Smith Andrea L, Carter Stacy M, Dunlop Sally M, Freeman Becky, Chapman Simon
Centre for Values, Ethics and the Law in Medicine, School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia.
Cancer Screening and Prevention, Cancer Institute NSW, Eveleigh, NSW, 2015, Australia.
BMC Public Health. 2017 May 11;17(1):430. doi: 10.1186/s12889-017-4326-4.
To better understand the process of quitting from the ex-smokers' perspective, and to explore the role spontaneity and planning play in quitting.
Qualitative grounded theory study using in-depth interviews with 37 Australian adult ex-smokers (24-68 years; 15 males, 22 females) who quit smoking in the past 6-24 months (26 quit unassisted; 11 used assistance).
Based on participants' accounts of quitting, we propose a typology of quitting experiences: measured, opportunistic, unexpected and naïve. Two key features integral to participants' accounts of their quitting experiences were used as the basis of the typology: (1) the apparent onset of quitting (gradual through to sudden); and (2) the degree to which the smoker appeared to have prepared for quitting (no evidence through to clear evidence of preparation). The resulting 2 × 2 matrix of quitting experiences took into consideration three additional characteristics: (1) the presence or absence of a clearly identifiable trigger; (2) the amount of effort (cognitive and practical) involved in quitting; and (3) the type of cognitive process that characterised the quitting experience (reflective; impulsive; reflective and impulsive).
Quitting typically included elements of spontaneity (impulsive behaviour) and preparation (reflective behaviour), and, importantly, the investment of time and cognitive effort by participants prior to quitting. Remarkably few participants quit completely out-of-the-blue with little or no preparation. Findings are discussed in relation to stages-of-change theory, catastrophe theory, and dual process theories, focusing on how dual process theories may provide a way of conceptualising how quitting can include elements of both spontaneity and preparation.
从戒烟者的角度更好地理解戒烟过程,并探讨自发性和计划性在戒烟中所起的作用。
采用定性扎根理论研究方法,对37名澳大利亚成年戒烟者(年龄在24 - 68岁之间;男性15名,女性22名)进行深入访谈,这些戒烟者在过去6 - 24个月内成功戒烟(26人未借助辅助手段戒烟;11人使用了辅助手段)。
基于参与者对戒烟经历的描述,我们提出了一种戒烟经历类型学:有计划的、机会主义的、意外的和天真的。参与者对其戒烟经历描述中不可或缺的两个关键特征被用作该类型学的基础:(1)戒烟的明显起始情况(从逐渐开始到突然开始);(2)吸烟者为戒烟做准备的程度(从没有准备的迹象到有明确准备的证据)。由此形成的2×2戒烟经历矩阵还考虑了另外三个特征:(1)是否存在明确可识别的触发因素;(2)戒烟过程中涉及的努力程度(认知和实际方面);(3)构成戒烟经历的认知过程类型(反思性的;冲动性的;反思性和冲动性兼具的)。
戒烟通常包含自发性(冲动行为)和准备(反思行为)的元素,重要的是,参与者在戒烟前投入了时间和认知努力。极少有参与者几乎没有或完全没有准备就突然彻底戒烟。我们结合变化阶段理论、灾难理论和双过程理论对研究结果进行了讨论,重点关注双过程理论如何为理解戒烟如何能同时包含自发性和准备性元素提供一种概念化方式。