The Gap Between Attitudes and Use in Prediction of Effect of an Online Smoking Cessation Program

Abstract

This article describes an investigation of the effect of attitude toward and use of different components of an online smoking cessation program on stage transition based on the Transtheoretical Model. Participants were 299 users of the StopSmokingCoach, an online smoking cessation program, who completed an online questionnaire concerning their attitudes toward the program and its components within 6 months after registration. These attitude measurements and participants’ actual use of the program components were linked to stage transitions of these users. Attitudes toward the StopSmokingCoach and its components were positive; however, only one of these attitude measurements (instructiveness of e-mail tips) predicted actual stage transitions. In contrast, frequency/intensity of use of the coach and 3 of its components (advices, forum, and personal charts, but not the diary, tips, or decisional balance) was significantly related to stage transitions. These results suggest that users do not need to have positive attitudes toward a health program in order to achieve behavioral change. Use of some, but not all program components appears to be more important.

Notes

¹Although the TTM uses a criterion of 6 months smoking abstinence to move from the action to the maintenance stage, this criterion is arbitrary (Brug et al., 2005). The modification of this criterion in the StopSmokingCoach was based on the clinical experience of the founder of the program in helping people to quit smoking, showing people who just stopped smoking (action phase) were in need of short term, day-to-day help to go through this acute phase; while after a few weeks, help could be focused more on a long-term, smoke-free lifestyle. These modifications do need to be kept in mind when comparing our findings with other TTM-based studies.

***p < .001. **p < .01. *p < .05.