Table 2

Intervention components, aims, content and indicative change in processes

Intervention componentsAimContentIndicative change in processes
Active participant involvement (1)Develop rapport, build trust and shared respect.Effective communication skills. Build autonomous support.Participant feedback on health trainer-led support.
Build motivation to reduce smoking (2) and increase physical activity (3)Identify ambivalence towards reduction and quitting. Build self-awareness and confidence to cut down and increase physical activity.Help smoker to identify importance and challenges of reduction and cessation, and implicit and explicit roles of physical activity (motivational interviewing techniques).Smoker has desire and confidence to cut down and perhaps quit over the early sessions, and increase physical activity. Smoker engages in more self-monitor of smoking and physical activity behaviour.
Self-monitor smoking and physical activity and set goals to reduce smoking (4) and increase physical activity (5)Develop strategies to reduce smoking and increase physical activity.Set SMART goals to reduce smoking and increase physical activity. Signpost to physical activity opportunities and remove barriers to do physical activity.Goals identified and action plans developed. Smoker engages in more goal setting to reduce smoking and increase physical activity behaviour.
Review/problem solving for smoking (6) and physical activity (7)Build confidence, perceptions of control and self-regulation skills.Smoker reflects on smoking reduction and physical activity, identifies barriers and possible solutions, increases and sets new targets; perhaps to quit.Goals revised to reflect confidence to increase physical activity, reduce smoking and possibly quit.
Integrating idea of changing smoking and physical activity (8)To help smoker to identify any links between smoking and physical activityExplore with smoker how physical activity may influence smoking (and vice versa) (person centred exchange of information (Ask–Tell–Discuss)).Smoker increases use of physical activity as an aid to smoking reduction.
Reinforce health identity shift (9)To help identify shift from smoker to healthier identity.Smoker reflects on label as heavy–moderate–light or non-smoker status, and more active person.Decrease in importance of smoking and increase in importance of doing physical activity identified.
Manage social influences on smoking (10) and physical activity (11)To involve others in process of reducing smoking and increasing physical activity. Manage negative or undermining social influences.Smoker identifies key others who can support reduced smoking (or cessation) and increasing physical activity, and engages with them in preferred ways. Uses negotiation and discussion to manage negative social influences.Support from others identified as important and used for smoking reduction or cessation, and increasing physical activity.