Associations between Advisor Personality and Client Quit Rates in Stop Smoking Services Heather Gainforth 1 ; Sarita Aujla 1, Emma Beard 1, Emma Croghan 2, Robert West 1 1 University College London 2 North51

Conflict of Interest Heather Gainforth None to declare Sarita Aujla None to declare Emma Beard Unrestricted research funding from Pfizer Emma Croghan Employed by North51 Robert West Travel funds and hospitality from, and undertaken research and consultancy for, pharmaceutical companies that and manufacture and/or research products aimed at helping smokers to stop

English Stop Smoking Services (SSS) 1999: NHS establishes the first national network of Stop Smoking Services (SSS) Services offer: –Free evidence-based behavioral and pharmacological support to those motivated to quit –Six weekly group or one-to-one meetings –Trained practitioners 600,000 sought treatment 4x more likely quit using the SSS than unaided (NICE, PH10, 2008; Department of Health, Smoking Kills:, 1998, West, NCSCT Briefing, 2012)

Variation in SSS Success Rates Four-week CO-validated quit rates range: 3 – 57%. (Date range: ; NHS Information Service, 2011)

Advisor Personality Advisor personality may be one factor that explains this variation Personality: ‘a consistent and enduring way of thinking, feeling and behaving that characterises an individual’ Measured using the FFM Model: –Openness-to-experience –Conscientiousness –Extraversion –Agreeableness –Neuroticism (Carver & Scheier, Perspectives on Personality, 2000)

Advisor Personality & Smoking Cessation Relationship not examined to date Other domains: Agreeableness Neurotocism Conscientousness Extraversion Openness-to-experience (Lafferty et al., J Consulting & Clinical Psychology, 1989; Martlett, ProQuest, 2008; Miller et al., J Consulting & Clinical Psychology, 1980; Najavits et al., Psychotherapy, 1994; Valle et al., J Studies on Alcohol and Drugs, 1981)

Purpose Determine if stop smoking advisors’ self-assessed personality scores were associated with clients’ four-week CO-verified quit status.

Design and Procedure Data were collected from: Clients n = 1,958 treatment episodes 54% female M age = years ± Advisors n = 19 79% female M age = ± 10.33years

Measures Confounding factors –Client Characteristics Age (years) Sex (male/female) Ethnicity (White/non-White) Medication use (yes/no) Social grade (low/medium/high) –Practitioner Characteristics Age (years) Sex (male/female) Experience as a stop smoking practitioner (years)

Measures Predictor Variable: SSS Advisor Personality –Measured using the Ten-Item Personality Inventory (TIPI) –Completed by advisors (self-assessed) Outcome Variable: Client Quit Status –CO-validated quit status at 4 weeks –Clients that did not attend the 4-week follow-up were assumed to still be smoking (Gosling, Rentfrow, & Swann Jr, J Research in Personality, 2003)

Analysis Personality scores calculated for each of the FFM personality dimensions for each advisor –i.e. openness-to-experience, conscientiousness, agreeableness, extraversion, neuroticism Multi-level random intercept model with a random effect for the advisors to account for clustering –R version and the glmer() function in the lme4 package –Confounding variable: practitioner and client characteristics –Predictor variable: advisor personality –Outcome variable: client CO-verified four-week quit status

Results Odds Ratio95% Confidence Interval Confounding Factors: Client & Practitioner Characteristics Client sex Client ethnicity Medication1.44* Client social grade Client age at quit date1.02*** Practitioner experience (years) Practitioner sex Practitioner age Practitioner Personality Dimensions Extraversion1.10* Agreeableness Conscientiousness Neuroticism Openness-to-experience (Note: ***p<0.001; **p<0.01; *p<0.05)

Results Odds Ratio95% Confidence Interval Confounding Factors: Client & Practitioner Characteristics Client sex Client ethnicity Medication1.44* Client social grade Client age at quit date1.02*** Practitioner experience (years) Practitioner sex Practitioner age Practitioner Personality Dimensions Extraversion1.10* Agreeableness Conscientiousness Neuroticism Openness-to-experience (Note: ***p<0.001; **p<0.01; *p<0.05)

Discussion Stop smoking advisor extraversion was positively associated with clients’ being abstinent from smoking at four weeks. A low introversion score (i.e. reserved, quiet) is associated with client abstinence from smoking at four weeks.

Implications for Smoking Cessation Adviser training –Train introverted practitioners to overcome their quiet and reserved manner Replication and further research needed –Mechanism by which the extraversion dimension affects the advisor-client interaction: Confidence when engaging with client? Application of evidence-based behaviour change techniques?

Limitations TIPI is only brief measure of personality Only included data from 19 practitioners who provided one-to-one support in two English SSSs Clients who did not attend the four-week follow-up were still assumed to be smoking

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