trend for the more physically active advisors to promote PA more often.

Conclusions

About half the advisors promoted PA and TM variables predicted this variability.

Practice implications

PA promotion among smoking cessation advisors may be facilitated by enhancing self-efficacy, outcome efficacy and pro- and con-beliefs related to PA promotion.

Introduction

Physical activity (PA) may be a useful aid for smoking cessation [1], [2], but little is known about whether smoking cessation advisors promote PA (e.g., provide brief counselling and advice towards a PA program for aiding cessation) and the factors associated with promoting PA. Such information may be useful for changing practitioner behaviour, which typically focuses on offering pharmacological and behavioural individual and group support in stop smoking services (see [3] for more details). The Transtheoretical Model (TM) [4] has been widely used as a framework for explaining both smoking cessation and PA [5], as separate behaviours. Also, studies of practitioners have examined the cognitions (e.g., self-efficacy) associated with stage of readiness to promote smoking cessation and PA within the TM framework [6], [7], [8], again as separate behaviours. To date, no study has investigated the readiness of smoking cessation practitioners to promote PA as an aid to cessation. Those who are considered as less ready to promote PA might be expected to have weaker self-efficacy, outcome efficacy and beliefs about the pros of doing PA, and stronger beliefs about the cons, compared with those actively promoting PA for smoking cessation. It might also be expected that stop smoking advisors who are more active would be more likely to hold positive beliefs about PA and to promote PA to their clients [6]. The present study assessed the extent to which PA was promoted in UK smoking cessation clinics. Additionally, in this context, we examined the relationship between advisor characteristics and cognitions within the TM.

Section snippets

Participants, design and procedure

The study was approved by the local ethics committee. Five hundred and forty-seven questionnaires were distributed at training events and a smoking practitioner national conference. Questionnaires were completed by 170 advisors (31% response¹

Sample characteristics

The characteristics of the sample are presented in Table 1. Advisors reported, on average, spending 29 min promoting PA throughout a typical 6–7-week clinic. Data (N = 70) from respondents who provided information for each week, across the 6–7-week clinic, indicated little variation (between 5.6 and 6.0 min per week), except in week 3 (Mean = 4.5 min; SD = 0.8) and week 4 (Mean = 8.8 min; SD = 1.7). Fifty-six percent of advisors were engaged in PA promotion for smoking cessation (i.e., in action or

Discussion

This is the first study to examine smoking cessation practitioners’ beliefs and behaviour concerning PA promotion specifically as a smoking cessation aid. Clearly practitioners spend on average relatively little time in a typical 70–90 min clinic promoting PA as an aid, which matches national guidelines and training [3] but there was a good deal of variability across the sample. The sample was drawn from advisors working in both deprived and more affluent areas, but a fairly low response rate

Acknowledgments

We are grateful for funding for research from collaborators in the National Prevention Research Initiative (NPRI), namely: British Heart Foundation; Cancer Research UK; Department of Health; Diabetes UK; Economic and Social Research Council; Medical Research Council; National Cancer Research Institute; Research and Development Office for the Northern Ireland Health and Social Services; Chief Scientist Office, Scottish Executive Health Department; Welsh Assembly Government.

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Smoking CessationDeterminants of physical activity promotion by smoking cessation advisors as an aid for quitting: Support for the Transtheoretical Model

Abstract

Objectives

Methods

Results

Conclusions

Practice implications

Introduction

Section snippets

Participants, design and procedure

Sample characteristics

Discussion

Acknowledgments

Prev Med

Patient Educ Counsel

Exercise interventions for smoking cessation

Cochrane Rev

The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect and smoking behaviour: a systematic review

Addiction

Manual of smoking cessation: a guide for counsellors and practitioners

Smoking Cessation
Determinants of physical activity promotion by smoking cessation advisors as an aid for quitting: Support for the Transtheoretical Model