A longitudinal study of the association between the teachable moment heuristic and smoking of head and neck cancer patients

Background The Teachable Moment Heuristic (TMH) posits that change in its three components (ie, affective response, risk perception, and social role/self-concept) could increase motivation and confidence for health promotion, such as smoking cessation. For patients with cancer, smoking cessation can extend survival, while persistent smoking causes numerous problems (eg, cancer recurrence). Purpose This intensive longitudinal study with cancer patients aimed to evaluate the link between TMH constructs and smoking outcomes. Methods Participants included 42 newly diagnosed head/neck cancer patients who reported smoking in the past month. Participants completed a baseline questionnaire before a 30-day daily assessment. Single-item measures were used for all constructs. Results Participants who perceived more benefits of quitting smoking smoked fewer cigarettes, P < .05. Also, participants who reported less cancer worry smoked fewer cigarettes, P = .03. Within-persons, less cancer worry than one’s personal average predicted decreases in cigarettes the next day, P = .01. Perceiving greater benefits of quitting, and social support than one’s average predicted lower motivation but higher confidence to quit the same day, Ps < .05. Greater cancer worry than one’s average predicted day-to-day increases in cigarettes smoked, P < .01. Perceiving greater benefits of quitting and greater social support than one’s average predicted smoking fewer cigarettes that day, Ps < .05. Conclusions Components of the TMH are associated with favorable smoking cessation outcomes after a cancer diagnosis. Interventions to aid cancer patients with smoking cessation should focus on the benefits of quitting, bolster social support, and reduce cancer-related worry.