Motivational factors predict quit attempts but not maintenance of smoking cessation: findings from the International Tobacco Control Four country project

Nicotine Tob Res. 2010 Oct;12 Suppl(Suppl 1):S4-11. doi: 10.1093/ntr/ntq050.


Aim: To explore whether measures of motivation to quit smoking have different predictive relationships with making quit attempts and the maintenance of those attempts.

Methods: Data are from three wave-to-wave transitions of the International Tobacco Control Four (ITC-4) country project. Smokers' responses at one wave were used to predict the likelihood of making an attempt and among those trying the likelihood of maintaining an attempt for at least a month at the next wave. For both outcomes, hierarchical logistic regressions were used to explore the predictive capacity of seven measures of motivation to quit smoking, controlling for a range of other known or possible predictors.

Results: Bivariate analyses indicate that measures of motivation to quit are predictive of making quit attempts, but they predict relapse among those making attempts. Multivariate analyses identified wanting to quit and frequency of prematurely butting out cigarettes as the main positive predictors of making attempts, but this was reduced by intention and recency of last attempt. For maintenance, premature butting out was the main motivation variable predicting relapse and was essentially unaffected by other measures.

Discussion: The findings show that it is wrong to suggest that all one needs to quit is to be motivated to do so. The reality is that one needs to be motivated to prompt action to stop smoking, but this is not sufficient in and of itself to ensure that cessation is maintained. These findings call attention to the importance of understanding the differential roles that prequit and postquit experiences play in smoking cessation and of providing help to smokers to stay off cigarettes.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude to Health*
  • Australia / epidemiology
  • Canada / epidemiology
  • Female
  • Humans
  • Intention
  • International Cooperation
  • Male
  • Middle Aged
  • Motivation
  • Multivariate Analysis
  • Risk Reduction Behavior
  • Secondary Prevention
  • Self Efficacy*
  • Smoking / epidemiology
  • Smoking / psychology*
  • Smoking Cessation / methods*
  • Smoking Cessation / psychology*
  • Smoking Cessation / statistics & numerical data
  • Smoking Prevention
  • Socioeconomic Factors
  • Tobacco Use Disorder / epidemiology
  • Tobacco Use Disorder / prevention & control
  • Tobacco Use Disorder / psychology*
  • United Kingdom / epidemiology
  • United States / epidemiology
  • Young Adult