The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence
Open accessAbstract
BACKGROUND: The Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence (Fiore et al. 2000) recommends supporting autonomy and perceived competence to facilitate tobacco abstinence. PURPOSE: The aim of the study was to evaluate the effectiveness of an intensive tobacco-dependence intervention based on self-determination theory (SDT) and intended to support autonomy and perceived competence in facilitating long-term tobacco abstinence. METHODS: One thousand and six adult smokers were recruited into a randomized cessation-induction trial. Community care participants received cessation pamphlets and information on local treatment programs. Intervention participants received the same materials and were asked to meet four times with counselors over 6 months to discuss their health in a manner intended to support autonomy and perceived competence. The primary outcome was 24-month prolonged abstinence from tobacco. The secondary outcome was 7-day point prevalence tobacco abstinence at 24 months postintervention. RESULTS: Smokers in the intervention were more likely to attain both tobacco abstinence outcomes and these effects were partially mediated by change in both autonomous self-regulation and perceived competence from baseline to 6 months. Structural equation modeling confirmed the SDT model of health-behavior change in facilitating long-term tobacco abstinence. CONCLUSIONS: An intervention based on SDT and consistent with the PHS Guideline, which was intended to support autonomy and perceived competence, facilitated long-term tobacco abstinence.
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The instruments described have been used to assess to what extent a medical professional, healthcare intervention, or a procedure supports autonomy.
“The instruments described herein have been used in various contexts, for example to assess to what extent a medical professional (Williams et al., 2009), healthcare intervention (Williams et al., 2011; Teixeira et al., 2012) or a procedure (Ng et al., 2012) supports autonomy.”
From Designing for Motivation, Engagement and Wellbeing in Digital Experience (2018) · cites this paper as Williams et al., 2009
The citation to Williams et al. (2009) is attached to the medical-professional example. The Method > Measures section describes questionnaires assessing smokers’ autonomous reasons and perceived competence, not an instrument assessing how much autonomy support a medical professional provides. Searches for a provider-autonomy-support scale or assessment found no such use in our copy; page numbers were unavailable. (LLM, conf=0.72)
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- Authors
- Williams, G. C., Niemiec, C. P., Patrick, H., Ryan, R. M., & Deci, E. L.
- Affiliations
- University of Rochester Medicine (US)
- University of Rochester (US)
- Corresponding author
- Williams, Geoffrey C.
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-04-17
- Volume
- 37
- Issue
- 3
- Pages
- 315-324
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- PMC
- PMC2819097
- OpenAlex
- W2124904904
- Cited by
- 201
- References
- 37
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 11 · 2023: 5 · 2022: 17 · 2021: 7 · 2020: 14 · 2019: 12 · 2018: 13 · 2017: 15 · 2016: 25 · 2015: 9 · 2014: 17 · 2013: 16 · 2012: 14
- FWCI
- 7.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01-MH59594, R01MH059594)
- National Cancer Institute (R01CA106668)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- smoking abstinence, smoking cessation, self-determination theory, autonomy support, perceived competence, tobacco dependence, health behavior change
- MeSH terms
- Adult, Humans, Psychological Theory, Psychotherapy, Tobacco Use Disorder, Mental Competency, Treatment Outcome, Practice Guidelines as Topic, Tobacco Use Cessation, Personal Autonomy
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