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The PRIME theory of motivation and its application to smoking cessation
Robert West
Abstract
There are many theories and models that have been applied to help understand the process by which a smoker becomes a non-smoker. These range from the pharmacological to the social. The problem is that none of them encompass the full range of factors that are known to be relevant. In some cases, such as the Stages of Change approach, they assume a degree of stability with regard to intentions about stopping that is not borne out by the evidence. Moreover existing accounts do not adequately relate smoking cessation to a more general understanding of human motivation. In fact published theories and models of human motivation also fail to account for the diverse range of phenomena that have been observed, some focusing on choice and decision-making, others of drives and biological needs and others on learning processes. PRIME Theory is a first attempt to develop a comprehensive theory of human motivation that explicitly seeks to encompass the full range of observations using a language that is as close as possible to everyday usage. It explicitly addresses how 'responses' arise from momentary 'impulses' created directly by habit and instinct and by 'motives' which are feelings of desire based on anticipation of pleasant and unpleasant experiences. These are driven by emotional states, perceptions, memories, imagination, biological drives and sometimes by 'evaluations' involving beliefs about what is good and bad, right and wrong, harmful and damaging etc. Sometimes, instead of acting immediately we are motivated to form 'plans' which involve more or less well formulated intentions to undertake actions in the future. Plans,
responses, impulses, motives and evaluations make up the five levels of 'the motivational system' which is one theme of PRIME Theory. The theory has four other themes: the focus on 'the moment', 'dispositions and the role of experience', the importance of 'identity' and the application of 'chaos theory'. Stopping smoking is a 'chaotic' process involving a change in identity in the face of momentary impulses, motives and evaluations arising from pharmacological and non-pharmacological influences. The presentation will describe the theory and make specific predictions about smoking cessation arising from it.
Biography
Robert West is Director of Tobacco Studies at the Cancer Research UK Health Behaviour Unit, University College London. He started researching tobacco and nicotine use in 1982 under the direction of Michael Russell. His early research focused on the nicotine withdrawal syndrome but since then he has also contributed to clinical trials of behavioural and pharmacological aids to cessation, population surveys and cohort studies of smokers looking at patterns of smoking and smoking cessation, as well as surveys of health professionals examining attitudes, knowledge and behaviours relating to smoking cessation. He has also contributed to the development of clinical practice guidelines on smoking cessation in the UK and elsewhere. He is Editor-in-Chief of the journal, Addiction. He has been an author on more than 250 scientific works and has recently written a book developing a new, comprehensive theory of motivation and its application to addiction. More information can be found at www.rjwest.co.uk
Robert West
Professor of Health Psychology
Department of Epidemiology and Public Health
University College London
London
WC1E 6BT
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