Table 1.

PRIME Theory principles underlying intervention design

Directly address motivation

1. Establish a very clear mental image of the goal of becoming an ex-smoker and how to get to it with the help of the quit plan.

2. Construct the personal rule such that it will generate strong resolve whenever needed (clear boundaries: ‘not even a puff’, achievable: ‘day at a time if necessary’, applicable to every relevant situation: ‘no matter what’).

3. Associate adhering to the rule with things to which the smoker has strong emotional attachment/central aspects of their identity (e.g. good role model for others, protecting loved ones).

4. Develop new sources of desire not to smoke and maximise the impact of existing sources of desire (e.g. wanting to keep the achievement to date).

5. Change aspects of identity that promote smoking (e.g. an ‘unhealthy’ person) and foster aspects of identity that promote not smoking (e.g. a healthy persona), in a way that supports rather than conflicts with other core aspects of identity (e.g. a rebel).

6. Change beliefs that generate a desire to smoke (e.g. that smoking helps with stress) in such a way that negative images of the results of smoking are generated.

7. Maximise the experience of reward they obtain from moving towards their goal of becoming an ex-smoker (e.g. by helping them visualise their achievement).

8. When describing what to expect ensure that it is phrased positively but realistically.

Maximise self-regulatory capacity and skills

9. Avoid cues that will trigger strong urges to smoke (e.g. through social or environmental restructuring).

10. Develop effective ways of distracting attention from smoking cues in the environment and from urges to smoke when they occur (e.g. by developing as routine activity).

11. Maximise levels of mental energy available to exercise self-control (e.g. by teaching ways of avoiding or reducing stress).

Make effective use of adjuvant activities

12. Make most effective use of medications that reduce the urges to smoke (e.g. by making sure that they choose the best medication, have appropriate expectations, use it properly and for long enough, and are not put off by side effects).

Promoting engagement

13. Establish a ‘rapport’ between the smoker and personification of the website (e.g. by creating a visual sense of the team behind the website who want the smoker to succeed) and use language that expresses shared understandings and empathy. Give feedback to the user to show that the program ‘understands’ his or her situation.

14. Set up clear expectations concerning how the site will be used early on.

15. Keep demands on the smoker to a minimum (e.g. for every question asked of the smoker calculate the cost in terms of making the site unattractive versus the benefit in terms of helping to tailor the website).

16. Make use of the site as habitual as possible in terms of the location of different elements, consistent forms of interaction and clear associations between goals that smokers may have and actions needed to achieve these.

17. Keep main pages as simple and visually appealing as possible but encourage and make it easy for smokers to explore the site to find out more information.

18. Always provide users with a rewarding experience when they visit the website. Each interaction must provide pleasure, satisfaction and/or relief, combat a tendency to habituate to website materials, and establish strong anticipated pleasure, satisfaction or relief for the next session. Do not require users to enter more than a few responses on a page without immediately rewarding them with answers to concerns, advice that is perceived as useful and information about themselves that they find interesting.

19. From the user’s perspective the website must provide desired information and advice and not be an overt attempt to motivate.