Shepard and Glantz (2004) found that myocardial infarction admissions to a hospital
in Montana, USA fell significantly over 6 months during a smoking ban in public
places, while at the same time, surrounding areas (without a smoking ban) experienced
non-significant increases. In some cases, international legislation may be necessary. For
example, while taxation can be effective in reducing smoking, raising the price of
cigarettes in one country might have limited impact if it encouraged cigarette
smuggling from neighbouring countries in which cigarettes were cheaper.
The ‘social ecological’ model (Bartholomew et al., 2011) presented in Figure 9.2
illustrates different levels at which processes that regulate behaviour patterns can
operate. The model reminds us that individual behaviour patterns can only be
adequately understood by also taking account of the interpersonal, organizational,
cultural, economic and legislative contexts in which that behaviour develops and is
maintained. Acknowledging this point, in this chapter we will focus primarily on
interventions targeting intra-personal processes to bring about individual change. This
simplified approach will allow us to illustrate principles of intervention design and
evaluation that are generalizable across other levels highlighted by the ‘social ecological’
model.
CHANGING BEHAVIOUR 195SUPRANATIONALSOCIETYCOMMUNITYORGANIZATIONINTERPERSONALINDIVIDUALFIGURE 9.2Processes that regulate behaviour operate at different levels.
Source: Adapted from Bartholomew et al. (2011).