Smoking Cessation: Theory of Planned Behavior for Native American Youths

This assignment discusses the use of the Theory of Planned Behavior for developing an educational tool for young Native Americans regarding smoking cessation to prevent chronic disorders like cardiovascular and pulmonary disorders.

Running head: SMOKING CESSATION
SMOKING CESSATION
Name of the student:
Name of the university:
Author note:

1
SMOKING CESSATION
Introduction:
Constructs of different types of theoretical models are extensively utilized for elucidating
different health behaviors as well as guiding different interventions like that of smoking
cessation programs. The theory of the Planned Behavior acts as one such model and is actually
the extension of another model called the Theory of Reasoned Action. These theories are of the
opinion that the attitude of an individual, social norms and the perceived control over the
behavior have the abilities in influencing the intention of performing the behavior (Hagger et al.,
2015). This intention in turn will predict whether the behavior would occur or not. This
assignment would use the theory of reasoned/planned behavior for developing an educational
tool for the young native Americans regarding smoking cessations to develop quality of their
lives by preventing chronic disorders like cardiovascular and pulmonary disorders
Beliefs of the target: (Attitudes)
Studies opine that attitudes about the target behavior can be direct or indirect. One of the
direct attitudes about smoking might be like where the smoker’s overall assessment about
whether quitting is bad or good. An indirect attitude involves how strongly an individual is of the
opinion that peripheral outcome will result in performing the behavior coupled with that of the
assessment of that outcome. The targets are the Native American youths who have both direct
and indirect beliefs. The first belief is a direct belief where they are of the opinion that tobacco
smoking is good for health spiritually, physically and socially (Tanner et al., 2017). Secondly,
they are of the indirect beliefs that their Creator or the spirits whom they call the manidog love
tobacco and thus they need to show them respect by having tobacco as a ritual. Third, they are of
the opinion that they have strenuous lives due to lack of employments and income opportunities

2
SMOKING CESSATION
where they feel facially insecure and in these situations tobacco help them to overcome the stress
by providing pleasant and soothing feelings.
Evaluations of the belief: (identification as important or not important)
All the beliefs are considered to be important as they have humungous impact on the
attitudes and intentions of the target population. The tobacco use mainly acts as a ritual and
traditional custom among the Native Americans and hence it has deep roots among the very
existence and psychological development of the ethnic group. Studies have already opined that
for most of the groups of smokers, knowledge of the multitude of the risks posed by that of
smoking is enough for encouraging the quitting of smoking but when the smoking habit is deeply
tied to that of the religious and cultural traditions, completely eliminating the habit becomes
extremely difficult (Hagger, 2015). Hence, such beliefs are a matter of concern and needs to be
tackled sensitively but with priority. The other belief that smoking results in relieving them from
stress and anxiety because of their economical constraints and other social determinants of health
needs to be tackled with proper interventions. It is indeed true that quality of life, living
conditions, various employment and education opportunities and health equality of the native
Americans are poorly managed in comparison to that of the other Americans in the nation.
Hence, these issues need to be advocated along with health literacy development among
individuals to change their attitudes and help in cessation of their smoking behaviors.
Beliefs of the target population also called the (subjective norm):
A subjective norm is mainly seen to involve the people around the target cohort. The
target cohorts often consider what the people around them think about the behavior. It can be
seen that the community of Native Americans respect ritualistic traditional tobacco as a medicine

3
SMOKING CESSATION
with cultural as well as spiritual importance. Many of the tribes are seen to maintain teachings as
well as stories on the origin of tobacco. These teachings are seen to address tobacco in the purest
form and are deeply ingrained in their beliefs and existence ensuring their physical, spiritual,
emotional, and community well-being and are offered to Creator as a sign of respect (Mowery et
al., 2015). Therefore, the young natives have no intentions in changing such attitudes. Therefore,
it remains the duty of the professionals to develop their health literacy of not only the target
young people but also of the whole community to make them understand how smoking affects
their life expectancy. It is a sensitive issue since it incorporates cultural beliefs and hence,
healthcare professionals need to be extremely careful in the health education session so as to
change their beliefs towards betterment.
Targets whether capable or confident in completing the behavior (perceived behavioral control)
Perceived behavioral control is mainly like the concept of self-efficacy which mainly
talks about the confidence of the individuals in successfully executing the behavior. It mainly
accounts for the external factors that might affect the intent of the person towards a behavior.
The young Native Americans have no idea about how smoking is affecting their physical health
and making them prone to develop chronic ailments. Therefore, they are not confident enough to
participate in smoking cessation programs (Montano et al., 2015).
The various strategies that need to be inculcated are:
 Healthcare professionals would first assess the degree to which the client is intending to
change their tobacco use behavior
 Then he would discuss the positive as well as the negative expectancies that the client
have for tobacco use. In this area, the professionals should develop the health literacy of

4
SMOKING CESSATION
the young natives in ways by which they learn the negative impacts of tobacco use. They
can make them participate in motivational interviewing in order to develop their
motivation to change their behavior internally. Professionals should provide feedback at
the constant rate and handle their incorrect expectancies (Gohdes et al., 2016)
 The clients should be asked that whether their family members and friends support
tobacco use or not. It is likely that the young natives might not be supported to quit
tobacco as it belongs to their customs and traditions. Family centered counseling
approach can be taken so that the family members understand importance of quitting
smoking and how that young help the young people. This would provide support to
young natives and they would feel confident (Paul et al., 2016)
 The professionals should advocate the government to undertake nation based policies and
health promotion program implementation so that the entire community can be taught
about ill-effects of tobacco and the future generations can be protected from developing
misconceptions about the importance of tobacco that is ingrained in history
 The communities need to have the scope of education to that of higher degree. This will
only help them to rationalize and argue the use of tobacco in native communities. This
would make young people understand the negative outcomes of tobacco. Hence health
education in schools and colleges need to be implemented and every young natives
should be given the opportunity and encouragement to attend schools and complete
education (Kaestle, 2015)
 Government should be advocated in developing job opportunities so that they can have
stable financial capability and do not fall prey to smoking as means of killing pressure,
anxiety and boredom.

5
SMOKING CESSATION
Conclusion:
The above discussion showed that the theory of planned and reasoned behavior showed
that the young Native Americans neither have the attitude to leave smoking not their society
supports them to do so. This habit is ingrained in their culture and also to some extent due to
stress and anxiety because of loss of employment opportunities. Hence, professionals need to
develop strategies by which they can motivate the young people to overcome barriers and
develop proper lifestyle habit by quitting smoking successfully

6
SMOKING CESSATION
References:
Gohdes, D., Harwell, T. S., Cummings, S., Moore, K. R., Smilie, J. G., & Helgerson, S. D.
(2016). Smoking cessation and prevention: an urgent public health priority for American
Indians in the Northern Plains. Public Health Reports.
Hagger, M. S. (2015). Retired or not, the theory of planned behaviour will always be with us.
Hagger, M. S., Chan, D. K., Protogerou, C., & Chatzisarantis, N. L. (2016). Using meta-analytic
path analysis to test theoretical predictions in health behavior: An illustration based on
meta-analyses of the theory of planned behavior. Preventive Medicine, 89, 154-161.
Kaestle, C. E. (2015). Age of smoking milestones: longitudinal inconsistencies and
recanting. Journal of Adolescent Health, 56(4), 382-388.
Montano, D. E., & Kasprzyk, D. (2015). Theory of reasoned action, theory of planned behavior, and the integrated
behavioral model. Health behavior: Theory, research and practice, 95-124.
Mowery, P. D., Dube, S. R., Thorne, S. L., Garrett, B. E., Homa, D. M., & Henderson, P. N.
(2015). Disparities in smoking-related mortality among American Indians/Alaska
natives. American journal of preventive medicine, 49(5), 738-744.
Paul, J., Modi, A., & Patel, J. (2016). Predicting green product consumption using theory of
planned behavior and reasoned action. Journal of retailing and consumer services, 29,
123-134.
Tanner, J. A., Henderson, J. A., Buchwald, D., Howard, B. V., Henderson, P. N., & Tyndale, R.
F. (2017). Relationships between smoking behaviors and cotinine levels among two

7
SMOKING CESSATION
American Indian populations with distinct smoking patterns. Nicotine and Tobacco
Research, 20(4), 466-473.