The proposed research is an effort to translate current theory and research on intrinsic and extrinsic motivation into the prevention area. Our goal is to assess the individual and combined impact of extrinsic and intrinsic motivation enhancement strategies on the use of self-help materials for smoking cessation and relapse prevention. The target population is smokers who request self-help materials for quitting smoking. The principle outcome of interest is long-term maintenance of nonsmoking. Use of the self-help materials, as distinct from relapse prevention is also an outcome of interest. The specific research questions that this investigation will address are: (1) Do extrinsic and intrinsic motivation enhancement strategies each increase the probability of utilizing self-quit materials for smoking cessation; (2) If each type of motivation enhancement strategy has a positive impact on program utilization, what is their combined effect? (3) Do motivational effects that enhance program utilization result in comparable positive effects on long-term cessation of smoking? (4) Does type of motivation for quitting smoking interact with the effectiveness of the different motivation enhancement strategies? A 2 x 2 factorial design will be implemented. The extrinsic motivation strategy will be operationalized as a financial incentive for using the self-help materials. The intrinsic motivation strategy will be operationalized by providing personalized feedback designed to enhance the salience of internal motivations for using the self-help materials. A total of 1200 smokers (N=300 per group) will be randomized to the four study groups. Smokers will be recruited through a collaborative agreement with the Cancer Information Services at the Hutchinson Center and through local media ads. Subjects will provide data upon enrollment and 3, 6 and 12 months after they are sent the self-help materials. Reported abstinence at 12 months will be biochemically validated with saliva continine analysis. The long-term objective is to provide effective strategies for enhancing use of self-help materials that are applicable in large scale, public health prevention programs.
