I Want to Quit Smoking! Is It Enough to Just Change My Attitude?

Until very recently, it was believed that people’s behaviour could only be changed by providing them with information. It was hoped that this would suffice to change their attitudes and behaviour. We all know we have to eat healthy and exercise, but does this mean we do it? ‘Behaviour change communication is a complex concept that covers not only an individual’s desire and motivations, but also includes influences from the social and physical environment, the actions of legislators, community support and other factors. The importance of this communication has become very clear during the pandemic, and we have come to understand how difficult it is to change people's behaviour quickly,’ says Vita Savicka, Head of the Health Communication master’s study programme at Rīga Stradiņš University (RSU).

‘Behaviour change communication is a research object for the teaching staff and students in our study programme. The research requires an interdisciplinary approach, which is also one of our programme’s trumps. It is important that these studies have practical application, as they can be used in various communication campaigns.’

Behaviour change communication is a current issue for researchers in many countries. Savicka regularly supplements her knowledge at the Centre for Behaviour Change (University College London), which is the leading research institute in the field.

Last year Savicka, together with her colleague Assoc. Prof. Anda Ķīvīte-Urtāne, the Director of the RSU Institute of Public Health, carried out a study surveying smokers in Latvia. We invited Savicka to explain this study in more detail. In-depth interviews were conducted as part of the study and the data that was obtained data was analysed to develop practical recommendations on how to help people quit smoking.

How was the study conducted?

We studied quite a narrow group of people – smokers who actually wanted to quit smoking. We found that 15 factors influencing behaviour were important to them. These included knowing about methods for quitting, willpower training, attitude, goals and social norms. Skills were named as the most important factor like how to react to negative environmental factors, for example, if your colleague invites you join them for a cigarette, or if people around you are unsupportive. People also wanted to acquire skills on how to relieve stress, how to relax and develop new habits, to reduce withdrawal symptoms, as well as specific methods for quitting smoking.

We could conclude that it’s important to involve relatives and friends for support, but social support and support groups where they could share their experience are also important.

Respondents mentioned that generalised recommendations and international mobile phone apps don’t help, and that a more personalised approach is required. It is important to formulate a personal one rather than a general goal – why it is important for me to become a non-smoker?

Confidence in the ability to quit smoking is essential. If you don’t have confidence or have failed in the past there is little motivation to try to quit again. Respondents generally understood the potential benefits of giving up smoking very well, but this wasn’t enough for them to actually do so. Various fears from gaining weight to the inability to socialise or finding other ways to reduce stress were listed as serious obstacles.

Another interesting trend that emerged from the study is that people are ashamed of their smoking and hide it from their family and colleagues. They admit it is cool to quit, but at the same time they feel despair that they can’t. Respondents did not connect that the willpower they had successfully used in other areas of their lives could be used here.

By grouping these factors that influence smoking behaviour, it is possible to further understand at what level action is needed to influence behaviour. Is it necessary to help or persuade, to demonstrate desired behaviours, to make changes to the environment or to impose restrictions?

In order to influence individuals, you have to look at what other levels of the socio-ecological system changes need to be made – local communities, municipalities or possibly legislature? Of course, communication also plays an important role alongside other actions.

What were the main conclusions you drew and the practical recommendations that came out of the study?

Although legislation has improved significantly in recent years and the environment has become more friendly to non-smokers, one of the main conclusions of the study was that

Latvia lacks a targeted support system for those who want to quit smoking. Counselling is not freely available and there is no peer support movement. This problem requires involving various specialists, not only narcologists and psychologists, but also general practitioners, gynaecologists and nutritionists.

As part of the study, we developed strategic recommendations on how to build communication. For example, it is very important to talk about recognising and overcoming withdrawal, about emotions – how to recognise them and understand that they need to be a part of the process of quitting. It is important to not only talk about the medical, but also about the social benefits of quitting smoking. Communication should also cover how to set and achieve goals, how people can use their resources and learn stress management techniques.

Communication alone is not enough, and relatives and employers should also be involved in solving the problem by creating a support system. The state needs to think more seriously about legislative changes regarding cigarette trade and financial instruments, such as increasing excise duties on cigarettes, as well as funding support groups and specialist counselling. It is important to educate professionals who can help people quit smoking, as there are few of them.