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The Importance of Supporting Autonomy and Perceived Competence in Facilitating Long-Term Tobacco Abstinence

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  • Published:
Annals of Behavioral Medicine

Abstract

Background

The Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence (Fiore et al. 2000) recommends supporting autonomy and perceived competence to facilitate tobacco abstinence.

Purpose

The aim of the study was to evaluate the effectiveness of an intensive tobacco-dependence intervention based on self-determination theory (SDT) and intended to support autonomy and perceived competence in facilitating long-term tobacco abstinence.

Methods

One thousand and six adult smokers were recruited into a randomized cessation–induction trial. Community care participants received cessation pamphlets and information on local treatment programs. Intervention participants received the same materials and were asked to meet four times with counselors over 6 months to discuss their health in a manner intended to support autonomy and perceived competence. The primary outcome was 24-month prolonged abstinence from tobacco. The secondary outcome was 7-day point prevalence tobacco abstinence at 24 months postintervention.

Results

Smokers in the intervention were more likely to attain both tobacco abstinence outcomes and these effects were partially mediated by change in both autonomous self-regulation and perceived competence from baseline to 6 months. Structural equation modeling confirmed the SDT model of health-behavior change in facilitating long-term tobacco abstinence.

Conclusions

An intervention based on SDT and consistent with the PHS Guideline, which was intended to support autonomy and perceived competence, facilitated long-term tobacco abstinence.

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Notes

  1. In all SEM analyses, a tetrachoric correlation matrix was used as input for the estimation of the models because of the inclusion of the dichotomous long-term tobacco abstinence variable.

  2. The measurement model was saturated, or just-identified, and thus had zero degrees of freedom. Therefore, all incremental fit indices [e.g., Comparative Fit Index (CFI)] and χ 2 yielded perfect fit (i.e., CFI = 1.00, χ 2 = 0), and other indices (e.g., nonnormed fit index (NNFI), root mean square error of approximation (RMSEA)) could not be computed, so fit indices will not be reported.

  3. The direct effect model was also saturated, or just-identified.

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Author information

Authors and Affiliations

  1. Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, USA

    Christopher P. Niemiec M.A., Richard M. Ryan Ph.D. & Edward L. Deci Ph.D.

  2. Departments of Medicine and Clinical and Social Sciences in Psychology, University of Rochester, R.C. Box 270266, Rochester, NY, 14627-0266, USA

    Geoffrey C. Williams M.D., Ph.D. & Heather Patrick Ph.D.

Authors
  1. Geoffrey C. Williams M.D., Ph.D.
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  2. Christopher P. Niemiec M.A.
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  3. Heather Patrick Ph.D.
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  4. Richard M. Ryan Ph.D.
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  5. Edward L. Deci Ph.D.
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Corresponding author

Correspondence to Geoffrey C. Williams M.D., Ph.D..

Additional information

Trial Registration. ClinicalTrials.gov number, NCT00178685.

This research was supported by grants R01-CA106668 from the National Cancer Institute and by R01-MH59594 that was cofunded by the National Institute of Mental Health and the National Cancer Institute. Requests for reprints may be made to Geoffrey C. Williams, M.D., Ph.D., University of Rochester, R.C. Box 270266, Rochester, NY 14627-0266.

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Williams, G.C., Niemiec, C.P., Patrick, H. et al. The Importance of Supporting Autonomy and Perceived Competence in Facilitating Long-Term Tobacco Abstinence. ann. behav. med. 37, 315–324 (2009). https://doi.org/10.1007/s12160-009-9090-y

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  • DOI: https://doi.org/10.1007/s12160-009-9090-y

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