Reasons for quitting: Intrinsic and extrinsic motivation for smoking cessation in a population-based sample of smokers

doi:10.1016/S0306-4603(97)00059-2

Addictive Behaviors

Volume 22, Issue 6, November–December 1997, Pages 727-739

https://doi.org/10.1016/S0306-4603(97)00059-2 Get rights and content

Abstract

An intrinsic-extrinsic model of motivation for smoking cessation is extended to a population-based sample of smokers (N = 1,137), using a previously validated Reasons for Quitting (RFQ) scale. Psychometric evaluation of the RFQ replicated the model that includes health concerns and self-control as intrinsic motivation dimensions and immediate reinforcement and social influence as extrinsic motivation dimensions. Compared to volunteers, the population-based sample of smokers reported equivalent health concerns, lower self-control, and higher social influence motivation for cessation. Within the population-based sample, women compared to men were less motivated to quit by health concerns and more motivated by immediate reinforcement; smokers above age 55 expressed lower health concerns and higher self-control motivation than smokers below age 55. Higher baseline levels of intrinsic relative to extrinsic motivation were associated with more advanced stages of readiness to quit smoking and successful smoking cessation at a 12-month follow-up. Among continuing smokers, improvement in stage of readiness to quit over time was associated with significant increases in health concerns and self-control motivation.

References (20)

E.H. Wagner et al.
Participation in a smoking cessation program: A population-based perspective
American Journal of Preventive Medicine
(1990)
D.B. Abrams et al.
Integrating individual and public health perspectives for treatment of tobacco dependence under managed health care: A combined stepped-care and matching model
Annals of Behavioral Medicine
(1996)
A. Bandura
Self-efficacy: The exercise of control
(1997)
Centers for Disease Control
Cigarette smoking among adults: United States, 1993
Morbidity and Mortality Weekly Report
(1994)
S.J. Curry
Self-help interventions for smoking cessation
Journal of Consulting and Clinical Psychology
(1993)
S.J. Curry et al.
A randomized trial of selfhelp materials, personalized feedback and telephone counseling with nonvolunteer smokers
Journal of Consulting an Clinical Psychology
(1995)
S.J. Curry et al.
Intrinsic and extrinsic motivation for smoking cessation
Journal of Consulting and Clinical Psychology
(1990)
S.J. Curry et al.
Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program
Journal of Consulting and Clinical Psychology
(1991)
E.L. Deci et al.
Intrinsic motivation and self-determination in human behavior
(1985)
M.C. Fiore et al.
Smoking cessation

There are more references available in the full text version of this article.

Cited by (193)

Motivation, acceptability and attitudes toward lung cancer screening among persons who attend a tobacco cessation program: A multicenter survey in Italy
2023, Preventive Medicine Reports
This study aimed to evaluate smoking cessation (SC) motivation and the acceptability of a lung cancer screening (LCS) program with low-dose computed tomography (LDCT) among people who attend SC programs. A multicenter survey was conducted in the period January-December 2021 involving 197 people who attended group or individual SC courses in Reggio Emilia and Tuscany. Questionnaires, information sheets, and decision aids about the potential benefits and harms of LCS with LDCT were distributed at different time points during the course. The wish to protect own health (66%) was the most frequent reason given for quitting smoking, followed by cigarette dependence (40.6%) and current health problems (30.5%). Half of the participants (56%) considered periodic health checks including LDCT, as an advantageous activity. The great majority of participants were in favor of LCS (92%), with only 8% being indifferent, and no one was against these programs. Interestingly, those with sufficiently high smoking-related LC risk to be eligible for LCS and those attending the individual course were less in favor of LCS but also less concerned about the possible harms associated with LCS. The type of counseling was a significant predictor for both LCS acceptability and perceived harm of LCS. The favorable perception of LCS in people attending SC courses, despite the considerable preoccupation with potential harms, is an important finding of this study. Introducing a discussion on the benefits and harms of LCS in SC programs may prepare persons who smoke to make informed decisions on utilizing LCS.
Determinants of quit attempts among current Indian tobacco users: Findings from global Adult tobacco survey, 2016-17
2023, Clinical Epidemiology and Global Health
Tobacco use is the second most common preventable cause of death in the world and quitting tobacco is an important strategy to prevent premature morbidity and mortality. The objective of this study was to determine the correlates of quit attempts among tobacco users in India from GATS-2 data.
Complex sample analysis was considered for logistic regression analysis to identify the correlates of quit attempts using Global Adult Tobacco Survey (GATS)- 2 (2016–17) data. Weighted estimates were calculated for sample statistics.
A marked difference was observed in quit attempt rates across various states of India (p < 0.001). The quit attempt rate among current smokers and smokeless tobacco users was 33.7% [95% confidence interval (CI) = 32.8–34.7] and 28.9% [95% CI = 28.1–29.6] in India as per GATS 2. Individuals from scheduled caste and other backward classes had higher odds of making a quit attempt among current smokers. Among the smokeless tobacco users (SLT), factors namely age, belonging to other backward classes and having a belief that tobacco use is dangerous to health were independently associated with quit attempts. Majority of the users, 83.5% (95%CI = 82.2–84.8) of the smokers and 88%(95%CI = 87.0–88.9) of the SLT users made a quit attempt without any cessation aid.
Formulating tobacco control policies specific to the groups identified may bridge the gap between tobacco users and cessation services. The varying quit attempt rates reported across the country necessitates stringent implementation of tobacco control policies and programmes.
Effects of large financial incentives on motivation to quit smoking and on cigarette dependence
2023, Addictive Behaviors
Financial incentives enhance long-term smoking cessation rates, but their effects on motivation to quit in those who fail to quit are not well documented.
To test the effects of large financial incentives on motivation to quit smoking and on cigarette dependence in smokers who failed to quit despite receiving incentives.
Low-income smokers in the general population in Geneva, Switzerland, in 2011–2013.
A randomised controlled trial with follow-up after three, six and 18 months. Participants were assigned to receive either booklets plus access to a smoking cessation website (control group, n = 404), or the same intervention plus financial incentives (intervention group, n = 401). Incremental financial rewards, to a maximum of CHF 1500 (USD 1650, GBP 1000), were offered for biochemically verified smoking abstinence. No in-person counselling, telephone counselling, or medications were provided.
Intrinsic and extrinsic motivation to quit, intention to quit, cigarette dependence.
In smokers at 6-month follow-up, intrinsic motivation decreased in the control group (-0.24 SD units, p < 0.001), extrinsic motivation increased in the intervention group (+0.35 SD units, p = 0.001), and twice as many participants in the intervention group (35 %) than in the control group (17 %, p < 0.001) said they intended to quit smoking in the next 30 days. Quit attempts were more frequent and their duration was longer in the intervention group than in the control group. The intervention had no impact on cigarette dependence scores.
Large financial incentives increased motivation to quit smoking in smokers who failed to quit smoking despite receiving incentives.
Readiness to change among justice-involved young adults in an alternative sentencing program who screened positive for alcohol or drug risk
2022, Addictive Behaviors Reports
Readiness to change is a key component of substance use behavioral change; yet little is known about readiness to change among justice-involved young adults. This study 1) describes readiness to change alcohol and drug use and 2) examines predictors of readiness to change alcohol and drug use among justice-involved young adults.
Justice-involved young adults (18–24 years; n = 137) who were positive on a validated alcohol and/or drug screening tool completed an interview assessing substance use, readiness to change, and reasons to quit. A multivariable linear regression model examined whether reasons to change and substance use severity, and interactions between these, predicted readiness.
More than half of participants were contemplating or had decided to quit/cut down substance use. Personal reasons to quit were positively related to readiness to change; interpersonal reasons were negatively associated.
This study contributes information needed to design motivational interventions for substance use among justice-involved young adults. Personal reasons to quit using drugs are a potential intervention target.
Phenomenological insight into the motivation to quit smoking
2021, Journal of Substance Abuse Treatment
Citation Excerpt :
Previous studies have reported that quit rates for tobacco use increase more with personalized advice (e.g., physical health goals) compared to financial enticements (e.g., saving money). Personalized advice also helps an individual from slips and relapse (Curry et al., 1997, 1990, 1991; Niemiec et al., 2009). Ryan and Deci emphasized not promoting behavior change through financial compensation to prevent relapse (Ryan & Deci, 2008).
Quitting tobacco is often viewed as a difficult experience as the dependence includes sets of behavioral, cognitive, social, and physiologic phenomena that prevent most smokers from having a successful first attempt of quitting. The aim of this qualitative study was to gain insight into and understand the motivation for attempts to quit smoking in relation to the stages of the behavior change model.
The study team based this qualitative study on Alfred Schütz's social phenomenology framework. The study team planned for fourteen in-depth interviews with patients registered at a Quit Smoking Clinic. Each in-depth session lasted 45–60 min and we audio recorded them with consent. Following full verbatim transcription, the study team carried out detailed thematic analysis using Nvivo software.
Out of a total of 14 patients, 10 agreed to participate (response rate 71.4%). Seven participants (70%) had successfully quit smoking, while the remaining 30% relapsed after the first quit attempt. The study team extracted from the data three key themes with eight child nodes: barriers to quitting smoking, reasons for quit attempt, and how to quit. Unsuccessful attempts were related to tobacco addiction and successful attempts were based on the need to improve one's health and family. The study explored two intrinsic (self-realization and healthy lifestyle) and two extrinsic motivations (family's health and role model for children) for attempting to quit.
The study highlights the importance of psychological support in successful quit attempts. Treatment providers should encourage behavior change through intrinsic goals, as such goals, compared to extrinsic goals, have a long-term and positive impact because they can activate autonomous motivation.
Issues surrounding incentives and penalties for COVID-19 vaccination: The Israeli experience
2021, Preventive Medicine
The purpose of this study was to examine patterns of COVID-19 vaccination in Israel and how these relate to different proposals made about benefits for those vaccinated, and to present the legal and ethical dilemmas surrounding these issues.
A retrospective study of COVID-19 vaccination rates in Israel was conducted, with data obtained from the Ministry of Health (MOH). Information on benefits proposed or offered for vaccination and restrictions for non-vaccination were obtained from the MOH and presented in a timeline.
By March 1st, 51% of the total population, and 91% of those aged 60 and over, had received their first COVID-19 vaccine. Exemption from quarantine was granted to vaccinated or recovered people from 17th January 2021. The ‘green pass’ incentive scheme, granting access to social, cultural and sporting events for those fully vaccinated or immune, was proposed in December 2020, and came into effect on February 21st 2021.
Incentive schemes which impose limitations on those who choose not to vaccinate may motivate some people to take action. Policymakers should use a measured approach to protect public health, with minimum infringement on citizens' rights. Providing transparent and culturally appropriate information on immunization and ensuring maximal and equitable access to COVID-19 vaccines may help build trust.

View all citing articles on Scopus

^☆: Data reported in this article were collected in studies supported by National Institute on Drug Abuse Grant Number RO1-DA04447. Portions of this article were presented at the First Annual Conference of the Society for Research on Nicotine and Tobacco, San Diego, March 1995. We thank Jason Petteway for his work on data analysis.

View full text

Reasons for quitting: Intrinsic and extrinsic motivation for smoking cessation in a population-based sample of smokers☆

Abstract

American Journal of Preventive Medicine

Integrating individual and public health perspectives for treatment of tobacco dependence under managed health care: A combined stepped-care and matching model

Annals of Behavioral Medicine

Self-efficacy: The exercise of control

Cigarette smoking among adults: United States, 1993

Morbidity and Mortality Weekly Report

Self-help interventions for smoking cessation

Journal of Consulting and Clinical Psychology

A randomized trial of selfhelp materials, personalized feedback and telephone counseling with nonvolunteer smokers

Journal of Consulting an Clinical Psychology

Intrinsic and extrinsic motivation for smoking cessation

Journal of Consulting and Clinical Psychology

Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program

Journal of Consulting and Clinical Psychology

Intrinsic motivation and self-determination in human behavior

Smoking cessation