Skip to main content

Table 1 Protocol-specified behaviours classified into behaviour change techniques

From: Assessing the fidelity of delivery of an intervention to increase attendance at the English Stop Smoking Services

Behaviour change techniquea Description Component behaviours in taster session manual (n = 73)
Give information on stop-smoking medication Explain the benefits of medication, safety, potential side effects, contraindications, how to use them most effectively and how to get them; advise on the most appropriate medication for the smoker and promote effective use 1. Use of medication is an important part of quitting
2. Nicotine deprivation may lead to withdrawal symptoms
3. Medication available to reduce cravings while adjusting to not smoking
4. How NRT works
5. Types of NRT available
6. Zyban and Champix and how they can help reduce desire to smoke
Boost motivation and self-efficacy Give encouragement and bolster confidence in ability to stop 1. Congratulates attendees on coming to the session
2. Attending session suggests motivation to quit
3. This an important step in process of quitting
4. Positives of this, being something to prepare for
5. Good way of proving that attendees are doing something good for their health
Build general rapport/emphasise empathy of SSS advisors Establish a positive, friendly and professional relationship with the smoker and foster a sense that the smoker’s experiences are understood 1. Introduces self and describes personal background
2. Explains understanding of SSS advisors that smoking is something attendees enjoy
3. Support in event of ‘slip up’
4. SSS can help work out cause of slip up and work out strategies for avoiding future occurrences
5. Recap; thank attendees for attending
Elicit and answer questions Prompt questions from the smoker and answer clearly and accurately 1. Asks for questions
Elicit client views Prompt the client to give views on smoking, smoking cessation and any aspects of the behavioural support programme 1. Encourages participation
2. Encourages attendee participation
3. Encourages participation on withdrawal symptoms
Emphasise choice Emphasise client choice within the bounds of evidence based practice 1. Making decision in first session after weighing up pros and cons
2. Emphasises that they will not be told to quit
Explain expectations regarding treatment Explain to the smoker the treatment programme, what it involves, the active ingredients and what it requires of the smoker 1. SSS supports smokers to stop smoking completely, not to cut down
2. First session as preparation for stopping smoking
3. First session involves discussion of reasons for and against smoking
4. Setting of quit date will be encouraged during first few sessions
5. Emphasises that weekly contact is extremely important
6. Explains that this is why weekly contact is so important
Explain purpose of CO monitoring Explain to the smoker the reasons for measuring CO at different time points, e.g. before and after the quit date 1. Introduces test for CO present in body
2. Explains its use in SSS courses
3. Mentions that it will be possible to compare this reading to one they have later at SSS after they quit
Explain the importance of abrupt cessation Explain why it is better to stop abruptly rather than cut down gradually if at all possible 1. Not a single puff rule and its effectiveness
Give options for support with the SSS Give information about options for additional support where these are available (e.g. websites, self-help groups, telephone helpline) 1. How many sessions in a course
2. Courses can be run by SS advisor or practice nurse
3. Minimum number of sessions following quit date
4. Gives detail on length of sessions
Identify reasons for wanting and not wanting to stop smoking Help the smoker to arrive at a clear understanding of his or her feelings about stopping smoking, why it is important to stop and any conflicting motivations 1. Asks attendees how many of them enjoy smoking
2. Identify reasons for wanting and not wanting to stop smoking
3. Asks attendees why they are considering quitting smoking
Measure CO Measure expired-air carbon monoxide concentration 1. Offers attendees opportunity to have CO levels read
2. Encourages all attendees to have reading taken
Provide info on consequences of smoking and smoking cessation Give, or make more salient, information about the harm caused by smoking and the benefits of stopping; distinguish between the harms from smoking and nicotine; debunk myths about low tar and own-roll cigarettes and cutting down 1. Short-term benefits of quitting
2. Long-term benefits of quitting
3. Explains CO is a poisonous gas contained in cigarette smoke
4. Explains nature of toxicity of CO
5. Good news that levels of CO drop very quickly once they stop smoking
6. Immediately improves circulation and chance of any related health problems
Provide info on withdrawal symptoms Describe to smokers what are, and are not, nicotine withdrawal symptoms, how common they are, how long they typically last, what causes them and what can be done to alleviate them 1. Asks attendees for any common withdrawal symptoms
2. Mentions common symptoms if none are suggested by attendees (e.g. stress/anger/lower concentration/increased appetite)
3. Emphasises that not everyone will experience these symptoms
Summarise information/confirm client decisions Provide a summary of information exchanged and establish a clear confirmation of decisions made and commitments entered into 1. Recap-Mention that there are benefits to quitting in both long and short term
2. Recap-Mention that attending a course will make it four times more likely that they will have a successful quit attempt
3. Recap-Mention the courses will help develop strategies to avoid smoking
4. Recap-Mention they will also receive information on available medications
5. Recap-Remind attendees to complete an evaluation form and return it to an advisor
6. Recap-Emphasise that immediate sign up to a SSS course is possible
Importance of behaviour changeb Detail the role habits play in smoking and emphasise the help the SSS can provide in breaking the associations between smoking and situational triggers 1. Explains habitual nature of smoking
2. Trigger points
3. Importance of developing strategies to break the association between these trigger points and smoking
4. SSS support of behaviour change
5. Emphasises medication not being miracle cure and behaviour change is also needed
Promote SSSb Detail the success rates of the SSS and explain how SSS advisors can help smokers stop smoking and remain quit in the long term 1. Explains SSS is based on well-researched evidence
2. Attending an SSS course has been proven to be the best way to help people quit
3. Services are free
4. Those attending course are four times more likely to stop and stay stopped than those who try and quit on their own
5. Remaining sessions are for support
6. Help in developing strategies to avoid smoking is key aspect of SSS course
7. Able to find out more about NRT at SSS
8. Advisors can aid in choosing between different forms of NRT
9. Able to find out more about these medications from SSS
10. Support available from SSS advisors in this process
11. Mentions potential sign up
12. Shows DVD to attendees
  1. aFrom Michie et al. [15]
  2. bNovel BCTs not derived from Michie et al. [15]