Robert West is Professor of Health Psychology and Director of Tobacco Studies at the Cancer Research UK Health Behaviour Research Centre, University College London, UK. Professor West is also co-director of the National Centre for Smoking Cessation and Training and is Editor-in-Chief of the journal Addiction. He is co-author of the English National Smoking Cessation Guidelines that provided the blueprint for the UK-wide network of stop-smoking services that are now an established part of the UK National Health Service. His research includes evaluations of methods of helping smokers to stop and population surveys of smoking and smoking cessation patterns.
Addiction is a chronic condition, learned through experience, involving repeated powerful motivation to engage in a behaviour to an extent that causes, or risks, significant unintended harm. Addiction cannot be adequately understood in terms of any one discipline, but each of the disciplines of the behavioural and social sciences, from neuroscience to anthropology, can provide valuable insights.
A psychological approach to understanding addiction involves core motivational constructs such as intention, evaluation, want, need, impulse, inhibition, and self-regulation. It involves social constructs such as identity and norms. And it involves processes of change such as dissonance reduction, assimilation and accommodation, imitation, operant and classical conditioning, drive reduction, sensitisation, and habituation.
The PRIME Theory of motivation is an evolving attempt to integrate these and other key constructs into a coherent model that can provide a basis for reducing the prevalence of, and harm from, addictive behaviours, and to achieve behaviour change more generally. Its roots are in psychology but it aims for integration with other behavioural and social science types of model.
This presentation outlines the current version of PRIME Theory and how it accounts for major observations in the study of addiction, where it sits within the broader model of behaviour (COM-B: capability, opportunity, motivation, behaviour), and the implications for individual- and population-level strategies for combatting addiction. It illustrates the principles using a recent exercise to support English Local Authorities to develop effective tobacco control strategies.
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