Increased self-efficacy to quit and perceived control over withdrawal symptoms predict smoking cessation following nicotine dependence treatment

Abstract

Aim: To examine changes in nicotine withdrawal, nicotine craving, self-efficacy to quit smoking, and perceived control over withdrawal symptoms as predictors of smoking cessation following behavioral counseling and nicotine replacement therapy in a sample of smokers.

Design and setting: The data were ascertained from a randomized effectiveness trial comparing nicotine patch to nicotine lozenge. Predictors of smoking cessation were assessed at baseline and 5 weeks post-baseline, and 24-hour point prevalence abstinence, biochemically confirmed, was assessed at the end-of-treatment (week 15) and 6 months after a target quit date (week 27).

Participants: 642 treatment-seeking smokers randomized to 12 weeks of nicotine patch or nicotine lozenge.

Findings: Participants who showed a greater increase in self-efficacy to quit smoking (OR=1.09, 95% CI: 1.02-1.16, p=.01) and perceived control over withdrawal symptoms (OR=1.02, 95% CI: 1.00-1.04, p=.05) were significantly more likely to have quit smoking at week 15. Participants who showed a greater increase in self-efficacy to quit smoking (OR=1.04, 95% CI: 1.01-1.06, p=.01) were significantly more likely to have quit smoking at week 27. Changes in withdrawal symptoms and craving were not related to week 15 or week 27 abstinence rates.

Conclusions: The results highlight two relatively under-studied potential psychological predictors of abstinence following treatment for nicotine dependence. Behavioral counseling interventions to promote smoking cessation should help smokers develop confidence in their ability to quit smoking and increase their sense of control over withdrawal symptoms to increase their chances for cessation.