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

Issues in multiple health behaviour change 2 A qualitative perspective on multiple health behaviour change: Views of smoking cessation advisors who promote physical activity Abstract There are mixed views on whether smoking cessation advisors should focus only on quitting smoking or also promote simultaneous health behaviour changes (e.g. diet, physical activity), but no studies have qualitatively examined the views and vicarious experiences of such health professionals. Semistructured interviews were conducted with 11 trained smoking cessation advisors who promote physical activity to their clients. The data were categorised into themes using thematic analysis supported by qualitative data analysis software. We report themes that were related to why advisors promote multiple health behaviour change and issues in timing. Physical activity could be promoted as a cessation aid and also as part of a holistic lifestyle change consistent with a non-smoker identity, thereby increasing feelings of control and addressing fear of weight gain. Multiple changes were promoted pre-quit, simultaneously and post-quit, and advisors asserted that it is important to focus on the needs and capabilities of individual clients when deciding how to time multiple changes. Also, suggesting that PA was a useful and easily performed cessation aid rather than a new behaviour (i.e. structured exercise that may seem irrelevant) may help some clients to avoid a sense of overload.

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“…This complements the finding that advisors who are more physically active are more likely to promote PA as a cessation aid (Everson et al, 2010).…”

Section: Tailoring To the Individualsupporting

confidence: 68%

“…There is growing interest in PA as an aid for smoking cessation and some evidence for its effectiveness (Ussher et al, 2008), and a national survey of 170 smoking cessation advisors revealed that 56% of advisors promote PA as a strategy to help smokers quit (Everson, Taylor & Ussher, 2010).…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Perspective on Multiple Health Behaviour Change: Views of Smoking Cessation Advisors Who Promote Physical Activity

Everson-Hock

Taylor²,

Ussher

et al. 2010

J Smok Cessat

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“…In a cross-sectional survey the negative association between PA and smoking was mediated by having a physically active identity. 37 Thus, by simply increasing PA there may be implicit positive effects on smoking habits.…”

Section: Possible Mechanisms For How Exercise Might Influence Smokingmentioning

confidence: 99%

“…Increasing PA prior to any quit attempt (planned or otherwise) may address concerns about simultaneous health behaviour changes. Indeed NHS guidance for stop smoking advisors is to avoid changing diet and exercise during a quit attempt [4] , and as a result advisors generally spend little time promoting PA [37] , although recent evidence suggests that simultaneous health behaviour changes may not be detrimental [38] . However, a sample of advisors who did advocate simultaneous health behaviour changes had developed integrated strategies for using one behaviour change to positively support a quit attempt (Taylor et al, in press).…”

Section: Chronic Effects Of Exercise As An Aid To Smoking Cessationmentioning

confidence: 99%

A pilot randomised trial to assess the methods and procedures for evaluating the clinical effectiveness and cost-effectiveness of Exercise Assisted Reduction then Stop (EARS) among disadvantaged smokers

Taylor¹,

Thompson

Greaves

et al. 2014

Health Technology Assessment

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Declared competing interests of authors: PA has been a consultant and done research for manufacturers of smoking-cessation products. RW has undertaken research and consultancy for companies that develop and manufacture smoking-cessation medications. He is co-director of the National Centre for Smoking Cessation and Training and a trustee of the stop-smoking charity, QUIT. He has a share of a patent on a novel nicotine delivery device. All other authors have declared no competing interests.

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“…In addition, the findings may help practitioners prescribe PA more effectively to smokers attempting to quit. A survey of 170 Stop Smoking Service advisors in the UK revealed that 56% reported promoting PA for craving management (Everson et al 2010). This paper aims to address these issues using IPD metaanalysis methods.…”

Section: Introductionmentioning

confidence: 99%

The acute effects of physical activity on cigarette cravings: Exploration of potential moderators, mediators and physical activity attributes using individual participant data (IPD) meta-analyses

et al. 2014

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Rationale The effects of acute bouts of physical activity (PA) on Strength of Desire (SoD) and Desire to Smoke (DtS) using individual participant data (IPD) from 19 acute randomised controlled studies were quantified. However, there is a need to identify factors influencing this relationship. Objectives To understand who most benefits from PA, whether changes in affect mediate these effects, and whether any specific attributes of PA are associated with cigarette cravings. Methods IPD (N=930) contributed to one-stage IPD meta-analyses.Participants engaging in PA were compared against controls, using post-intervention DtS and SoD (when DtS not available) with baseline adjustments. The cravings scales were linearly rescaled to 0-100% (a mean difference between groups of -10 would indicate that postintervention cravings were 10% lower in the PA compared with the control group).Demographic, smoking and other characteristics were examined as predictors and potential moderators whereas change in affect was considered as a mediator. PA was categorised according to type, duration and intensity, to determine PA attributes associated with cravings reduction. Results None of the included covariates were shown to moderate or mediate the effects of PA. Intensity of PA was significantly associated with a reduction in cravings; moderate and vigorous intensity PA offered the most benefits. A one-stage IPD meta-analysis yielded effects size of -9.22 (-15.24; -3.20) for light, -34.57 (-42.64; -26.50) for moderate and -31.29 (-38.00; -24.57) for vigorous intensity in comparison with controls. Conclusions Moderate intensity PA could be recommended to all smokers regardless of demographic, smoking and other characteristics.

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

Abstract: 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.

Cited by 27 publications

References 8 publications

A Qualitative Perspective on Multiple Health Behaviour Change: Views of Smoking Cessation Advisors Who Promote Physical Activity

A Qualitative Perspective on Multiple Health Behaviour Change: Views of Smoking Cessation Advisors Who Promote Physical Activity

A pilot randomised trial to assess the methods and procedures for evaluating the clinical effectiveness and cost-effectiveness of Exercise Assisted Reduction then Stop (EARS) among disadvantaged smokers

The acute effects of physical activity on cigarette cravings: Exploration of potential moderators, mediators and physical activity attributes using individual participant data (IPD) meta-analyses

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