Application of the Theory of Planned Behavior to the Willingness to Stop Smoking - Research Paper Example

Table of Contents Table of Contents 1 List of Tables 1 Abstract 2 Introduction 2 Design of the Study 3 Data Collection 3 Research Participation and Restrictions 3 Analysis 3 Results 4 Sample Profile 4 Reliability Analysis 5 The Formulated Model 6 Model 1 6 Model 2 8 Multiple Comparisons 10 Conclusions 11 References 13 List of Tables Table 1: Descriptive Statistics 4 Table 2: Summary of Reliability Analysis 5 Table 3: Summary of Descriptive Statistics and T-test 5 Table 4: Hierarchical regression Analysis Predicting Confidence of Stopping Smoking 6 Table 5: Multiple Comparisons of Attitudes and Intentions by Country 10 Abstract This is a study carried out to examine the possibility of the application of the Theory of Planned Behavior (TPB) to the willingness to stop smoking. The participants in this research study were selected randomly from four European countries (Greece, Italy, Poland and Spain). A questionnaire was used to collect this data since it yield more information as opposed to interviews and is used as the most common data collection tool (Velicer et al. 1990). The questionnaire had parts on attitude of the participant towards smoking; whether pleasant to smoke, enjoyable, positive and whether smoking is good or bad, was recorded. Further, his/her intentions (both planned and whished were collected in addition to the probability and confidence of stopping smoking for participants from the four countries. The probability of not stopping smoking is very high for those who feel that smoking is very positive, pleasant and enjoyable despite that fact that they agree that smoking is harmful to one’s health. Introduction Planned behavior at time affects the real actions of a research participant. The Theory of Planned Behaviour is the model proposed for use in the determination of smokers’ attitude and the plans to sop smoking in the near future. According to Ajzen and Driver (1991), ones attitudes and behaviour towards a certain habit determine the future relations of the person and the habit. Quoting the example of smokers and their habits, Conner (1993) focuses on the social well-being of the person as a concrete part of the habits arguing that they have a strong bearing on the social well being of an individual. Accountability on the other hand is a very complicated variable which really contributes to the habit-person relationship since ones belief on how to handle certain situations determine future actions significantly (Dejoy and Wilson (1995); DeVellis et al. (1990); Godin et al. (1993)). Further, many other conditions exist which have been and others are being discussed and evaluated. Some of these are behaviour related where the person is evaluated by investigating his/her attitudes towards certain behaviours. For example, in this case the behaviour is smoking while the attitudes include smoking being a positive thing, smoking being pleasant, smoking being good or bad and smoking being enjoyable (Fiore (1992); Godin et al. (1992); Joreskog and Sorbom (1993); Hellman et al. (1993); Heatherton et al (1993)). The other belief to habits is included in the situation where a person is subjected to a certain condition and then observed after sometime. In this case, however as Kashima et al. (1993) puts it, leads to what is called internal validity which results from time lapse and which leads to data being collected after the participant has been influenced by other factors apart from the study factors. In such a case, the data collected is normally biased since the element of time has other factors which negatively affect them. Further, to what affects habits perceptions is control of behaviour where the person thinks that he/she is accountable and assumes to know what he/she is doing and which turns out to be a lie (Kimiecik (1992); MacKay (1994); McBride (1992); Neter et al. (1989)). In such cases, personal intentions are the evaluated to see how each individual plans to handle his/her habit and whether there are concreted plans to stop the habit now or in future. This is what this research study has been build on; using the attitudes and understanding the future persona intentions. Design of the Study This research study was done using some 500 participants from four different countries (Greece, Italy, Poland and Spain) all in Europe. The selection of the sample followed the requirements in sampling including non-biasness-equal representation which was maintained by drawing a random sample. The participants were required to respond to several attitudes towards smoking and to indicate whether they were planning or wanted to stop smoking in the near future. The attributes and probability of stopping smoking was to be used in evaluating the model. Data Collection A questionnaire was the research tool used to collect the data/information for this research study. According to Argyrous (2005), a questionnaire is a data collection tool used since it is cheap and closed questions limits the respondent to give certain answers to easily enable the researcher to analyze the data. Further, according to Punch (2005), the use of both open and closed questions is exhaustive and leads to as much information as you would have wished for. Research Participation and Restrictions Test reliability and validity is an important step in research work as it affords the whole process validity the research the required scientific rigor. According to Ajzen, I. (1988), if any research work is build on too many assumptions, then its validity and reliability are compromised. This assertion is also supported by Adams (1994) arguing that internal validity and reliability of a research work is affected by the assumption that the sample is un-biased which in many instances is not the case. In this research study, the only restriction placed was that the participant had to be a smoker. Analysis The data was entered into a computer and analyzed using SPSS. Tables are mostly used to represent the results. The following types of analysis were done; mean comparisons between groups were used to determine the difference in attitude and perceptions of the smokers per country and gender. This kind of analysis is emphasized by Brindle (2007) arguing that they show which part of the distribution sample is stronger as compared to the others and by how much and are often used to assist in determining if finer details research works are to be requested for. Multiple regressions were used to determined the significance of the explanatory variables i.e. attitudes, to the confidence and probability of quitting smoking. Results Sample Profile Table 1: Descriptive Statistics Attitude smoking - good to bad Attitude smoking - pleasant to unpleasant Attitude smoking - enjoyable to un-enjoyable Attitude smoking - positive to negative Intend Plan Want SE smoker - confidence SE smoker - probability Whole Sample All Cases 467 459 448 459 447 421 470 485 496 Mean -1.03 .91 .64 -1.41 1.83 1.83 2.45 3.68 3.52 Std. Deviation 2.174 2.105 2.021 2.030 1.666 1.674 1.225 1.945 1.934 Minimum -3 -3 -3 -3 -3 -3 -3 0 0 Maximum 3 3 3 3 3 3 3 6 6 Males Cases 267 256 264 261 263 250 269 273 278 Mean -.99 .69 .48 -1.27 1.80 1.84 2.40 3.65 3.55 Std. Deviation 2.160 2.104 2.009 2.047 1.754 1.637 1.336 1.980 1.925 Minimum -3 -3 -3 -3 -3 -3 -3 0 0 Maximum 3 3 3 3 3 3 3 6 6 Females Cases 195 198 179 192 179 167 197 207 212 Mean -1.12 1.18 .86 -1.64 1.89 1.83 2.53 3.75 3.52 Std. Deviation 2.179 2.074 2.030 1.982 1.506 1.746 1.052 1.904 1.941 Minimum -3 -3 -3 -3 -3 -3 -3 0 0 Maximum 3 3 3 3 3 3 3 6 6 Overall, the participants agreed that smoking is bad (-1.03) although the level of variations was huge at 2.174. Further, there was agreement that smoking is pleasant although not as strong (mean = .91) due to differing assertions (SD = 2.105). This trend is also manifested in the fact that smoking is enjoyable (Mean = .64). Most of the participants agree that smoking is negative and is harmful to ones health (Mean = -1.41). Smokers in the four countries gave below average ratings on the intent, plans and if they wanted to stop smoking in the next three months (Mean = 1.83, 1.83 and 2.45 respectively). In terms of gender, males agreed that smoking is bad (-0.99) although the level of variations was huge at 2.16. Further, they agreed that smoking is pleasant although not as strong (mean = .69) due to differing assertions (SD = 2.104). This trend in habit in males is also manifested in the fact that smoking is enjoyable to males (Mean = .48). Most of the male participants agree that smoking is negative and is harmful to their health (Mean = -1.27). Females agreed that smoking is bad (-1.12) although the level of variations was huge at 2.179 but their feelings on smoking being bad are stronger than males. Further, they agreed that smoking is pleasant although (mean = 1.18) and this is manifested in the fact that smoking is enjoyable to females (Mean = .86) despite the fact that smoking is negative and is harmful to their health (Mean = -1.64). Females in the four countries intent/plan/want to stop smoking in the next three months at a higher rate than their male counterparts although males lead in terms of planned stopping in future. Reliability Analysis Table 2: Summary of Reliability Analysis Item Correlation Alpha (α) Range Attitude smoking - good to bad .3616 .7741 -3 to 3 Attitude smoking - pleasant to unpleasant .4438 .7649 -3 to 3 Attitude smoking - enjoyable to un-enjoyable .4024 .7709 -3 to 3 Attitude smoking - positive to negative .3814 .7701 -3 to 3 Intend .5225 .7540 -3 to 3 Plan .5064 .7579 -3 to 3 Want .4561 .7673 -3 to 3 SE smoker - confidence .5603 .7459 0 to 6 SE smoker - probability .5294 .7517 0 to 6 From the reliability analysis table above, all the variables; attitudes to smoking, intentions, planned stopping and wanting to stop, confidence and probability to stop smoking, are said to be reliable (not redundant) and should be used in the analysis since each has a positive contribution to the whole study. This is so because, the Cronbach alpha (Alpha (α)) are less than .9 with a Test scale = .7828. Table 3: Summary of Descriptive Statistics and T-test Males Females Whole Sample T-test Mean SD Mean SD Mean SD T Significance Attitude smoking - good to bad -.99 2.16 -1.12 2.179 -1.03 2.174 .658 NS Attitude smoking - pleasant to unpleasant .69 2.104 1.18 2.074 .91 2.105 -2.48 ** Attitude smoking - enjoyable to un-enjoyable .48 2.009 .86 2.030 .64 2.021 -1.96 NS Attitude smoking - positive to negative -1.27 2.047 -1.64 1.982 -1.41 2.030 1.91 NS Intend 1.8 1.754 1.89 1.506 1.83 1.666 -.535 NS Plan 1.84 1.637 1.83 1.746 1.83 1.674 .105 NS Want 2.40 1.336 2.53 1.052 2.45 1.225 -1.13 NS SE smoker - confidence 3.65 1.980 3.75 1.904 3.68 1.945 -.566 NS SE smoker - probability 3.55 1.925 3.52 1.941 3.52 1.934 .158 NS **Significant at 5% level of significance and NS=Not significant Running t-test to test the difference in means of the variables for males and females yield the results shown above. From table 3, it is evident that the mean difference of the following variables; attitude of smoking being bad or good, smoking being pleasant or un-pleasant, smoking being positive or negative, intend to stop smoking, planned stop to smoking, wanting to stop smoking, smoker confidence and probability of stopping smoking are not significant at 5% level of significance. However, the attitude of smoking being enjoyable is significant at 5% level of significance. The Formulated Model Table 4: Hierarchical regression Analysis Predicting Confidence of Stopping Smoking Model R2 R2 (Adjusted) B SEB T-value Significance Model 1 Attitude smoking – good to bad .349 .335 -.118 .056 -2.088 .038 (**) Attitude smoking – pleasant to unpleasant -.008 .054 -.143 .886 (NS) Attitude smoking – enjoyable to un-enjoyable -.021 .054 -.387 .699 (NS) Attitude smoking – positive to negative .108 .062 1.755 .080 (NS) Intend .332 .080 4.162 .000 (*) Plan .266 .081 3.299 .001 (*) Want .224 .085 2.642 .009 (*) Model 2 Attitude smoking – good to bad .351 .336 -.117 .056 -2.074 .039 (**) Attitude smoking – pleasant to unpleasant -.015 .054 -.273 .785 (NS) Attitude smoking – enjoyable to un-enjoyable -.024 .054 -.447 .655 (NS) Attitude smoking – positive to negative .117 .062 1.877 .061 (NS) Intend .328 .080 4.109 .000 (*) Plan .271 .081 3.349 .001 (*) Want .221 .085 2.603 .010 (**) Gender .191 .178 1.072 .284 (NS) **Significant at 5% level of significance, * Significant at 1% level of significance, NS=Not significant Model 1 Model 1 was estimated with the following variables; Smoking being good or bad; Smoking being pleasant Smoking being enjoyable Smoking being positive Intention to stop; Planned stop to smoking; and Confidence of stopping smoking. From the above hierarchical regression analysis table (table 4), a unit increase in the perception of smoking being good or bad leads to -.118 units decrease in the confidence of stopping smoking. Further, a unit increase in the perception of smoking being pleasant leads to -.008 units decrease in the confidence of stopping smoking. A unit increase in the perception of smoking being enjoyable leads to -.021 units decrease in the confidence of stopping smoking. In addition, a unit increase in the perception of smoking being positive leads to .108 units increase in the confidence of stopping smoking. Further, a unit increase in the intention to stop smoking leads to .332 units increase in the confidence of stopping smoking. Also, a unit increase in planned stopping smoking leads to .226 units increase in the confidence of stopping smoking. A unit increase in wanting to stop smoking leads to .224 units increase in the confidence of stopping smoking. The regression line can be formulated as shown below; C = 2.25 – .118Att1 – .008Att2 - .021Att3 + .108Att4 + .332I + .266P + .224W……………1 (Where C = confidence to stop smoking, Atts are the attitudes, I = intent, P = Plan and W = Want) The coefficients for; Smoking being good or bad; Intention to stop; Planned stop to smoking; and Confidence of stopping smoking. Are significant at 5% level of significance while; The coefficients for; Smoking being pleasant; Smoking being enjoyable; and Smoking being positive. Are not significant at 5% level of significance This means that smoking is pleasant, enjoyable and positive can be left out in model 1 without affecting the outcome. Model 2 Model 2 was estimated with the following variables; Smoking being good or bad; Smoking being pleasant; Smoking being enjoyable; Smoking being positive; Intention to stop; Planned stop to smoking; Confidence of stopping smoking; and Gender. From the above hierarchical regression analysis table (table 4), a unit increase in the perception of smoking being good or bad leads to -.117 units decrease in the confidence of stopping smoking. Further, a unit increase in the perception of smoking being pleasant leads to -.015 units decrease in the confidence of stopping smoking. A unit increase in the perception of smoking being enjoyable leads to -.024 units decrease in the confidence of stopping smoking. In addition, a unit increase in the perception of smoking being positive leads to .117 units increase in the confidence of stopping smoking. Further, a unit increase in the intention to stop smoking leads to .328 units increase in the confidence of stopping smoking. Also, a unit increase in planned stopping smoking leads to .271 units increase in the confidence of stopping smoking. A unit increase in wanting to stop smoking leads to .221 units increase in the confidence of stopping smoking. A unit increase in gender (from male to female) leads to .191 units increase in the confidence of stopping smoking. The regression line can be formulated as shown below; C = 2.34 - .117Att1 - .015Att2 - .024Att3 + .117Att4 + .328I + .271P + .221W + .191G……………2 (Where C = confidence to stop smoking, Atts are the attitudes, I = intent, P = Plan and W = Want and G = Gender) The coefficients for; Smoking being good or bad; Intention to stop; Planned stop to smoking; and Confidence of stopping smoking. Are significant at 5% level of significance while; The coefficients for; Smoking being pleasant; Smoking being enjoyable; Smoking being positive; and Gender. Are not significant at 5% level of significance This means that smoking is pleasant, enjoyable, positive and gender can be left out in model 2 without affecting the outcome. This means also that the introduction of the variable gender has no significant effect in the model. Multiple Comparisons Table 5: Multiple Comparisons of Attitudes and Intentions by Country Dependent Variable (I) COUNTRY (J) COUNTRY Mean Difference (I-J) Std. Error Sig. 95% Confidence Interval Lower Bound Upper Bound good to bad Greece Italy -1.74(*) .253 .000 -2.24 -1.24 Poland -1.55(*) .257 .000 -2.05 -1.04 Spain .01 .264 .984 -.51 .53 Italy Greece 1.74(*) .253 .000 1.24 2.24 Poland .19 .267 .468 -.33 .72 Spain 1.75(*) .275 .000 1.21 2.29 Poland Greece 1.55(*) .257 .000 1.04 2.05 Italy -.19 .267 .468 -.72 .33 Spain 1.55(*) .278 .000 1.01 2.10 Spain Greece -.01 .264 .984 -.53 .51 Italy -1.75(*) .275 .000 -2.29 -1.21 Poland -1.55(*) .278 .000 -2.10 -1.01 pleasant to unpleasant Greece Italy -.52 .265 .052 -1.04 .00 Poland -.56(*) .265 .036 -1.08 -.04 Spain .52 .281 .066 -.03 1.07 Italy Greece .52 .265 .052 .00 1.04 Poland -.04 .268 .876 -.57 .49 Spain 1.03(*) .284 .000 .48 1.59 Poland Greece .56(*) .265 .036 .04 1.08 Italy .04 .268 .876 -.49 .57 Spain 1.08(*) .284 .000 .52 1.63 Spain Greece -.52 .281 .066 -1.07 .03 Italy -1.03(*) .284 .000 -1.59 -.48 Poland -1.08(*) .284 .000 -1.63 -.52 enjoyable to un-enjoyable Greece Italy 1.23(*) .235 .000 .77 1.69 Poland .71(*) .243 .004 .23 1.19 Spain 2.21(*) .252 .000 1.72 2.70 Italy Greece -1.23(*) .235 .000 -1.69 -.77 Poland -.52(*) .252 .040 -1.01 -.02 Spain .98(*) .261 .000 .47 1.49 Poland Greece -.71(*) .243 .004 -1.19 -.23 Italy .52(*) .252 .040 .02 1.01 Spain 1.50(*) .268 .000 .97 2.03 Spain Greece -2.21(*) .252 .000 -2.70 -1.72 Italy -.98(*) .261 .000 -1.49 -.47 Poland -1.50(*) .268 .000 -2.03 -.97 positive to negative Greece Italy -.55(*) .253 .032 -1.04 -.05 Poland -.40 .256 .117 -.90 .10 Spain .45 .267 .096 -.08 .97 Italy Greece .55(*) .253 .032 .05 1.04 Poland .14 .266 .588 -.38 .67 Spain .99(*) .277 .000 .45 1.54 Poland Greece .40 .256 .117 -.10 .90 Italy -.14 .266 .588 -.67 .38 Spain .85(*) .279 .003 .30 1.40 Spain Greece -.45 .267 .096 -.97 .08 Italy -.99(*) .277 .000 -1.54 -.45 Poland -.85(*) .279 .003 -1.40 -.30 SE smoker - confidence Greece Italy .48(*) .238 .043 .02 .95 Poland -.30 .238 .205 -.77 .17 Spain .29 .252 .255 -.21 .78 Italy Greece -.48(*) .238 .043 -.95 -.02 Poland -.79(*) .247 .002 -1.27 -.30 Spain -.20 .260 .450 -.71 .31 Poland Greece .30 .238 .205 -.17 .77 Italy .79(*) .247 .002 .30 1.27 Spain .59(*) .260 .024 .08 1.10 Spain Greece -.29 .252 .255 -.78 .21 Italy .20 .260 .450 -.31 .71 Poland -.59(*) .260 .024 -1.10 -.08 * The mean difference is significant at the .05 level. In terms of comparisons of smokers from the four countries using the nine (9) variables, the results show that smokers from Italy feel that smoking is good while smokers from Spain and Greece feel that smoking is very bad. The difference in mean between smokers from Greece, Poland and Italy is significantly different at 5% level of confidence. Further, smokers from Greece feel that smoking is pleasant as compared to smokers from other countries. The mean difference of pleasantness in Poland is not significantly different from Greece but different from Italy and Spain. Again smokers from Greece agree to a great extend that smoking is enjoyable than smokers from the other countries. Most smokers in Poland intent to stop smoking in the next three months while in Spain most of them plan to stop smoking in the next three months. Smokers in Spain and Poland want to stop smoking in the next three months. In terms of confidence of stopping smoking in the next three months, Poland smokers are more confident followed by smokers in Greece and then smokers in Spain. This trend is also manifested in the probability to stop smoking. Conclusions From the above analysis, the assertions of (Newcomb et al. (1992); O’Donnell et al. (1994); Penner, M. and Penner, S. (1990)) that gender is not significant in control behaviour effects. Further, it is evident that the behaviours and intentions differ fro one country to another may be due to Conner (1993) assertions of social wellbeing. The probability of not stopping smoking is very high for those who feel that smoking is very positive, pleasant and enjoyable despite that fact that they agree that smoking is harmful to one’s health. Clearly form the results presented above; there is need for more research to identify underlying behaviour. References Adams, M. L. (1994). The public health impact and economic cost of smoking in Connecticut—1989. Connecticut Medicine, 58(4), 195–198. Ajzen, I. (1988). Attitude, personality, and behavior. Chicago: Dorsey. Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211. Ajzen, I., & Driver, B. L. (1991). Prediction of leisure participation from behavioral, normative, and control belief: An application of the theory of planned behavior. Leisure Science, 13(3), 185–204. Ajzen, I., & Driver, B. L. (1992). Application of the theory of planned behavior to leisure choice. Journal of Leisure Research, 24(3), 207–224. Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall. Conner, M. T. (1993). Pros and cons of social cognition models in health behavior. Health Psychology Update, 14, 24–31. Dejoy, D. M., & Wilson, M. G. (1995). Critical issues in worksite health promotion. Boston: Allyn & Bacon. DeVellis, B. C., Blalock, S. J., & Sandler, R. S. (1990). Predicting participation in cancer screening: The role of perceived behavior control. Journal of Applied Social Psychology, 20(8), 639–660. Godin, G. (1993). The theories of reasoned action and planned behavior: Overview of findings, emerging research problems and usefulness for exercise promotion. Journal of Applied Sport Psychology, 5, 141–157. Godin, G., Valois, P., & Lepage, L. (1993). The pattern of influence of perceived behavioral control upon Planned behavior and smoking cessation 237 exercising behavior: An application of Ajzen’s theory of planned behavior. Journal of Behavioral Medicine, 16(1), 81–102. Godin, G., Valois, P., Lepage, L., & Desharnais, R. (1992). Predictors of smoking behavior: An application of Ajzen’s theory of planned behavior. British Journal of Addiction, 87, 1335–1343. Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The Fagerstrom test for nicotine dependence: A revision of the Fagerstrom tolerance questionnaire. British Journal of Addiction, 86, 1119–1127. Hellman, R., Cummings, K. M., Haughey, B. P., Zielenzy, M. A., & Shea, R. M. O. (1991). Predictors of attempting and succeeding at smoking cessation. Health Education Research, 6(1), 77–86. Joreskog, K., & Sorbom, D. (1993). LISREL 8: Structural equation modeling with the SIMPLIS command language. Hillsdale, NJ: Erlbaum. Liska, A. E. (1984). A critical examination of the causal structure of the Fishbein/Ajzen attitude-behavior model. Social Psychology Quarterly, 47(1), 61–74. MacKay, J. L. (1994). The fight against tobacco in developing countries. Tubercle and Lung Diseases, 75, 8–24. Neter, J., Wasserman, W., & Kutner, M. H. (1989). Applied linear regression models. Irwin. Newcomb, P. A., & Carbone, P. P. (1992). The health consequences of smoking: Cancer. The Medical Clinics of North America, 76(2), 305–331. O’Donnell, M. P., & Harris, J. S. (1994). Health promotion in the workplace. Albany, NY: Delmar. Argyrous, G. (2005). Statistics for Research: With a Guide to SPSS. 2nd ed. London: Sage. Bryman, A. (2008). Social Research Methods. 3rd ed. Oxford: Oxford University Press. Green, S.B. & Salkind, N.J. (2008). Using SPSS for Windows and Macintosh: Analyzing and Understanding Data. Pearson international ed., 5th ed. London: Pearson Prentice Hall. Punch, K. (2005). Introduction to Social Research: Quantitative and Qualitative Approaches. 2nd ed. London: Sage. Read More