Beliefs and determinants predicting smoking initiation and cessation

SmokingSynthesis is a systematic review and (hopefully) meta-analysis aiming to provide an overview of the modifiable beliefs and determinants of smoking initiation and cessation.

This overview can then inform prevention efforts. This project was started as a response to the 'fear appeal controversy': the debate that has existed for decades about whether fear appeals 'work' or not (see http://fearappeals.com for a website that collects evidence advising against the application of fear appeals). At times, this debate devolves into an 'is not'-'is too'-esque dialogue, and the current project is an attempt to head into a more constructive direction.

SmokingSynthesis is a natural consequence of the realisation that the 'fear appeal controversy' misses the point.

The question is not "can fear appeals work".

The question is, "what is the most effective communication that we can use".

One of the reasons people insist on using fear, threatening communication, and an emphasis on risks of behavior is because alternatives to fear appeals are not always known (see this qualitative study). Although behavior is predicted by many different beliefs and determinants, many are not as intuitive as risk perception ("if people would just realise bad it was for them, they would never do it"). In the case of smoking initiation and cessation, the problem is exacerbated because the literature on which beliefs and determinants predict smoking initiation and cessation has, unfortunately, not been synthesised sufficiently. For example, look for reviews and meta-analyses using Google Scholar: at the time of writing, that query yielded 17 hits, including only one review of modifiable determinants, and that only concerns adolescents and is over ten years old.

The most effective communication is the one that uses the most effective psychological method of behavior change to target those beliefs and determinants that most strongly predict smoking initiation and/or cessation (for an explanation, see this special issue of the European Health Psychologist, especially the first two original articles).

Thus, the first step towards identifying the most effective communication, be it a threatening message or something else, is identifying which beliefs and determinants predict smoking initiation and cessation. Once this is known, the most effective methods for identifying each of these beliefs/determinants can be selected, and translated into practical applications.

SmokingSynthesis aims to contribute to this first step.

The resources we use are publicly available at the Open Science Framework. Note that this is a project in progress, so nothing published there currently is final; literature syntheses are iterative projects.

Do you know a study that you think should be included? Please contact us!

SmokingSynthesis was conceived by Gjalt-Jorn Peters (Greater Good, Open University of the Netherlands, and Maastricht University), Marc Willemsen (Maastricht University) and Fleur van Bladeren (KWF Kankerbestrijding). We collaborate further with Gerjo Kok and Rob Ruiter (both Maastricht University), and involved research assistants Bram de Boer, Dabyon Schöne and Eline Primowees. The project is funded by Greater Good, KWF Kankerbestrijding, Maastricht University, and the Open University of the Netherlands.