Functional beliefs about smoking and quitting activity among adult smokers in four countries: findings from the International Tobacco Control Four-Country Survey.

OBJECTIVE

To examine the psychometric properties, distributions, and predictive utility for quitting behavior of six functional beliefs about smoking among adult smokers.

DESIGN

Data was from the first three waves of the International Tobacco Control Four-Country Survey (ITC-4), a random-digit dialed telephone survey of a cohort of over 8,000 adult current smokers from the United Kingdom, United States, Canada, and Australia followed up annually.

MAIN OUTCOME MEASURES

Quitting attempts and the success of such attempts at the next wave.

RESULTS

The six functional belief measures are modestly correlated with each other and are moderately stable over time. Smoking for enjoyment and life enhancement were significantly negatively related to quitting attempts, at least partly mediated by quitting intention and dependence. Smoking for stress management appeared to reduce quit success among those who tried, an effect mediated by quitting self-efficacy and dependence. Smoking for weight control, social facilitation, and as an aid to concentration were not independently associated with cessation.

CONCLUSION

Positive reasons for smoking may discourage quitting, but stress management is the only function that appears to prospectively predict quit success. Interventions should target those beliefs, and review the value of intervening on beliefs that are unrelated to cessation outcomes.