Using Motivation to Help Employees Stop Smoking. Christine DiSpina. Jessica Warstler. Educational Psychology. The University of Akron

Transcription

1 Running Head: Smoking Cessation Motivation Program Page 1 Using Motivation to Help Employees Stop Smoking Christine DiSpina Jessica Warstler Educational Psychology The University of Akron Dr. Mudrey-Camino July 27, 2012

2 Running Head: Smoking Cessation Motivation Program Page 2 Introduction We have chosen a timely topic in Higher Education in the State of Ohio. Wellness and Smoking Cessation are important topics in Higher Education and Human Resources. We both work in the Human Resources Department at The University of Akron, so our department provides Health Benefits to University employees. We are currently working on Wellness programs to facilitate smoking cessation and counteract the negative effects on both employees that smoke and people that are exposed to second hand smoke. We are also focused on the increasing health care cost of employees that are smokers. This topic is especially relevant because on July 23, 2012, the Ohio Board of Regents voted to recommend that all university campuses in the state of Ohio ban the use and sale of all tobacco products on campus. We will be analyzing methods to assist University of Akron employees to quit smoking. Specifically, we are going to address Goal Theory and Intrinsic and Extrinsic Motivation to help motivate our employees to stop smoking. The University of Akron employee population is very diverse. Employees range in age from There are both men and women, smokers and nonsmokers and we are well represented by many different cultural backgrounds. We will take these traits into account as we design our smoking cessation programs. The two topics that we will be analyzing will be goal theory and intrinsic and extrinsic motivation. We are going to try to motivate smokers employed by the University to quit smoking permanently. The reasons why we want them to stop smoking are for their own

3 Running Head: Smoking Cessation Motivation Program Page 3 health, lower insurance costs for the University, and recently the Ohio Board of Regents is recommending to end all smoking on campuses. We will discuss the use of extrinsic motivation and intrinsic motivation as one method to motivate employees to quit smoking. Some techniques we will use are positive feedback and rewards. We will set up a rewards program to assist in the motivation of employees. Positive feedback will also motivate employees to quit smoking. Goal Theory is another theory we will use to help motivate our employees to quit smoking. We will establish an outline of both proximal and distal goals to permanently stop smoking. We are optimistic that the outcome of our smoking cessation program will motivate our employees to stop smoking. We will try to utilize what we know to facilitate this goal. We will use rewards, positive feedback, goal setting, and an accountability partner. We want to help employees stop smoking for the following reasons: 1. Our employees will be healthier, which allow them to be more effective at work and require less sick leave. 2. Students and employees will be healthier because they are not breathing in second hand smoke. 3. The University will save money from lower health care costs. Theoretical Analysis Intrinsic and Extrinsic Motivation Intrinsic and extrinsic motivation can be key factors in the classroom for teachers to use. There are major differences between extrinsic and intrinsic motivations. Intrinsic motivation refers to motivation to engage in an activity for its own sake. There is no tangible benefit from

4 Running Head: Smoking Cessation Motivation Program Page 4 being intrinsically motivated except sheer enjoyment of participating in or accomplishing the task. Conversely, extrinsic motivation does not come from within; it comes from something outside whether it s a reward, teacher praise, or avoidance of punishment (Schunk, Pintrich, and Meece, 2008, p. 236). We have a diverse group of employees at the University. We do not know the exact number of employees that smoke; however, we will assume the smoking population is a mixture of both genders, a wide range of ages, and culture backgrounds. We could do a survey to find out the statistics to compare the smoking population. This would provide information on the demographics of smokers vs. non-smokers in the categories of gender, age and ethnicity, but there is no way of knowing if employees would tell the truth or not. We are not certain that smokers would be comfortable providing this information to their employer. Therefore, we will assume our population is very diverse due to gender, age, and ethnicity. There are several factors that contribute to the challenges of quitting smoking. Addiction to nicotine is widely accepted as the primary reason that it is very difficult to quit smoking, thus there must be some sort of incentive for employees to want to quit smoking. Since our population of smokers is assumed to be diverse, we have decided to use several different methods to help motivate smokers to stop smoking. We know that everyone is different, so we think different things will motivate different people. Our first method of extrinsic motivation will be a rewards program. We will set up a rewards system in which the rewards increase in valence for employees. Valence refers to individuals personal value beliefs about the importance of the goal, which may be based on interest, utility, monetary, or

5 Running Head: Smoking Cessation Motivation Program Page 5 attainment value beliefs (Schunk, Pintrich, and Meece, 2008, p. 145). There will also be different steps in which employees must reach in order to receive a reward. The different levels would depend on how long the employees have managed to remain smoke free. We will be using an honor system to determine their reward time; we will just assume employees will be honest if they have been smoke free. The different rewards will be given at the time intervals of one week, one month, three months, six months, and one year. The following table describes the available choices of rewards for employees. We want employees to have choices, because various prizes will appeal to each gender and employees in different age ranges. SMOKE FREE REWARD CHOICES Choose 1 When You Reach Each Level TIME ONE WEEK ONE MONTH $20 Subway gift card, $20 Starbucks gift card Free lunch at Rob s Café, 2 free football game tickets, $50 credit on Flexible Spending Account for Health Care related expenses THREE MONTHS SIX MONTHS 6 month free membership to Rec Center, 4 free Zips Soccer Tickets $100 credit on Flexible Spending Account, 4 free tickets to any Zips sporting event, $50 credit of women apparel at Book Store 1 YEAR 4 tickets to Zips Football game, Soccer game or Basketball game, $100 Zipcard credit Besides using rewards as an extrinsic motivator, we will also use positive feedback for our employees. Positive feedback will make employees feel good about their progress, so it

6 Running Head: Smoking Cessation Motivation Program Page 6 should motivate them to keep being smoke free. A positive reinforce is a stimulus that, when presented following a response, increases the future rate or likelihood of the response in that situation (Schunk, Pintrich, and Meece, 2008, p. 23). The positive feedback will be setup similarly to our rewards program. At one week of being smoke free employees will be given verbal positive feedback from their accountability partner and their HRSCS. After each week of being smoke free, the HRSCS will give verbal positive feedback through an or phone call. Even though extrinsic motivation techniques such as rewards and positive feedback may help motivate people to stop smoking, motivation from within will be a stronger factor in motivating employees to stop smoking. Extrinsic factors such as offering money or tickets to employees may be an assisting factor in motivating people to stop smoking, but our employees are going to have to want to quit and make the choice for themselves. The views of de Charms (1968), Rotter (1966), White (1959), and Harter (1978) stress that motivation derives in part from the belief that individuals can exert control over their environment. A related perspective, which has been advanced by Deci, Ryan, Connell, Skinner, and their colleagues postulates that humans have a need to be autonomous and engage in activities because they want to (Schunk, Pintrich, and Meece, 2008, p. 248). To help increase employees internal motivation to stop smoking, we also need to offer valid reasons why employees themselves should make the choice to stop smoking. If employees have the choice now before it s mandatory for universities to be smoke free, employees are going to feel better that the choice was theirs. The concept of perceived control over task engagement and outcome is central to many views of intrinsic motivation. Those with

7 Running Head: Smoking Cessation Motivation Program Page 7 an internal locus of control believe that outcomes are contingent on their actions and largely under their control (Schunk, Pintrich, and Meece, 2008, p. 244). To motivate our employees to choose to stop smoking, we can offer seminars in which we educate our employees. If we can educate people in detail on the advantages to stop smoking, then they can make their own decision to stop or not. If they are more in control of their own decisions, intrinsic motivation should help them more than rewards or positive feedback. Extrinsic motivation factors can serve as additional motivational factors. We can educate them on the health benefits and financial benefits of not smoking. We can also educate them how their own actions to stop smoking will positively influence their health and their relationships with their friends and family. Goal Setting There are three characteristics involved with effective goal setting. We are going to work with employees to teach them to set their own goals by using the following three characteristics. The first characteristic is specificity. The employee will obviously be setting their goal to stop smoking. The specifics include: will they stop cold turkey or will they wean themselves gradually. Cold turkey is defined as abruptly stopping smoking. Weaning is defined as gradually decreasing the amount of smoking over several days or weeks. With either choice, the employee will need to choose a day that they will begin the program. Research shows that they will have a higher chance of success if they choose a special day to begin their program. For example, they may want to choose a birthday, holiday or anniversary to stop smoking.

8 Running Head: Smoking Cessation Motivation Program Page 8 If the employee chooses to wean themselves gradually, then they need to specify how long they will stay at each level before the next decrease. For example, if they decrease their smoking to 10 times per day for the first week, they may choose to drop down to 8 times per day for the second week. This plan should be very specific to increase their chances for success. The second characteristic of goal setting is to set both proximal and distal goals. Proximal are short term and distal are long term. When setting goals, individuals are more likely to experience efficacy for goal attainment and higher motivation. (Schunk, Pintrich, and Meece, 2008, p. 149). If the employee chooses to wean themselves gradually from smoking, then the proximal and distal goals are related to amount of smoking over time. If the employee chooses to quit cold turkey, then the proximal goal is to quit smoking for the first week. The distal goal is to be still not smoking in one month or in six months. The employee may have a special occasion coming up in six months, for example, a wedding, or a birthday. They may set a distal goal that they will be not smoking at their 40 th birthday that is six months in the future. We will work with the employees to set their own goals using their guidelines. We think the goal setting is more effective if they make their own choices that best fit what successes they envision. The third characteristic of goal setting is utilizing the appropriate level of difficulty. If the goal is too difficult, then they will not be as likely to achieve their goal. If the goal is too easy, then they may not be motivated enough to work towards achieving the goal. Goal orientation theory suggests that tasks that offer an optimal level of challenge are best. An

9 Running Head: Smoking Cessation Motivation Program Page 9 example of a goal that is too difficult would be to try and stop smoking during a very difficult or stressful time. If an employee is experiencing a death in the family or financial crisis, then it may be difficult to quit cold turkey. If they really need to quit cold turkey and they have other significant stress in their life, then we would recommend they seek professional help to cope with these other issues while working on their smoking cessation goals. We would encourage them to use the employee assistance program that has free counseling sessions. An example of a goal that may not be difficult enough is for an employee to try and smoke one less cigarette per day for an extended period of time. Instead of smoking ten times per day, they want to smoke nine times per day for six months before dropping down to eight times per day. This goal would be too easy and also not ambitious enough to make any progress towards the distal goal of quitting smoking. We will work with employees to set their own goals that meet these guidelines. In addition to providing the employee with guidelines on goal setting, we will also provide information on what to expect during this process and what other methods other employees have used to accomplish this goal. Bandura (1986, 1988) found that observation of peers can lead students to adopt comparable goals, (as cited in Schunk, Pintrich, and Meece, 2008, p. 275). If employees see other employees accomplishing their goals, then it will motivate them to work towards their own goals. Practical Applications To begin the Smoking Cessation program for University of Akron employees, we would create an implementation project plan. The following steps would be implemented in order.

10 Running Head: Smoking Cessation Motivation Program Page Announcement of New Smoking Cessation Program. This would be through Digest and messages sent directly to all Full Time and Part Time employees. 2. Kick Off Event. This event will be scheduled in the Student Union and include information, rewards, food, games and an appearance by Zippy. Employees can sign up to begin the program at this time. Setup appointment with Human Resources Smoking Cessation Specialist (HRSCS) at event to begin goal setting process. Employees may also setup appointment with HRSCS for more convenient time in the near future. 3. Employees will sign contract to begin program, receive consultation with HRSCS to set their goals and identify accountability partner. 4. HRSCS will continue to follow and support employee throughout process. 5. Smoking Cessation Classes and Support Groups will be setup on a weekly basis at various times throughout the day at various locations on campus. Light refreshments will be served at these sessions to encourage attendance. 6. Rewards will be distributed as determined by program guidelines. 7. We will continue to promote the Smoking Cessation program after initial kickoff meeting. We will continue to provide information to employees to try and motivate additional employees to join the program. We will include information about the success of other employees and reasons to stop smoking. 8. We will complete follow up surveys with all employees that sign up that will allow us to determine the strengths and weaknesses of our program.

11 Running Head: Smoking Cessation Motivation Program Page 11 Obstacles and Strategies: 1. According to the Centers for Disease Control and Prevention, many smokers try to quit many times before they are successful. This idea shows that this will be a long term program and we need to follow up with employees even after they drop out. We need to continue to set goals and give them the option to try again after identifying why it didn t work on previous attempts. 2. We would like to follow up with employees, but we need to treat them with respect. We cannot cross over the line whereas they feel as if we are hounding them to quit smoking. They will be more successful in the long term if they decide that they need to quit smoking. When an employee drops out of the program, we need to let them know that the program is still available when they are ready to try again. 3. In our research, we discovered studies that related Smoking Cessation to the Self Determination Theory. Studies show that Smoking Cessation programs are actually more successful without external rewards. According to Deci, et al. (2001), external rewards undermined intrinsic motivation. In one study by Curry, et al. (1990), smokers who were rewarded for smoking cessation did better at first but after three months were worse than those given no rewards and no feedback. Participants that received rewards even lied more about the amount they were smoking. Taking this into account, we decided that we want to still offer the rewards but put more focus on developing the intrinsic motivation. We will communicate to the employee that the rewards may be helpful to get started, but the strength and

12 Running Head: Smoking Cessation Motivation Program Page 12 motivation will have to come from within. The issue of rewards will be reevaluated after the preliminary phase of the program and we analyze the results. 4. We have identified three popular motivating factors that individuals cite when asked why they want to quit smoking: Better Health, Money, Children s Health. After the employee specifies in the contract what their primary motivation is, we are going to continue to provide them with information in that particular area. The employee has already identified what motivates them, so we want to continue to educate them on that issue. The following table provides links to some of the information that we will use to enhance their intrinsic motivation for these factors. We will add additional factors as they are specified by participants. We want to help them by using what they specify is important to them. Factor: Money Information: Smoking Calculator at Better Health Motivational Facts From Wikipedia: hin 20 minutes after quitting, blood pressure and heart rate decrease recovering

13 Running Head: Smoking Cessation Motivation Program Page 13 Children s Health 5. Fear of Gaining Weight - Some individuals are concerned about weight gain as a result of quitting smoking. We will offer Weight Watchers programs on campus and Nutrition Seminars. Also, participants are eligible for reduced membership at the Rec Center. We will highlight these areas to help motivate employees to start the smoking cessation program. 6. Privacy Many employees may feel that this is a private matter and do not want their employer or coworker to be aware of their smoking or progress in the program. The consultation with the HRSCS can be held privately. If the employee is uncomfortable going to a group meeting at their workplace, then they can participate in meetings at other area businesses that we can network with to share resources. For example, a Summa employee could attend a support meeting at the University and a University employee could attend a support meeting at Summa. 7. Honor System We will use the Honor System for employees to report their smoking/not smoking to us. There will not be a blood test or a smell test as this could

14 Running Head: Smoking Cessation Motivation Program Page 14 be construed as a violation of privacy. Also, there will not be Smoking Police to monitor employees at their workplace. 8. This paper is focused on the motivation aspect and some of the logistics of the program; however, we have uncovered so many more aspects of the program that we would like to research and offer in future stages of the program. For example, we would like to offer behavior modification sessions, counseling that includes discussion of past quit attempts and relapses, information on medication, and relapse prevention planning. 9. There are several smoking cessation products, some containing nicotine and some nicotine free. These are available through the Ohio Department of Health or through our employee health benefits. The use of these can be discussed with the employee s doctor. The HRSCS will provide information to the employee if they are interested in this option. Reflection and Conclusion DiSpina I eagerly started this project because I knew it was something that we may actually implement in our department. I knew very little about smoking or quitting smoking. I ve never had somebody close to me smoke or quit smoking. Jessica and I chose two theoretical perspectives and began to research the obvious aspects of smoking and smoking cessation. I was familiar with the cost aspects of smoking and medical insurance and life insurance. When I started talking to coworkers about the process, I realized how little I knew about the challenges of quitting smoking. Several coworkers explained to me that smokers really only

15 Running Head: Smoking Cessation Motivation Program Page 15 decide to quit when they have to. My coworker told me her first husband quit smoking when he had his first heart attack. It didn t last and he started smoking again. He died when he had his second heart attack at 44 years old. Another coworker told me that her husband plans to quit smoking if he ever has a heart attack. Their stories were a very important part of the research for this paper. I could not really imagine how hard it is to quit smoking. I can t imagine being addicted to something that you know is life threatening. Only after these conversations did I realize how difficult it would be to make this program successful. I then realized that we have to develop their intrinsic motivation based on what mattered most to them. Another interesting lesson learned was when I came across the studies that showed that extrinsic motivation may do more harm than good. I very much agree with this viewpoint. I think that you can only do what is inside you and what you believe in. The conflict is that people want to see programs with rewards. We want people to buy into the program and some of them may only be able to see the simplistic viewpoint. This includes administrators that would approve the program as well as many of the potential participants. We also discussed the financial aspect of this program, although we chose to not include it in the paper. I discussed with my supervisor why this program has not been implemented yet. There was a committee to discuss the options in At that time, they planned on making all campus buildings smoke-free. After the 2008 study, they decided not to move forward with a smoke-free campus because they were concerned that people would view it negatively. Smoke free areas have become much more widely accepted in the last 4 years.

16 Running Head: Smoking Cessation Motivation Program Page 16 My supervisor and I discussed how to determine the cost for implementing the program designed in this project and the potential savings. I found documentation that references the CDC as estimating that a smoker costs their employer $3856 more than a non-smoker. I was not able to verify this statistic with the CDC but think it is ok for project estimates. We also tried to estimate what percentage of employees are smokers. The CDC statistics showed 20% of adults smoke, 9% of adults with college degrees smoke, and 6% of adults with post graduate degrees smoke. We estimate that the average employee at the University has a college degree and we used the 9%. We have approximately 2600 full time employees. Our estimate is that 234 employees smoke. We are going to continue looking at these numbers and determine if we could implement a smoking cessation program with a goal of helping at least 50 employees quit smoking. To do this, we would find out the reasons that they want to quit smoking and try to help them focus on those reasons to stay motivated. This project has been interesting and informative. I m very excited about the possibilities for further research in this area and possible implementation within the next 6 months.

17 Running Head: Smoking Cessation Motivation Program Page 17 References Deci, E., Koestner, R., & Ryan R. (2001). Extrinsic rewards and intrinsic motivation in education: Reconsidered once again. Review of Educational Research, 71, Curry, S., Wagner, E., & Grothaus, L. (1990). Intrinsic and extrinsic motivation for smoking cessation. Journal of Consulting and Clinical Psychology, 58, Schunk, D. H., Pintrich, P. R., & Meece, J. L. (2008). Motivation in Education: Theory, Research, and Applications (3 rd ed). Upper Saddle River, NJ: Pearson.