Presenting the facts about smoking to adolescents - Effects of an autonomy-supportive style

Objectives: To test the self-determination model of health-related behavior by examining whether the degree to which adolescents experience an appeal to not smoke as autonomy supportive would affect their autonomous motivatio n for not smoking and, in turn, their behavior of either refraining from sm oking or smoking less, and to validate the measures of perceived autonomy s upport and autonomous motivation for not smoking. Design: Two studies of physicians presenting information about not smoking using 2 message styles, 1 of which was designed to be more autonomy support ive. The preliminary study involved nonrandomized assignment to message sty le and only immediate assessment of perceptions, motivation, and behavior, while the primary study involved randomized assignment and 4-month longitud inal assessments. Setting and Participants: Nearly 400 ninth- through 12th-grade students at 2 suburban high schools in upstate New York. Main Outcome Measures: Adolescents' perceptions of the presentations' auton omy supportiveness of the pre-senters, as well as adolescents' autonomous m otivation for not smoking and their self-reports of smoking. The primary st udy also assessed change in students' autonomous motivation and change in t heir self-reported smoking during 4 months. Results: In both studies, the measures were reliable and valid. Students pe rceived significantly (P = .04 and P < .001, respectively) greater autonomy support in the "It's Your Choice" presentation, after controlling for whet her the students were smokers. Perceived autonomy supportiveness of the pre sentation was positively correlated with autonomous reasons for not smoking in the preliminary study and with increases in autonomous motivation for n ot smoking in the primary study. Change in autonomous reasons for not smoki ng significantly (P < .001) predicted reduction in smoking during 4 months. Conclusion: When adolescents perceived messages about not smoking as autono my supportive, they had more autonomous motivation for not smoking, and tha t, in turn, predicted a decrease in their self-reports of smoking.