Background: Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. While hundreds of interventions addressing the clustering of smoking and other modifiable risk behaviours have been conducted worldwide, there is insufficient information available about the context and mechanisms in these interventions that promote successful smoking cessation. The aim of this rapid realist review was to identify possible contexts and mechanisms used in multiple health behaviour change interventions (targeting tobacco and two or more additional risk behaviours) that are associated with improving smoking cessation outcome.
Methods: This realist review method incorporated the following steps: (1) clarifying the scope, (2) searching for relevant evidence, (3) relevance confirmation, data extraction, and quality assessment, (4) data analysis and synthesis.
Results: Of the 20,423 articles screened, 138 articles were included in this realist review. Following Michie et al.’s behavior change model (the COM-B model), capability, opportunity, and motivation were used to identify the mechanisms of behaviour change. Universally, increasing opportunities (i.e. factors that lie outside the individual that prompt the behaviour or make it possible) for participants to engage in healthy behaviours was associated with smoking cessation success. However, increasing participant’s capability or motivation to make a behaviour change was only successful within certain contexts.
Conclusion: In order to address multiple health behaviours and assist individuals in quitting smoking, public health promotion interventions need to shift away from ‘individualistic epidemiology’ and invest resources into modifying factors that are external from the individual (i.e. creating a supportive environment).
Study registration: PROSPERO registration number: CRD42017064430
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Posted 01 Jun, 2020
On 22 May, 2020
On 20 May, 2020
Received 11 May, 2020
On 01 Apr, 2020
On 01 Apr, 2020
Received 01 Apr, 2020
Invitations sent on 27 Mar, 2020
On 23 Mar, 2020
On 22 Mar, 2020
On 22 Mar, 2020
On 12 Mar, 2020
Received 11 Mar, 2020
Received 02 Mar, 2020
On 17 Feb, 2020
On 14 Feb, 2020
Invitations sent on 12 Feb, 2020
On 06 Feb, 2020
On 05 Feb, 2020
On 05 Feb, 2020
Posted 01 Jun, 2020
On 22 May, 2020
On 20 May, 2020
Received 11 May, 2020
On 01 Apr, 2020
On 01 Apr, 2020
Received 01 Apr, 2020
Invitations sent on 27 Mar, 2020
On 23 Mar, 2020
On 22 Mar, 2020
On 22 Mar, 2020
On 12 Mar, 2020
Received 11 Mar, 2020
Received 02 Mar, 2020
On 17 Feb, 2020
On 14 Feb, 2020
Invitations sent on 12 Feb, 2020
On 06 Feb, 2020
On 05 Feb, 2020
On 05 Feb, 2020
Background: Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. While hundreds of interventions addressing the clustering of smoking and other modifiable risk behaviours have been conducted worldwide, there is insufficient information available about the context and mechanisms in these interventions that promote successful smoking cessation. The aim of this rapid realist review was to identify possible contexts and mechanisms used in multiple health behaviour change interventions (targeting tobacco and two or more additional risk behaviours) that are associated with improving smoking cessation outcome.
Methods: This realist review method incorporated the following steps: (1) clarifying the scope, (2) searching for relevant evidence, (3) relevance confirmation, data extraction, and quality assessment, (4) data analysis and synthesis.
Results: Of the 20,423 articles screened, 138 articles were included in this realist review. Following Michie et al.’s behavior change model (the COM-B model), capability, opportunity, and motivation were used to identify the mechanisms of behaviour change. Universally, increasing opportunities (i.e. factors that lie outside the individual that prompt the behaviour or make it possible) for participants to engage in healthy behaviours was associated with smoking cessation success. However, increasing participant’s capability or motivation to make a behaviour change was only successful within certain contexts.
Conclusion: In order to address multiple health behaviours and assist individuals in quitting smoking, public health promotion interventions need to shift away from ‘individualistic epidemiology’ and invest resources into modifying factors that are external from the individual (i.e. creating a supportive environment).
Study registration: PROSPERO registration number: CRD42017064430
Figure 1
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