Nicotine Use in Adolescents
Theories to Compare: Health Belief Model, Transtheoretical Model, and Social Cognitive Theory
Selected theory: Health Belief Model
Why: To begin, I should first briefly break down each theory and describe how they function and what angle they come in at to target a health behavior. The Transtheoretical Model, also known as the Stages of Change Model, was developed in the late 1970s and evaluates the experiences of people breaking a bad health or lifestyle choice or habit. This theory proposes that people are at different stages of readiness to change their health behavior and it is ‘set up’ in a circular fashion, not linear (LaMorte, 2019). This is because people can regress in their habits and move forward again towards a changed behavior. The stages of this model are Precontemplation, where people are unaware of their problematic behavior and its consequences, they do not yet see the pros of changing their behavior. Next is contemplation, where one intends to make healthier choices in the future and recognize that their current habit is negative for them. Determination is when people are ready to take action soon. Action is when they are changing their behavior and intend to keep doing so. This can mean they modify their current habit or replace it with a new healthy/healthier one (LaMorte, 2019). Maintenance is when the positive behavior is sustained, and they intend to maintain this good behavior and they are making efforts to prevent relapse. Termination is when the unhealthy behavior is out the window and the person has no intention of going back. This model I believe is great when quitting a bad habit, like substance abuse or self-harm. I think a limitation to this study is that social context is not considered enough, such as what environmental factors can the person not control. This can be socioeconomic status, neighborhood, cultural norms, and support groups.
Next, the Social Cognitive Theory is a design that describes the influence of individual experiences, the actions of others, and environmental factors on individual health behaviors. It focuses on socially supporting expectations and other reinforcements to achieve behavior change. Expectations are set for the person to assign value to the outcome and regulating and monitoring individual behavior to maintain own accountability (LaMorte, 2019). Observing and modeling others displaying the correct behavior is part of the model and reinforcing the good behavior with incentives to encourage change.
The Health Belief Model is a model that explains and predicts individual changes in health behaviors and focuses on individuals’ beliefs about health conditions, which predict individual health-related behaviors (Rural Health Information Hub, 2018). Key factors that influence health behaviors are the person’s perceived threat of their behavior on their health, the consequence of the behavior, benefits of the behavior, and perceived barriers to actions and their confidence to succeed in changing behaviors.
I think the Health Belief Model is the best approach to tackle adolescent nicotine addiction, whether it be from cigarettes or vapes, because part of the model requires a pro and con approach by conveying to the population the health issues and risks related to their use. The population can be educated at school on social media, by family, and through many health campaigns like the Truth campaign, to reach the target audience and deliver the risks and consequences in a clear and unambiguous fashion to understand perceived severity. The model also aids in IDing barriers to action, which many times in this population are peer pressure and social standing. But by demonstrating actions and skill development activities to enhance self-efficacy to increase their chances of successful avoidance of nicotine use.
LaMorte, W. (2019, September 9). Behavioral change models. The Social Cognitive Theory. Retrieved March 9, 2022, from https://sphweb.bumc.bu.edu/otlt/mph-modules/sb/behavioralchangetheories/behavioralchangetheories5.html
LaMorte, W. (2019, September 9). Behavioral change models. The Transtheoretical Model (Stages of Change). Retrieved March 9, 2022, from https://sphweb.bumc.bu.edu/otlt/mph-modules/sb/behavioralchangetheories/behavioralchangetheories6.html
Rural Health Information Hub. (2018, April 30). The health belief model – rural health promotion and disease prevention toolkit. The Health Belief Model – Rural Health Promotion and Disease Prevention Toolkit. Retrieved March 9, 2022, from https://www.ruralhealthinfo.org/toolkits/health-promotion/2/theories-and-models/health-belief
Nicotine Response Behavior
Several theories can be used to explain behavioral changes among individuals. The transtheoretical model, which DiClemente and Prochaska developed, evolved by analyzing smokers’ experiences that quit on their own compared to those that required treatment to determine why some were capable of quitting on their own and others were not. The model assumes that individuals do not change their behavior decisively or quickly; instead, it occurs through a cyclical process. The model outlines six stages that last between 30 days and six months for each stage through which a person has to go through to ultimately change behavior and adopt a positive one. Precontemplation, contemplation, action, and maintenance last six months each, while preparation lasts within 30 days. Individuals apply cognitive, evaluative, and affective processes to progress through the stages. These include raising consciousness, dramatic relief, counter-conditions, stimulus control, self-reevaluation, self and social liberation, and reinforcement and management (Prochaska, 2020).
The social cognitive theory is derived from the social learning theory, which suggests that people learn by observing others and their own experiences. The theory has three major constructs, including personal factors such as cognition and experiences with the behavior. Environmental factors such as the access to resources to drive behavioral and social support. Aspects of the behavior such as the vigor and the outcomes associated with the behavior. For individuals to successfully change their current behavior, they are required to identify the positive and negative factors from each category. Identifying the positive and the negative factors can then be manipulated to achieve the desired behavior (Schunk & DiBenedetto, 2020).
The health belief model was developed in the 1950s, and it aims to predict health behaviors for individuals based on their belief patterns concerning the illness. The model includes six constructs that influence the health behaviors, including perceived susceptibility, which define the person’s perception concerning their susceptibility to acquiring the illness, perceived severity, benefits, barriers, cue to actions, and self-efficacy. A major advantage of this model is that it was developed by researchers that worked practically involved in behavioral health, and therefore most of the constructs have face validity to care, providers. However, a significant challenge is that it does not explain behaviors due to non-health reasons, such as social acceptability behavior. The health belief model would be the most suitable for dealing with nicotine addiction among teens. Nicotine addiction can be regulated by changing teens’ beliefs towards smoking and influencing their behaviors (Luquis & Kensinger, 2019).
Luquis, R. R., & Kensinger, W. S. (2019). Applying the health belief model to assess prevention services among young adults. International Journal of Health Promotion and Education, 57(1), 37-47. https://www.tandfonline.com/doi/full/10.1080/14635240.2018.1549958?casa_token
Prochaska, J. O. (2020). Transtheoretical model of behavior change. In Encyclopedia of behavioral medicine (pp. 2266-2270). Cham: Springer International Publishing. https://link.springer.com/referenceworkentry/10.1007/978-3-030-39903-0_70?noAccess=true
Schunk, D. H., & DiBenedetto, M. K. (2020). Motivation and social cognitive theory. Contemporary Educational Psychology, 60, 101832. https://www.sciencedirect.com/science/article/abs/pii/S0361476X19304370