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Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 3/2009

01-06-2009 | Rapid Communication

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

Authors: Geoffrey C. Williams, M.D., Ph.D., Christopher P. Niemiec, M.A., Heather Patrick, Ph.D., Richard M. Ryan, Ph.D., Edward L. Deci, Ph.D.

Published in: Annals of Behavioral Medicine | Issue 3/2009

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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.
Footnotes
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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Metadata
Title
The Importance of Supporting Autonomy and Perceived Competence in Facilitating Long-Term Tobacco Abstinence
Authors
Geoffrey C. Williams, M.D., Ph.D.
Christopher P. Niemiec, M.A.
Heather Patrick, Ph.D.
Richard M. Ryan, Ph.D.
Edward L. Deci, Ph.D.
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
Annals of Behavioral Medicine / Issue 3/2009
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-009-9090-y

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