Eating the elephant whole or in slices: views of participants in a smoking cessation intervention trial on multiple behaviour changes as sequential or concurrent tasks

Preethi Koshy,Wilma Leslie,Catherine Hankey,Mike Lean,Mhairi Mackenzie

doi:10.1186/1471-2458-12-500

Preethi Koshy, Wilma Leslie + Show 3 more

Open Access

https://doi.org/10.1186/1471-2458-12-500

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Abstract

BackgroundThis paper explores smoking cessation participants’ perceptions of attempting weight management alongside smoking cessation within the context of a health improvement intervention implemented in Glasgow, Scotland.MethodsOne hundred and thirty-eight participants were recruited from smoking cessation classes in areas of multiple deprivation in Glasgow and randomised to intervention, receiving dietary advice, or to control groups. The primary outcome of the study was to determine the % change in body weight. Semi-structured interviews were conducted with a purposive sample of 15 intervention and 15 control participants at weeks 6 (during the intervention) and 24 (at the end of the intervention). The current paper, though predominantly qualitative, links perceptions of behaviour modification to % weight change and cessation rates at week 24 thereby enabling a better understanding of the mediators influencing multiple behaviour change.ResultsOur findings suggest that participants who perceive separate behaviour changes as part of a broader approach to a healthier lifestyle, and hence attempt behaviour changes concurrently, may be at comparative advantage in positively achieving dual outcomes.ConclusionsThese findings highlight the need to assess participants’ preference for attempting multiple behaviour changes sequentially or simultaneously in addition to assessing their readiness to change. Further testing of this hypothesis is warranted.Trial RegistrationISRCTN94961361

Highlights

This paper explores smoking cessation participants’ perceptions of attempting weight management alongside smoking cessation within the context of a health improvement intervention implemented in Glasgow, Scotland
In an attempt to address these challenges, in 2007, a weight management intervention informed by the Transtheoretical Model was delivered to smoking cessation participants from deprived areas of Glasgow over 24 weeks; its components are detailed elsewhere [40] but it is important to note here that participants in the intervention arm were not explicitly directed whether behaviour change should occur sequentially or concurrently
The study aimed to determine whether a stage-matched intervention delivering dietary advice to smoking cessation participants would minimise post-cessation weight gain to ≤3% [39] and improve smoking cessation maintenance compared to controls receiving routine cessation advice

Summary

Introduction

This paper explores smoking cessation participants’ perceptions of attempting weight management alongside smoking cessation within the context of a health improvement intervention implemented in Glasgow, Scotland. There is a lack of consensus in academic literature about whether multiple behaviour change interventions are effective and most lifestyle interventions are behaviour-specific. In the literature a single behaviour intervention can be one that is more accurately a single goal intervention that may be achieved through changing more than one behaviour. Weight loss may be achieved through both improved diet and increased physical activity. In this context multiple behaviour interventions are those that include separate goals that may not operate in tandem with one another. Interventions aimed at changing behaviours that share similar mechanisms are of interest as they offer the potential to act in concert with one another, thereby improving treatment impact and reducing health costs [6]. Research indicates that individuals who choose to improve activity levels tend to adopt healthier eating habits and maintain smoking cessation as compared to those who do not [7,8,9]

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