1. Smoking cessation in cardiac patients: the influence of action and coping plans and self-efficacy Natascha de Hoog¹, Catherine Bolman¹, Nadine Berndt¹,², Esther Kers¹, Aart Mudde¹, Hein de Vries³, Lilian Lechner¹ ¹Department of Health Psychology, Open University of the Netherlands; ²Cellule d’Expertise Médicale, Ministère de la Sécurité, Luxembourg; ³Department of Health Promotion, Maastricht University

2. Open University?

3. Background Smoking is bad for you…
Smoking cessation most effective action cardiac patients
More than half cardiac patients continue to smoke

4. Background Cardiac patients very motivated to quit… …at the hospital
Intention – behavior gap
quitting is hard
determination: I can do this
planning: How I will do this

5. Background determination: Self-efficacy: I can quit smoking
Relapse self-efficacy: I can continue to quit smoking if I relapse
planning:
Action planning: plans how to quit smoking succesfully
Coping planning: plans what to do to continue smoking cessation

6. Theoretical model Action and coping plans Intention Smoking cessation
(Relapse) self-efficacy

7. Research design Usual Care (N=234) Usual Care (N=184)
8 (cardiac-) nursing units
625 patients
TC + NRT (N=223)
TC + NRT (N=170)
FC + NRT (N=157)
FC + NRT (N=123)
Recruting units and Baseline months
patients (Questionnaire) (Phone interview) 7 7

8. Questionnaire Baseline:
Self-efficacy  “Will you be able to continue to quit smoking if..”
Relapse self-efficacy  “Will you be able to continue to quit smoking if you were to light a cigarette..”
Intention  “How strong is your intention to quit smoking..”
Action plans  “Do you plan to…remove ashtrays from the house?”
Coping plans ”I will make plans what to do to not take up smoking again if…”
6 month follow-up:
Continued abstinence  smoking cessation > 5 months

9. Results M (SD) N (%) Baseline Age 58 (11) Gender (Male) 174 (74)
Cigarettes a day
20 (10)
Intention
3.77 (1.15)
Self-efficacy
2.70 (.88)
Relapse self-efficacy
2.35 (1.20)
Action plans
2.31 (.84)
Coping plans
2.22 (1.19)
6 months follow-up
Continued abstinence
57 (31)

10. Action plans
β = -.43, p = .03

11. Coping plans
β = .92, p = .02

12. Predicting intention β t p Self-efficacy .52*** 9.18 .00
Relapse self-efficacy
-.02
-.27
.79
R² = .36***
*** p < .001, ** p < .01, * p < .05.

13. Predicting smoking cessationβ
Self-efficacy
.18
Relapse self-efficacy
.29
Intention
.70**
Action plans
.47*
Coping plans
-.24
AP * intention
.24
CP * intention
.01
Nagelkerke R² = .31
( .58**)
*** p < .001, ** p < .01, * p < .05.

14. Results based model Action and coping plans Intention
Smoking cessation
(Relapse) self-efficacy

15. Results based model Action and coping plans Intention
Smoking cessation
(Relapse) self-efficacy

16. Results based model Action and coping plans Intention
Smoking cessation
Self-efficacy

17. Results based model Action and coping plans Intention
Smoking cessation
Self-efficacy

18. Results based model Action plans Intention Smoking cessation
Self-efficacy

19. Discussion Discussion Action and coping plans:
What exactly is important?
How does it influence smoking cessation?
What about that intention-behavior gap for cardiac patients?

20. Thanks for your attention! Any questions?
@Ndehoog