Using the Theory of Planned Behavior to Assess Intention to Quit Tobacco

Theoretical Background and research questions/hypothesis:  Media communication campaigns are one of the primary means used to encourage the cessation of tobacco use. There is consensus that the effectiveness of such campaigns improves if the campaign is tailored to a target audience. To operationalize the objective of tailored campaigns, segmentation strategies have been proposed that seek to identify key variables that play an important role in informing intention to quit tobacco. The logic behind segmentation is that the more homogeneous the identified target segment, the more likely it is that a single campaign message will be similarly responded to by the majority of the particular segment. One way for health professionals to identify these key variables is through behavior change theories. Behavior change theories seek to explain people’s behavior by describing the relationships between a limited number of psycho-social determinants of the behavior and intention to perform the behavior. One prominent behavior change theory, the theory of planned behavior, postulates that attitudes, social norms and perceived behavioral control are the most important determinants of intention to perform a behavior, which, in turn, should be the most immediate determinant of behavior. The theory suggests that identifying these key determinants can help campaign professionals tailor media content to best reach the target audience. The present research uses a modified version of the theory of planned behavior to assess key determinants of intention to quit tobacco. Furthermore, the research operationalizes social norms as two distinct constructs—“personal” norms and “societal” norms. In using the modified version of the theory of planned behavior, the research aims to both add to the academic literature and demonstrate how theory can be used to effectively evaluate professional health campaigns and inform future campaign content.  RQ1:  What is the relationship between exposure to a statewide tobacco control media campaign and attitudes, social norms and self-efficacy? RQ2: What is the relationship between attitudes, social norms and self-efficacy and intention to quit using tobacco? 

Methods and Results (informing the conceptual analysis):  Data was collected through Knowledge Networks as part of an ongoing, multi-wave evaluation of ClearWay Minnesota^SM’s tobacco control media campaign. This large-scale campaign features television ads that highlight the negative consequences of smoking, and encourages people to quit. Structural equation modeling was used to identify and quantify the relationships. Results suggest that exposure to the campaign was positively associated with both personal (β=.33) and societal norms (β=.17) and attitudes about quitting tobacco (β=.29). Furthermore, personal norms (β=.42) was most strongly associated with intention to quit tobacco. 

Conclusions:  Results suggest that 1) exposure to the campaign may have impacted key variables associated with intention to quit tobacco and 2) campaign messages targeting personal norms would likely have the greatest impact on changing intention to quit. 

Implications for research and/or practice:  The present research demonstrates how health practitioners can use behavior change theory as a tool for evaluating the impact of a media campaign, and importantly, crafting future media content in a way that will be most impactful on the target audience.