The role of self-efficacy, adaptive coping, and smoking urges in long-term cessation outcomes

Objective: Smoking cessation self-efficacy and adaptive coping are posited as 2 important treatment targets in smoking cessation interventions, especially in the context of handling strong urges to smoke. Yet, less is known about whether intervention-related changes in these constructs predict long-term smoking outcomes. The current study aimed to examine changes in smoking urges, smoking cessation self-efficacy, and adaptive coping after a health-focused and cognitive-behavioral telephone-delivered smoking cessation treatment, and the association to smoking reduction during long-term, 12-month follow-up. Methods: Participants (n=61) were daily smokers enrolled in a 12-week pilot trial that tested the efficacy of 2 different health-focused interventions with an adjunct of traditional telephone-delivered cessation counseling. Smoking urges, smoking cessation self-efficacy, and adaptive coping were assessed as baseline and immediately posttreatment. An average of 7-day cigarettes use per day were assessed at posttreatment, and 6 and 12 months postbaseline follow-up timepoints. Results: Smoking urges were significantly lower posttreatment, and smoking cessation self-efficacy and adaptive coping were significantly higher posttreatment, relative to baseline. After adjusting for baseline values, posttreatment smoking urges were significantly positively associated with cigarette use at posttreatment and 6-month follow-up. Posttreatment smoking cessation self-efficacy, but not adaptive coping, was significantly negatively predictive of cigarette use at posttreatment and 6- and 12-month follow-up timepoints. Posttreatment smoking cessation self-efficacy emerged as significant indirect predictor of the association between posttreatment smoking urges and posttreatment cigarette use. Conclusions: Interventions that target smoking cessation self-efficacy may facilitate long-term reductions in smoking among daily smokers undergoing a quit attempt.