The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence

Geoffrey C. Williams, Christopher P. Niemiec, Heather Patrick, Richard M. Ryan, Edward L. Deci

Research output: Contribution to journalArticlepeer-review

149 Scopus citations

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.

Original languageEnglish
Pages (from-to)315-324
Number of pages10
JournalAnnals of Behavioral Medicine
Volume37
Issue number3
DOIs
StatePublished - 2009

Bibliographical note

Funding Information:
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. C.P.Niemiec.R.M.Ryan.E.L.Deci Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, USA

Keywords

  • Autonomy
  • Perceived competence
  • Self-determination theory
  • Tobacco abstinence

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