Smoking Assessment through Information Technology

Smoking Assessment through Information Technology

Paola Gremigni (University of Bologna, Italy)
DOI: 10.4018/978-1-60566-356-2.ch013
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Abstract

This chapter introduces a proposal for the role of information technology as a means of completing a comprehensive assessment of smoking behaviour. Smoking cessation is an important goal both in primary care and in healthcare settings. Results of the literature encourage the utilisation of self-report questionnaires to assess individual differences that could assist to develop stage-matched-intervention for smoking cessation. Reliable and valid measurement tools are available in this area, but comprehensive assessment procedures are not yet standardized. Computerized/web-based psychological testing procedures may provide relevant advantages, in comparison to traditional paper-pencil approach, in that they may guarantee reliable results through the standardization of both testing and scoring procedures. They may also allow creating a common database accessible to researchers from various healthcare organizations.
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Introduction

The World Health Organization has defined the control of smoking as the single most important preventive health measure that developed nations can take (World Health Organization, 2001). The control of smoking risk is clear an important goal, albeit uneasy to achieve. Actually, literature reviews have consistently concluded that smoking treatment is characterized by good initial success but very high rates of relapse (Piasecki, Fiore, McCarthy & Baker, 2002).

Literature findings support evidence-based efficacy of both behavioural and pharmacological interventions for smoking cessation (Lancaster et al., 2004; Lancaster, 2005; Stead, Perera, Bullen, Mant & Lancaster, 2008). Accordingly, various countries organizations and authorities have established and disseminated treatment guidelines to provide guidance to clinicians and smoking treatment specialists (Australian Government, Department of Health and Aging, 2004; Fiore et al., 2000; Hughes et al., 1996; West, McNeill & Raw, 2000; World Health Organization, 2001).

Guidelines on smoking cessation have largely focused on primary care practices, paying less attention to healthcare settings. As Rigotti (2000) has underlined, healthcare settings have instead a great opportunity to deliver to patients interventions for changing behaviours. A hospital stay provides a special incentive for setting up cessation, because of the widespread policies that prohibit tobacco use. Furthermore, an illness condition may increase smoker’s perceived vulnerability to the health hazards of smoking, thus enhancing his/her motivation to quit. Finally, healthcare settings offer to smoking patients access to multiple caretakers who could provide smoking cessation interventions (Rigotti, 2000). Various studies emphasise the role of different healthcare providers in reducing the burden of tobacco-related diseases (e.g. Fagan, Eisenberg, Frazier, Stoddard, Avrunin & Sorensen, 2003; Quraishi, Orkin & Roizen, 2006). Thus, healthcare providers need standardised protocols to deliver effective cessation interventions.

Combined use of psychological procedures directed toward cognitive, behavioural and social modification, along with pharmacological treatment, seems to produce the best clinical results in the treatment of nicotine dependence (Miller & Wood, 2002). Pharmacotherapy, in particular nicotine replacement, reduces withdrawal symptoms subsequent to quitting and, so, increases the likelihood that successful cessation will be reached and maintained (Cofta-Woerpel, Wright & Wetter, 2006; Lancaster et al., 2004). Behavioural therapy contributes to improve quit rates (Lancaster et al., 2004; Park et al, 2004). Skills training and problem solving, in particular, emerge as effective techniques in predicting abstinence maintenance (Matheny & Weatherman, 1998; Tsoh et al., 1997). In the summary, a behavioural approach to the analysis and modification of smoking behaviour seems to be the most productive, in combination with nicotine replacement (see Vidrine, Cofta-Woerpel, Daza, Wright & Wetter, 2006 for a review). Thus, the conceptual framework of this chapter has been taken out of behaviour modification and cognitive therapy. It may also provide a systematic framework for the analysis of variables predicting smoking behaviour. Actually, this approach assists to analyze the activating situations that lead to dysfunctional behavioural consequences such as smoking, as well as people’s belief system in relation to these events.

Key Terms in this Chapter

Validity: Characteristic of a test which actually measures what it claims to measure.

Tobacco Smoking: The inhalation of smoke from burned dried or cured leaves of the tobacco plant.

Psychological Assessment: A process that involves the integration of information about an individual from multiple sources.

Psychometrics: The science concerned with the theory and technique of psychological measurement. It involves both the construction of instruments and procedures for measurement, and the development of theoretical approaches to measurement.

Reliability: Characteristic of a test which is internally consistent or gives consistent results over time.

Nicotine Dependence: The physical vulnerability of the body to the chemical nicotine which is delivered by various tobacco products.

Computer Testing: Approach to psychological testing using computer modes of administration of tests.

Information Technology: The use of computer software to process, transmit, and retrieve information.

Psychological Testing: A field based on psychometrics and characterized by the use of samples of behavior to infer generalizations about an individual.

Online Testing: Assessment and data management system via Internet.

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