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Cited by 76Smoking Behavior and CessationBehavioral Health and InterventionsSubstance Abuse Treatment and Outcomes

Effectiveness and cost-effectiveness of repeated implementation intention formation on adolescent smoking initiation: A cluster randomized controlled trial.

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Conner, Mark, Grogan, Sarah, West, Robert, Simms-Ellis, Ruth, Scholtens, Keira, Sykes-Muskett, Bianca, Cowap, Lisa, Lawton, Rebecca +5 more·2019·Journal of Consulting and Clinical Psychology
DOI 10.1037/ccp0000387PMC PMC6474716
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Abstract

OBJECTIVE: Forming implementation intentions (if-then plans) about how to refuse cigarette offers plus antismoking messages was tested for reducing adolescent smoking. METHOD: Cluster randomized controlled trial with schools randomized (1:1) to receive implementation intention intervention and messages targeting not smoking (intervention) or completing homework (control). Adolescents (11-12 years at baseline) formed implementation intentions and read messages on 8 occasions over 4 years meaning masking treatment allocation was not possible. Outcomes were: follow-up (48 months) ever smoking, any smoking in last 30 days, regular smoking, and breath carbon monoxide levels. Analyses excluded baseline ever smokers, controlled for clustering by schools and examined effects of controlling for demographic variables. Economic evaluation (incremental cost effectiveness ratio; ICER) was conducted. Trial is registered (ISRCTN27596806). RESULTS: = .016) in intervention (29.3%) compared with control (35.8%) and remained so controlling for demographics. Similar patterns observed for any smoking in last 30 days. Less consistent effects were observed for regular smoking and breath carbon monoxide levels. Economic analysis yielded an ICER of $134 per ever smoker avoided at age 15-16 years. CONCLUSIONS: This pragmatic trial supports the use of repeated implementation intentions about how to refuse the offer of a cigarette plus antismoking messages as an effective and cost-effective intervention to reduce smoking initiation in adolescents. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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  • In studies with the longest follow-up periods, the intervention was typically reinforced through repeated sessions, which likely contributed to the sustained effects.

    “Second, in studies with the longest follow‐up periods, the intervention was typically reinforced through repeated sessions (e.g. Conner et al., 2019; Conner & Higgins, 2010), which likely contributed to the sustained effects.”

    From The effectiveness of implementation intentions in children: A systematic review and meta‐analysis (2026) · cites this paper as Conner et al., 2019

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Cited by

Sorted by citations

Authors
Conner, M., Grogan, S., West, R., Simms-Ellis, R., Scholtens, K., Sykes-Muskett, B., Cowap, L., Lawton, R., Armitage, C. J., Meads, D., Schmitt, L., Torgerson, C., & Siddiqi, K.
Affiliations
  • University of Manchester (GB)
  • Durham University (GB)
Corresponding author
Conner, Mark
ORCID
Venue
Journal of Consulting and Clinical Psychology
Publisher
American Psychological Association (APA)
Published
2019-05
Volume
87
Issue
5
Pages
422-432
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
DOI
10.1037/ccp0000387
PMC
PMC6474716
OpenAlex
W2921262281
Cited by
76
References
8
Citations by year
2026: 3 · 2025: 5 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 7 · 2020: 51 · 2019: 4 · 2017: 1
FWCI
10.55
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Consulting and Clinical Psychology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • Durham Research Online (Durham University) (acceptedVersion, cc-by)
  • Staffordshire Online Repository (Staffordshire University) (acceptedVersion)
  • e-space (Manchester Metropolitan University) (submittedVersion)
  • Durham Research Online (Durham University) (submittedVersion, cc-by)
  • Figshare (submittedVersion, cc-by)
  • Research Explorer (The University of Manchester) (submittedVersion, cc-by)
Funders
  • Medical Research Council (MR/J000264/1)
  • National Institute for Health Research
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
implementation intentions, adolescent smoking initiation, smoking prevention, anti-smoking messages, cost-effectiveness, school-based intervention, breath carbon monoxide
MeSH terms
Smoking Prevention, Adolescent, Adolescent Behavior, Child, Cost-Benefit Analysis, Female, Follow-Up Studies, Humans, Male, Smoking, Outcome Assessment, Health Care, Intention

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