Associations between Advisor Personality and Client Quit Rates in Stop Smoking Services Heather...

Associations between Advisor Personality and Client Quit Rates

in Stop Smoking Services

Heather Gainforth1; Sarita Aujla1, Emma Beard1, Emma Croghan2, Robert West1

1University College London2North51

Conflict of InterestHeather Gainforth•None to declare

Sarita Aujla•None to declare

Emma Beard•Unrestricted research funding from Pfizer

Emma Croghan•Employed by North51

Robert West•Travel funds and hospitality from, and undertaken research and consultancy for, pharmaceutical companies that and manufacture and/or research products aimed at helping smokers to stop

English Stop Smoking Services (SSS)

• 1999: NHS establishes the first national network of Stop Smoking Services (SSS)

• Services offer:– Free evidence-based behavioral and pharmacological

support to those motivated to quit– Six weekly group or one-to-one meetings– Trained practitioners

• 600,000 sought treatment• 4x more likely quit using the SSS than unaided

(NICE, PH10, 2008; Department of Health, Smoking Kills:, 1998, West, NCSCT Briefing, 2012)

Variation in SSS Success Rates• Four-week CO-validated quit rates range: 3 – 57%.

(Date range: 2010-2011; NHS Information Service, 2011)

Advisor Personality

• Advisor personality may be one factor that explains this variation

• Personality: ‘a consistent and enduring way of thinking, feeling and behaving that characterises an individual’

• Measured using the FFM Model:– Openness-to-experience– Conscientiousness– Extraversion– Agreeableness– Neuroticism

(Carver & Scheier, Perspectives on Personality, 2000)

Advisor Personality & Smoking Cessation• Relationship not examined to date

• Other domains:• Agreeableness• Neurotocism• Conscientousness• Extraversion• Openness-to-experience

(Lafferty et al., J Consulting & Clinical Psychology, 1989; Martlett, ProQuest, 2008; Miller et al., J Consulting & Clinical Psychology, 1980; Najavits et al., Psychotherapy, 1994; Valle et al., J Studies on Alcohol and

Drugs, 1981)

Purpose

Determine if stop smoking advisors’ self-assessed personality

scores were associated with clients’ four-week CO-verified quit

status.

Design and Procedure

• Data were collected from:

Clients

n = 1,958 treatment episodes

54% female Mage = 42.12 years ± 15.86

Advisors

n = 19

79% female Mage = 48.86 ± 10.33years

Measures

• Confounding factors

– Client Characteristics• Age (years)• Sex (male/female)• Ethnicity (White/non-White)• Medication use (yes/no)• Social grade (low/medium/high)

– Practitioner Characteristics• Age (years)• Sex (male/female)• Experience as a stop smoking practitioner (years)

Measures

• Predictor Variable: SSS Advisor Personality– Measured using the Ten-Item Personality

Inventory (TIPI) – Completed by advisors (self-assessed)

• Outcome Variable: Client Quit Status– CO-validated quit status at 4 weeks– Clients that did not attend the 4-week follow-up

were assumed to still be smoking

(Gosling, Rentfrow, & Swann Jr, J Research in Personality, 2003)

Analysis

• Personality scores calculated for each of the FFM personality dimensions for each advisor– i.e. openness-to-experience, conscientiousness,

agreeableness, extraversion, neuroticism

• Multi-level random intercept model with a random effect for the advisors to account for clustering– R version 2.3.1 and the glmer() function in the lme4 package– Confounding variable: practitioner and client characteristics– Predictor variable: advisor personality– Outcome variable: client CO-verified four-week quit status

Results  Odds Ratio 95% Confidence Interval

Confounding Factors: Client & Practitioner Characteristics

Client sex 1.13 0.93 1.37

Client ethnicity 1.06 0.76 1.49

Medication 1.44* 1.04 2.00

Client social grade1

23

1.070.92

0.810.72

1.421.16

Client age at quit date 1.02*** 1.01 1.02

Practitioner experience (years) 1.07 0.99 1.15

Practitioner sex 1.44 0.78 2.65

Practitioner age 0.99 0.97 1.02

Practitioner Personality Dimensions      

Extraversion 1.10* 1.01 1.19

Agreeableness 0.99 0.89 1.10

Conscientiousness 0.94 0.81 1.08

Neuroticism 1.03 0.95 1.12

Openness-to-experience 1.07 0.93 1.22

(Note: ***p<0.001; **p<0.01; *p<0.05)

Results  Odds Ratio 95% Confidence Interval

Confounding Factors: Client & Practitioner Characteristics

Client sex 1.13 0.93 1.37

Client ethnicity 1.06 0.76 1.49

Medication 1.44* 1.04 2.00

Client social grade1

23

1.070.92

0.810.72

1.421.16

Client age at quit date 1.02*** 1.01 1.02

Practitioner experience (years) 1.07 0.99 1.15

Practitioner sex 1.44 0.78 2.65

Practitioner age 0.99 0.97 1.02

Practitioner Personality Dimensions      

Extraversion 1.10* 1.01 1.19

Agreeableness 0.99 0.89 1.10

Conscientiousness 0.94 0.81 1.08

Neuroticism 1.03 0.95 1.12

Openness-to-experience 1.07 0.93 1.22

(Note: ***p<0.001; **p<0.01; *p<0.05)

Discussion

• Stop smoking advisor extraversion was positively associated with clients’ being abstinent from smoking at four weeks.

• A low introversion score (i.e. reserved, quiet) is associated with client abstinence from smoking at four weeks.

Implications for Smoking Cessation

• Adviser training– Train introverted practitioners to overcome their

quiet and reserved manner

• Replication and further research needed– Mechanism by which the extraversion dimension

affects the advisor-client interaction:• Confidence when engaging with client?• Application of evidence-based behaviour change

techniques?

Limitations

• TIPI is only brief measure of personality

• Only included data from 19 practitioners who provided one-to-one support in two English SSSs

• Clients who did not attend the four-week follow-up were still assumed to be smoking

THANK YOUTHANK YOU

Questions?heathergainforth@gmail.com

@hgainforth

Funding: