Psychological determinants of smoking cessation behaviors post group-intervention : a grounded theory explanatory model of long-term outcomes

Background: smoking is a highly prevalent adverse health behavior that is commonly treated using psychological interventions. research indicates that smoking cessation is a dynamic process; however, the psychological factors associated with successful cessation or relapse following a psychological intervention are unclear. Methods: adopting a grounded theory approach, twenty-eight individuals (successful in quitting smoking and not) who completed a psychological intervention for smoking cessation (in the previous 1 to 3 years) participated in focus groups where factors relating to smoking cessation were explored. Results: Factors related to the decision to stop smoking, in addition to behavioral and mental strategies used to change smoking behaviors, were similar in both successful and unsuccessful quitters. however, successful cessation was characterized by a greater prevalence of internal motivators, including higher self-efficacy and a search for an identity change, whereas relapse was associated with a greater tendency to attribute failure to quit on external factors such as the environment. Conclusions: the results provide novel evidence of the psychological factors associated with long-term successful smoking cessation or failure. These findings may assist in informing interventions aimed at facilitating cessation success in affected individuals and highlight the need to examine psychological determinants of smoking behavior change in clinical practice. Considering that smoking cessation success was linked to greater self-efficacy and identity reconstruction, the initial stages of psychological interventions should examine these factors as they may predict long-term cessation success. Similarly, building self-efficacy may shape the behavior change process towards success.