Self-efficacy for quitting vs. temporary abstinence: two aspects of the complex smoking process

Abstract

Background Behaviour change strategies for smoking cessation present different components, including self-efficacy. We hypothesized that self-efficacy to quit smoking (quitting self-efficacy, QSE) and self-efficacy to temporarily abstain from smoking (abstinence self-efficacy, ASE) are different aspects of the smoking cessation process. Methods The study included 156 smokers attending public psychiatric services, participating in a motivational intervention with a 26-hour tobacco-abstinence period. Pre- and post- measures on 10-point QSE and ASE scales were compared according to success of 26h temporary abstinence, quit attempts at 1 week and decision to quit. Findings ASE (median 8 at pre- and 10 at post-intervention; n=128; p<.001) and QSE (median 8 and 9; n=124; p=.05) significantly increased during the intervention. Patients succeeding with temporary abstinence (55.3%) had higher ASE before the intervention than patients who failed (median 9 versus 7; p<.001), but no difference was observed for QSE (p=.06). After intervention, both ASE and QSE were significantly higher in patients who had remained abstinent for 26 hours (p<.001 and p=.004, respectively). In smokers making a quit attempt immediately after the intervention (33.3%), ASE and QSE were significantly higher, before and after the program (p<.05). ASE increased from pre- to post-assessment both in quit attempters (p=.001) and non-attempters (p<.001), whereas QSE did not change significantly (attempters p=.26; non-attempters p=.18). Discussion Results suggest that mental preparation and intention-based elements related to QSE might differ from readiness for action-based elements involved in ASE. They highlight relevance of action-oriented interventions based on temporary abstinence and interest of eliciting unplanned quit attempts.