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

138 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

Keywords

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

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