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SCHOOL OF PSYCHOLOGY QUEEN'S UNIVERSITY BELFAST NAME: RUTH CARVILLE STUDENT NO.: 12542024 MODULE NAME: HEALTH PSYCHOLOGY MODULE CODE: 110PSY TITLE: THE SMOKING BEHAVIOUR OF A 19YR OLD FEMALE PSYCHOLOGY STUDENT: A CASE STUDY DATE: 15/11/04 "X" is a 19 year old female psychology student. She smokes between 15 and 20 cigarettes a day, and more if she goes out to a bar or nightclub. She has been smoking since the age of 14 and admits she started due to peer pressure from friends. As she hides her smoking from her family, her smoking has increased now that she has moved out of the family home, and this may also be due to the fact that she currently lives with three other smokers. She has tried to quit several times, but finds that it makes her more irritable and anxious. She is fully aware of the health risks, as several members of her family have died of, or are currently suffering from smoking-related diseases, but she says she enjoys smoking, and has tried to quit only due to pressure from non-smoking friends. The reason why she believes she smokes so much is mainly boredom between classes, or watching TV in the evenings, and is afraid that quitting smoking will lead her to replace cigarettes with junk food, leading to weight gain and lower self-esteem. She admits that she leads an unhealthy lifestyle, but says she lacks the motivation to change, as she enjoys smoking and has no obvious physical health problems at the minute. ...read more.


the effectiveness of the outcome of the behaviour). Feeding into these factors are environmental and interpersonal variables. Severity and susceptibility combine into appraisal of threat, and self-efficacy and response effectiveness feed into coping appraisal. In an attempt to incorporate an emotional component, Rogers has included fear in the appraisal of threat. Despite this, it has been criticised in many of the same ways as the HBM, for example, reliance on the individual without consideration of social pressures. The most recent model to be proposed is that of Schwarzer (1992); the Health Action Process Approach. It has two main stages: the motivation stage (determined by self-efficacy, outcome expectancies and threat appraisal) and the action stage (cognitive/volitional processes of action plans and action control, and situational factors such as barriers/resources and social support). Schwarzer believed that self-efficacy was the best predictor of intentions and behaviour, and this has been shown to be true in other studies for many behaviours, such as smoking cessation and weight loss (eg. Beck and Lund, 1981; Seydel et al, 1990). Again the model has been criticised for failure to account for emotional, social and environmental influences. The model which best explains X's smoking behaviour is the Theory of Planned Behaviour (Azjen, 1985, 1991). The model suggests that behavioural intention is the best predictor of actual behaviour, and that intention is determined by three factors: attitudes towards the behaviour, subjective norms and perceived behavioural control. ...read more.


As mentioned above, X has a positive attitude towards smoking, and believes that the outcomes of quitting would be negative (e.g. increased anxiety, irritability etc.). She also holds the belief that the costs of quitting outweigh the benefits, as she enjoys smoking and is not currently suffering any ill effects. Combining these factors to predict intentions to quit smoking, X has negative attitudes about quitting, quitting is not the norm in her current social environment, and she has low perceived behavioural control due to previous failed attempts to quit. Therefore intentions to quit will be low. To aid X in altering her smoking behaviour, the most important intervention would have to tackle the problem of low self-efficacy, as this seems to be the main factor in the maintenance of the smoking behaviour. As her current living situation cannot be altered, perhaps an attempt to change attitudes might be useful. X rates her enjoyment of smoking as very high, so a technique to reduce this enjoyment may be useful, such as aversion therapy. Also, as X smokes a lot when drinking alcohol, cue exposure procedures may help X formulate strategies to cope with this high-risk situation. The above case has been studied using the cognition and social cognition models of health beliefs. While these may apply to other health behaviours, such as exercise or diet, and are quite useful when considering psychological aspects of smoking, they fail to account for the physical dependence on nicotine. Therefore, a combination of these models with an addiction perspective may be more helpful when determining suitable interventions to help X quit smoking. ...read more.

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