Inger Synnøve Moan

Predicting the intention to quit smoking and quitting behaviour: extending the theory of planned behaviour.

OBJECTIVES The present study examined the ability of the TPB to predict the intention to quit smoking and quitting behaviour. In addition, the predictive power of future orientation, number of cigarettes smoked, planning, past behaviour and the interactions between intention and other predictors was examined. MATERIAL AND METHODS The data were derived from a longitudinal survey among 103 daily smoking students at the University of Oslo (mean age 24.6 years, mean number of years of smoking = 8 years). These data were collected by means of self-administered questionnaires at T1 (October 2003) and at T2 (February 2004) in terms of recording actual quitting. RESULTS The TPB components accounted for 30% of the variance in quitting intentions, and affective attitude and descriptive norm emerged as the strongest predictors of quitting intention. Ordinal regression analysis showed that intention was a borderline significant predictor of subsequent quitting behaviour, while the impact of PBC was non-significant (model 1). The inclusion of the additional variables improved the fit of the model, with number of cigarettes and planning appearing as significant predictors of behaviour (model 2). As predicted, there was a significant interaction between perceived control and intentions on quitting (model 3). Nagelkerke R(2) increased from .07 in model 1 to .54 in model 2, and finally to .58 in model 3. CONCLUSIONS The results indicate that affective attitude and descriptive norm play a more crucial role than the other TPB predictors in motivating smokers to quit. The results also indicate that self-regulatory strategies are important in relation to addictive behaviours.

Predicting intentions not to “drink and drive” using an extended version of the theory of planned behaviour

The aim of this study was to determine to what extent the theory of planned behaviour (TPB) extended with moral norm and descriptive norm is able to predict intentions not to drink and drive. We also wanted to examine whether different processes guide intentions among young drivers (35 years and below) versus drivers aged above 35 years, and womens versus mens intentions. Questionnaires were sent to a sample of 4000 people in Norway aged between 18 and 70 years, and were completed by 1025 respondents. Analyses were conducted among those who had a drivers licence and who reported drinking at least 1-2 times per year, resulting in a sample of 879 individuals (46.6% were men, 30.3% were 35 years and younger, M=43.9 years). The results showed that the TPB variables explained 10% of the variance in intentions in the sample as a whole, and that the extension variables added 2% to the explained variance after controlling for the impact of the TPB components. Perceived behavioural control was the strongest predictor of intentions (β=0.24, p<0.001), followed by descriptive norm (β=-0.12, p<0.001), attitude (β=0.09, p<0.01) and moral norm (β=0.08, p<0.05). Several group differences were found. The extended TPB model explained 16% and 5% of mens and womens intentions, respectively, and 26% and 9% of the variance in intentions among young and older drivers, respectively. The practical implications of these results for the development of interventions to encourage drivers not to drink and drive will be outlined.

Predicting parents’ intentions not to smoke indoors in the presence of their children using an extended version of the theory of planned behaviour

The present study examined whether the theory of planned behaviour (TPB) could predict parents’ intentions not to smoke indoors in the presence of their children. Moral norms, smoker identity, parent identity, and positive and negative anticipated affect were included as additional predictors. A questionnaire was sent to a representative sample of 1000 households in Norway with children born in 1998, and was completed by 612 respondents. The TPB variables and the extension variables were measured among the smokers in the sample (101 women and 61 men). Intentions were predicted by subjective norms and perceived behavioural control. The data were supportive of the inclusion of smoker identity and moral norms in the TPB. We also found a significant interaction effect between parent identity and smoker identity, and between negative anticipated affect and moral norms. Furthermore, we identified significant interactions between gender and three of the predictors of behavioural intentions. The TPB components explained 56% of the variance in intentions, while the additional variables explained a further 19%.

Use of alcohol and drugs by Norwegian employees: a pilot study using questionnaires and analysis of oral fluid

BackgroundThe use of alcohol and drugs may affect workplace safety and productivity. Little is known about the magnitude of this problem in Norway.MethodsEmployee recruitment methods with or without individual follow-up were compared. The employees filled in a questionnaire and provided a sample of oral fluid. Samples were analysed for alcohol, ethyl glucuronide (EtG; a biological marker of recent large alcohol intake), psychoactive medicinal drugs and illegal drugs.ResultsParticipation rates with and without individual follow-up were 96% and 68%, respectively. Alcohol was negative (≤0.1 mg/ml) in all samples, but 21.0% reported the intake of alcohol during the last 24 h. EtG was positive (>2.2 ng/ml) in 2.1% of the samples. In-efficiency or hangover at work during the past year was reported by 24.3%, while 6.2% had been absent from work due to the use of alcohol. The combination of self-report and analytical testing indicated that medicinal or illegal drugs had been used during the last 48 h by 5.1% and 1.7% of the participants, respectively; while only 4.2% and 0.4% admitted the use in the questionnaire.ConclusionsSelf-reported data suggest that hangover after drinking alcohol appears to be the largest substance abuse problem at Norwegian workplaces, resulting in absence and inefficiency at work. Analysis of oral fluid revealed that the use of illegal drugs was more common than drinking alcohol before working or at the workplace. The analysis of oral fluid may be a valuable tool in obtaining additional information on alcohol and drug use compared to using questionnaires alone.

Per capita alcohol consumption and sickness absence in Norway

BACKGROUND There is only one previous study addressing the relationship between population drinking and sickness absence. That study, based on Swedish time-series data, showed a statistically significant relationship between per capita alcohol consumption and the male sickness absence rate. Estimates suggested that a 1-l increase in consumption was associated with a 13% increase in sickness absence among men. In the present study, we aim at replicating and expanding the Swedish study on the basis of data for Norway. METHODS The outcome measure comprised annual data for Norway on registered sickness absence for manual employees covering the period 1957-2001. The unemployment rate was included as a control, as this factor may be correlated with alcohol as well as sickness absence. Alcohol consumption was gauged by sales of alcohol (total and beverage specific by beer, spirits and wine) per inhabitant 15 years and above. The data were analysed using the Box-Jenkins method for time-series analysis. RESULTS The results suggested that a 1-l increase in total consumption was associated with a 13% increase in sickness absence among men (P < 0.05). This corresponds to an elasticity coefficient equal to 0.62. The alcohol effect was not significant for women. Unemployment was negatively associated with the outcome for men as well as for women (P < 0.05). In the beverage-specific analyses, spirits were statistically significant for men (P < 0.05), but not beer and wine. CONCLUSION The present findings strengthen the conclusion from the Swedish study, that sickness absence may be added to the list of indicators of alcohol-related harm.

An extended version of the theory of planned behavour: Prediction of intentions to quit smoking using past behaviour as moderator

It was hypothesised that: (i) intentions to quit smoking were predictable from group identity, self-identity, moral norms and past quit attempts, beyond the components of the Theory of Planned Behaviour (TPB), and (ii) that past experiences with the behaviour (quit attempts) would increase the predictive utility of the extended TPB model on intentions. The data was collected among 357 daily smoking students (M = 24 years). The TPB components accounted for 12.3% of the variance in quitting intentions, while the extension variables added 16.5% to the explained variance in intentions beyond the impact of the TPB. Past behaviour had the strongest impact on intentions (α = 0.30), followed by moral norms (α = 0.25), perceived behavioural control (PBC, α = 0.20), attitude (α = 0.18) and group commitment (α = −0.11). By splitting the sample into three categories of past quit attempts the picture changed, revealing that the predictive utility of the TPB increased with the number of quit attempts (no past quit attempt, R2 = 1%, ns and several past quit attempts, R2 = 12.3%, p < 0.001). Moreover, PBC and group commitment were significantly stronger predictors of intention among those who had several previous quit attempts compared with those who never had tried to quit smoking. The extended TPB model explained 1% and 28% of the variance in intentions among those with no and several previous quit attempts, respectively. The practical implications of these results for the development of interventions to encourage smokers to quit smoking are outlined.

Alcohol-related sickness absence among young employees: Gender differences and the prevention paradox

BACKGROUND Few studies have examined alcohol-related sickness absence among young employees, although young adults are known to drink quite heavily. There are substantial differences in drinking patterns between men and women, yet gender differences have rarely been the main focus in research on alcohol-related sickness absence. Thus the present paper aims to examine gender differences in the prevalence of alcohol-related sickness absence among young employees in Norway, and in the associations between drinking patterns and such absence. Further, to examine whether the prevention paradox applies to alcohol-related sickness absence among both genders. METHODS A sample of employed young adults, 49.7% male (N = 1762, mean age = 28.3; SD = 1.9), was obtained from a general population survey of Norwegians. Self-reported measures on alcohol-related sickness absence and various drinking measures were applied. RESULTS Men reported absence from work due to drinking almost twice as often as women. There was a statistically significant gender difference in the drinking-absence association only for one of the three alcohol measures, indicating a stronger relationship among women. The heaviest drinkers (about 6% of the sample) reported a disproportionally large share of alcohol-related sickness absence (19%), yet the vast majority of such absence was found among the moderate drinkers (81%). CONCLUSIONS Alcohol-related sickness absence is more common among men than women. This gender difference may reflect differences in drinking habits rather than the likelihood of being absent after drinking. The results indicate that the prevention paradox applies to alcohol-related sickness absence among young employees of both genders.

Alcohol use-sickness absence association and the moderating role of gender and socioeconomic status: A literature review.

ISSUES How strong is the available empirical evidence for an association between alcohol use and sickness absence? Does type of measures influence the association, and is the association moderated by gender and socioeconomic status? APPROACH We designed a search strategy to find all studies on the alcohol use-sickness absence association using individual-level data, published in peer-reviewed journals from 1980 onwards. The quality of the associations was evaluated, giving a score of 0-4 points. KEY FINDINGS Our inclusion criteria were met by 27 papers containing 28 separate studies, testing 48 associations. There is empirical evidence for an association between alcohol use and both long- and short-term absence. High-quality associations were statistically significant in 100% of the cases. Among low-medium-quality associations, alcohol was less consistently related to long-term than to short-term absence (significant in 25% and 100% of the cases, respectively). Second, the association did not vary systematically across measures of alcohol use. Third, the association applies to both genders and in all socioeconomic strata, but in some instances more strongly in lower socioeconomic strata. IMPLICATIONS Preventive strategies have to be targeted at all drinking employees, but more research into group differences for example across gender, socioeconomics, occupations and age, could prove valuable. More longitudinal studies are needed to explore causal mechanisms. CONCLUSION The alcohol use-sickness absence association is well founded in research. The association may be moderated by gender and socioeconomics, but more research is needed to draw firm conclusions on this issue.

Experienced Harm from Other People's Drinking: A Comparison of Northern European Countries.

Objective This study addresses how experienced harm from other peoples drinking varies between six Northern European countries by comparing 1) the prevalence of experienced harm and 2) the correlates of harm. Method The data comprise 18ȓ69-year olds who participated in general population surveys in Denmark, Finland, Iceland, Norway, Sweden, and Scotland during the period 2008–2013. Comparative data were available on five types of harm: physical abuse, damage of clothes/belongings, verbal abuse, being afraid, and being kept awake at night. Results This study shows that harms from others drinking are commonly experienced in all six countries. Being kept awake at night is the most common harm, while being physically harmed is the least common. The proportions that reported at least one of the five problems were highest in Finland and Iceland and lowest in Norway, but also relatively low in Sweden. Across countries, the level of harm was highest among young, single, urban residents, and for some countries among women and those who frequently drank to intoxication themselves. Conclusions The study revealed large differences in the prevalence of harm in countries with fairly similar drinking cultures. However, the correlates of such experiences were similar across countries. Possible explanations of the findings are discussed, including differences in study design.

Use of alcohol and drugs among health professionals in Norway: a study using data from questionnaires and samples of oral fluid

Working under the influence of drugs and/or alcohol may affect safety and job performance. However, the size of this possible problem among health professionals (HPs) is unknown. The aim of this study was threefold: (i) to analyze samples of oral fluid and self-reported data from questionnaires to investigate the prevalence of alcohol and drugs among a sample of HPs in Norway, (ii) to study self-reported absence from or impairment at work due to alcohol and/or drug use, and (iii) to examine whether such use and absence/impairment due to such use depend on socio-demographic variables.A total of 916 of the 933 invited HPs from hospitals and pharmacies participated in the study (participation rate = 98.2%), and 81.1% were women. Associations were analyzed in bi-variate cross tables with Chi-square statistics to assess statistical significance.Alcohol was not detected in any of the samples. Ethyl glucuronide, a specific alcohol metabolite, was found in 0.3% of the collected samples. Illicit drugs and medicinal drugs were identified in 0.6% and 7.3% of the samples, respectively. Both analytical results and self-reported use of alcohol and drugs during the past 12 months indicate that recent and past year alcohol and drug use was lower among HPs than among workers in other business areas in Norway, Europe and US. Nevertheless, several HPs reported absence from work due to alcohol (0.9%) and medicinal drug use (0.8%) during the past 12 months. A substantial part (16.7%) of the self-reported medicinal drug users reported absence from work because of use of medicinal drugs during the past 12 months, and more than 1/4 of those reported in-efficiency at work because of the use of medicinal drugs during the past 12 months. Reduced efficiency at work due to alcohol use during the past 12 months was reported by 12.2%.This sample of HPs seldom used illicit drugs, few had a high level of alcohol consumption, and few tested positive for medicinal drugs. Absence or hangover related to the use of medicinal drugs or alcohol appeared to be a bigger issue than the acute intoxication or the use of illicit drugs.