Numerous theories in social and health psychology assume that intentions cause behaviors. However, most tests of the intention- behavior relation involve correlational studies that preclude causal inferences. In order to determine whether changes in behavioral intention engender behavior change, participants should be assigned randomly to a treatment that significantly increases the strength of respective intentions relative to a control condition, and differences in subsequent behavior should be compared. The present research obtained 47 experimental tests of intention-behavior relations that satisfied these criteria. Meta-analysis showed that a medium-to-large change in intention (d = 0.66) leads to a small-to-medium change in behavior (d = 0.36). The review also identified several conceptual factors, methodological features, and intervention characteristics that moderate intention-behavior consistency.

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Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence.

OBJECTIVES. The purpose of this study was to identify circumstances in which biochemical assessments of smoking produce systematically higher or lower estimates of smoking than self-reports. A secondary aim was to evaluate different statistical approaches to analyzing variation in validity estimates. METHODS. Literature searches and personal inquiries identified 26 published reports containing 51 comparisons between self-reported behavior and biochemical measures. The sensitivity and specificity of self-reports of smoking were calculated for each study as measures of accuracy. RESULTS. Sensitivity ranged from 6% to 100% (mean = 87.5%), and specificity ranged from 33% to 100% (mean = 89.2%). Interviewer-administered questionnaires, observational studies, reports by adults, and biochemical validation with cotinine plasma were associated with higher estimates of sensitivity and specificity. CONCLUSIONS. Self-reports of smoking are accurate in most studies. To improve accuracy, biochemical assessment, prefera...

https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.84.7.1086

The validity of self-reported smoking: a review and meta-analysis.

INTRODUCTION Smoking is a leading cause of premature mortality and preventable morbidity. Surveillance is most often based on self-reported data, but studies have shown that self-reports tend to underestimate smoking status. METHODS This study systematically reviewed the literature to measure the concordance between self-reported smoking status and smoking status determined through measures of cotinine in biological fluids. Four electronic databases were searched to identify observational and experimental studies on adult populations over the age of 18 years. RESULTS Searching identified 67 studies that met the eligibility criteria and examined the relationship between self-reported smoking and smoking confirmed by cotinine measurement. Overall, the data show trends of underestimation when smoking prevalence is based on self-report and varying sensitivity levels for self-reported estimates depending on the population studied and the medium in which the biological sample is measured. Sensitivity values were consistently higher when cotinine was measured in saliva instead of urine or blood. Meta-analysis was not appropriate because of the substantial heterogeneity among the cutpoints used to define smokers and the poor reporting on outcomes of interest. DISCUSSION Further research in this field would benefit from the standardization of cutpoints to define current smokers and the implementation of standard reporting guidelines to enhance comparability across studies. Accurate estimation of smoking status is important as data from population studies such as those included in this review are used to generate regional and national estimates of smoking status and in turn are used to allocate resources and set health priorities.

The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status.

Outcome measures for smoking cessation are reviewed and evaluated, including 3 self-report measures and 3 biochemical validation measures. Point prevalence reflects the percentage of participants taking action, prolonged abstinence reflects those in the maintenance stage, and continuous abstinence reflects those who progress from action to maintenance without lapsing or relapsing. Biochemical assessments are primarily measures of point prevalence abstinence. The desirability of biochemical validation is a particularly controversial and critical issue. Three factors affect the accuracy of self-report: Type of Population, Type of Intervention, and Demand Characteristics. False-negative rates are generally low. Three broad issues impact on decisions to use biochemical validation: (a) alternative explanations for false positives, (b) refusal rate problems, and (c) the effect of inaccuracy on intervention assessment.

Assessing outcome in smoking cessation studies.

The International Agency for Research on Cancer (IARC) was established in 1965 by the World Health Assembly, as an independently funded organisation within the framework of the World Health Organization. The headquarters of the Agency are in Lyon, France. The Agency conducts a programme of research concentrating particularly on the epidemiology of cancer and the study of potential carcinogens in the human environment. Its field studies are supplemented by biological and chemical research carried out in the Agency's laboratories in Lyon and, through collaborative research agreements, in national research institutions in many countries. The Agency also conducts a programme for the education and training of personnel for cancer research. The publications of the Agency contribute to the dissemination of authoritative information on different aspects of cancer research. Information about IARC publications, and how to order them, is available via the Internet at: http:// The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The authors alone are responsible for the views expressed in this publication.

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/cncr.11334

IARC Handbooks of Cancer Prevention

https://escholarship.org/content/qt1m2250g5/qt1m2250g5.pdf?t=p1kjfc

Cotinine validation of self-reported smoking in commercially run community surveys.

The "Quit. For Life" campaign was a media-based programme that was aimed at reducing the prevalence of smoking in Sydney. The programme committee set four intermediate goals which it felt had to be met for such a change in prevalence to occur. From households selected at random in Sydney and Melbourne, 5713 people were interviewed to assess whether the campaign attained these goals. The television commercials that were designed for the campaign, their frequency and the timing of their screening produced a higher recall of the commercial's message and the use of campaign back-up services than were specified originally in the goals. During the campaign there was a progressive increase in the number of smokers in Sydney who reported that they were likely to quit; this was significantly different from Melbourne data by the end of the campaign and thus fulfilled another campaign goal. However, shortly after the campaign ended, the proportion of smokers who intended to quit smoking was the same in the two cities. A cohort study of 949 people from the baseline study showed that, during the 12-month period of follow-up, 66% of Sydney smokers tried to stop or to reduce their smoking. In the control city, Melbourne, 60% of smokers reported making such attempts. Of the original smokers, 23% in Sydney and 9% in Melbourne quit during the follow-up period--a statistically significant difference. As well, 10% of the original ex-smokers in Sydney and 11% in Melbourne relapsed, while 4% of nonsmokers in both cities began smoking by the end of the second survey.

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Evaluation of the Sydney "Quit. For Life" anti-smoking campaign. Part 1. Achievement of intermediate goals.

Between June and November 1983, the "Quit. For Life" media campaign was conducted in Sydney to reduce the prevalence of smoking. Surveys on a cross-sectional sample of the Sydney population were conducted before and after the campaign, and similar measures were undertaken in the rest of Australia for comparison. The sample sizes for both the Sydney and control areas comprised more than 4000 subjects. In addition, a cohort of 949 residents of Sydney and Melbourne were followed for changes in the prevalence of smoking during the year of the campaign. The cross-sectional survey results for 1984 and 1983 demonstrated decreases in the prevalence of smoking of approximately 1% for both men and women in Sydney compared with the rest of Australia. In the cohort study there was a 3.4% decrease in smoking prevalence in Sydney compared with a 0.8% increase in Melbourne. The pooled estimate of the difference in smoking prevalence attributable to the campaign was 2.8% (95% confidence interval, 0.5%-5.1%).

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Evaluation of the Sydney "Quit. For Life" anti-smoking campaign. Part 2. Changes in smoking prevalence.

Cross‐sectional studies have demonstrated a negative association between the reported level of leisure‐time activity, measured endurance fitness, and blood pressure. There have also been a number of prospective trials; the majority indicate that an increase in fitness is followed by a fall in blood pressure. Few have included control subjects —a critical defect, since a spontaneous fall in blood pressure is customary with serial measurements in individuals. The studies which did have control subjects were examined in detail. These also generally indicated a lowering of blood pressure with increasing fitness. However, other flaws in design of these studies, such as a lack of blind assessment, prohibit confident conclusions. There is a need for further randomized, controlled, single‐blind trials concerning the relationship between physical activity and blood pressure.

The role of physical activity

Amsterdam: Excerpta Medica, 1979: 83. 2. Kohn G, Winter TSD, Mellman WJ, Trisomy X in three children. J Pediatr 1968; 72: 248-252. 3. Moorhead PS, Nowell PC, Mellman WJ, et a/. Chromosome preparations of leucocytes culturedfrom human peripheral blood. Exp Cell Res 1960; 20: 613-616. 4. FisherNL, Starr ED,GreeneT. HoehnH. Utility and limitations of chromosome banding in pre and postnatal service cytogenetics. Am J Med Genet 1980; 5: 285-294. 5. Therrnan E. Sex chromosome abnormalities. In: Humanchromosomes structure,behaviour, effects. Berlin: Springer-Verlag, 1980: 125. 6. Smith A, Elliott G. Occurrence of sex chromosome mosaicism and translocation Down'ssyndrome in the samefamily. ClinGenet 1980; 17: 341-345. 7. Maclean N, Court-Brown WM, Jacobs PA, et al. A survey of sex chromatin abnormalities in mental hospitals. J Med Genet 1968; 5: 1965-172. 8. Barr ML, Sergovitch FR, Carr DH, ShaverEL. The triple X female. An appraisal based on a study of 12 cases and a review of the literature. CanMedAssocJ 1969; 101: 247-258. 9. Dewhurst J. Fertilityin 47,XXXand 45,Xpatients. J Med Genet 1978; 15: 132-135.

Terry Dwyer

Papers

Cotinine validation of self-reported smoking in commercially run community surveys.

Evaluation of the Sydney "Quit. For Life" anti-smoking campaign. Part 1. Achievement of intermediate goals.

Evaluation of the Sydney "Quit. For Life" anti-smoking campaign. Part 2. Changes in smoking prevalence.

The role of physical activity

Effective health and personal development: an experiment in school education