Phdthesis.nl
Repository for several PhD. theses

Author: Eline Smit

Title: Motivating smokers to quit. Effectiveness and feasibility of a web-based multiple tailored smoking cessation programme and tailored counselling by practice nurses

Details: Despite the fact that each year 5.4 million people die from the consequences of smoking, more than one billion people in the world continue to smoke. To reduce both the number of people suffering from smoking-related illnesses and the num-ber of smoking-related deaths, continued efforts are required to move smokers towards cessation. As the effects of stand-alone interventions have been found to typically be limited, the smoking cessation intervention PAS (Personal Advice in Stopping smoking) combines two previously developed effective micro-level interventions: computer-tailoring and behavioural counselling by a practice nurse working in primary care. The first aim of the present dissertation was to develop and to evaluate PAS with regard to its effectiveness, cost-effectiveness and feasibility. The second aim of this dissertation was to inform the development of future smoking cessation interventions by contributing to an increased understanding of smokers’ motivation to quit, as a positive motivation is a necessary though not always sufficient prerequisite for smoking cessation to occur.

The main conclusions that can be drawn based on the results from the studies described in this dissertation are: 1) that before nationwide implementation, PAS should first be further improved; 2) that future research should aim at identifying an acceptable cut-off point for the willingness to pay per abstinent participant; 3) that the choice for a particular recruitment strategy should be informed by an intervention’s objectives as it is expected to influence the reach and subsequent potential public health impact of an intervention; 4) that to disseminate PAS and similar interventions, it is especially important to create a positive attitude and a positive social environment and to help practice nurses in the recruitment of their smoking patients; 5) that interventions aimed at promoting smoking cessation behaviour need to go beyond creating the belief that smokers ought to quit smoking by making them want to quit and/or intend to quit smoking; and 6) that for smokers categorized as contemplators item-based tailoring might be preferable over stage-based tailoring.

Defense: Wednesday, 3 October, 2012 16:00