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Type: Thesis
Title: Smoking Cessation Among Emerging Adults: Integrating and Expanding on Social Norms as Barriers and Facilitators of Behaviour Change
Author: Dono, Joanne
Issue Date: 2020
School/Discipline: School of Psychology
Abstract: Existing evidence-based smoking cessation strategies, which are efficacious for longer-term smokers, have low uptake among less experienced young adult smokers (Suls et al., 2012). Emerging adults (i.e., 18 to 25 year olds who are transitioning from adolescence into adulthood; Arnett, 2000) value social relationships highly, and social groups provide acceptance and belonging during a time of identity formation (Arnett, 2000; Erikson, 1968). Research confirms that having friends who smoke in early adulthood is linked to consolidation of smoking behaviour and can be a barrier to quitting (Hammond, 2005; Kobus, 2003; Tucker, Ellickson, & Klein, 2003). Moreover, young adult smokers living in countries with advanced tobacco control environments have evaded smoking prevention interventions and continue to smoke despite societal beliefs that smoking is culturally unacceptable. Therefore, it is important to understand how smoking cessation in emerging adulthood may be influenced by the attitudes and behaviours of others. The research reported in this dissertation aims to integrate and expand on the current understanding of the relationship between social norms and smoking cessation among emerging adults and to apply that knowledge to two contrasting smoking cessation strategies: e-cigarettes and anti-smoking mass media campaigns. Study 1 (focus groups) explored how social identity and normative group behaviours in social situations could be obstacles for quitting among emerging adults. The results showed that emerging adults were concerned with, and had difficulty managing, potential changes in social situations that could arise from quitting smoking. Moreover, the absence of quitting norms made it difficult to transition to a non-smoking identity. Study 2 (focus groups) explored perceptions of e-cigarettes as a potential smoking cessation strategy using a social norm perspective. The results showed that, beyond some initial curiosity, e-cigarettes held little appeal for the participants in this study. Furthermore, participants expressed concern that they would be negatively perceived by others when using an e-cigarette. Consequently, e-cigarettes were potentially more likely to undermine than to facilitate the development of smoking cessation norms. Study 3 (systematic scoping review) explored the role of social norms in the context of anti-smoking mass media campaigns. The results showed that the likelihood of smoking cessation increased following exposure to messages that conveyed disapproval of smoking by others. However, the role of quitting/non-smoking descriptive norms (i.e., what is commonly done when quitting) was rarely examined. Study 4 (cross-sectional online questionnaire) hypothesised that descriptive non-smoking norms would increase self-efficacy to resist smoking in social settings through its relationship with smoking-related social identities. The hypothesis was partially supported; the relationship between descriptive non-smoking norms and self-efficacy was mediated by ‘ex-smoker’ but not ‘attempting quitter’ social identity. Testing an alternative hypothesis revealed that ‘attempting quitter’ social identity was indirectly related to self-efficacy through higher descriptive non-smoking norms, especially when descriptive smoking norms were also high. The results described in this dissertation highlight the complexity of managing social environments when quitting smoking and that the transition from smoker to non-smoker is not straightforward and is context dependent. Acknowledging the importance of others in the smoking cessation process may enhance existing intervention strategies.
Advisor: Wilson, Carlene
Miller, Caroline
Ettridge, Kerry
Dissertation Note: Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2020
Keywords: Smoking cessation
emerging adults
social norms
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