The dynamics of smoking quit motivation in daily life: Associations with momentary self-regulation and nightly quit intentions

Most smokers know that smoking is a health hazard, yet despite half of smokers attempting to quit each year, <10 % are successful (US Department of Health and Human Services, 2020). Increasing both quit attempts and cessation success rates are important goals which both require an understanding of motivation and self-regulation. Without self-regulation—the processes needed to pursue and attain goals (Mann et al., 2013)—smokers are unlikely to attempt cessation, nor are they likely to successfully regulate the craving, physical withdrawal and negative affect that accompany quit attempts (Baker et al., 2004, Piasecki, 2006). Importantly, active quit attempts are typically preceded by quit intentions (i.e., a stated resolution or plan such as “I'm going to quit smoking next week”; (Berli et al., 2015; Herzog et al., 2015), which are in turn preceded by motivational processes such as desire (e.g. “I’d like to quit smoking”; Schwarzer and Luszczynska, 2008). Considering evidence that quit motivation and quit intentions vary over time (Berli et al., 2015, Herzog et al., 2015, Schwarzer and Luszczynska, 2008, Peters and Hughes, 2009), an understanding of motivation and self-regulation underlying quit intentions will involve examining these factors dynamically.

Over two-thirds of smokers report that their motivation to quit changes daily (Herzog et al., 2015), perceptions which are confirmed by daily diary studies (Peters and Hughes, 2009). Indeed, greater fluctuations in motivation predict cessation lapse in smokers undergoing a quit attempt (Hopkins et al., 2021). However, it is currently unclear what factors coincide with momentary quit motivation fluctuations. Affect and craving are also motivational concepts, where people are more likely to approach smoking when negative affect and craving are elevated (Baker et al., 2004). Yet, an experimental study found that participants randomized to view either negative affect or cigarette images reported greater motivation to quit than participants who viewed neutral images (Veilleux, 2019). These conflicting ideas suggest the importance of examining real-life fluctuations in affect and craving as related to quit motivation.

In addition, little is known about how quit motivation fluctuates for people who are considering quitting. Roughly 68 % of smokers indicate that they want to quit (US Department of Health and Human Services, 2020). Understanding motivation variability in people considering quitting is important because these smokers may be amenable to interventions to stabilize desire to quit and ultimately attempt cessation if the parameters of motivation variability were better understood (Cooke and Sheeran, 2004).

When people have higher cessation self-efficacy (Gwaltney et al., 2001) they also report greater quit intentions (Berli et al., 2015, Hopkins et al., 2021). Here we propose that when smokers feel generally more self-efficacious at self-regulation—exerting willpower, tolerating distress, and controlling cravings—they will feel more motivated to quit. These three aspects reference general (i.e., perceived willpower as a general sense of being able to exert control over behavior; Veilleux et al., 2021), emotion-specific (i.e., withstanding negative emotion) and smoking-specific (i.e., withstanding or controlling cigarette cravings) aspects of self-regulation. Self-efficacy for exerting willpower and perceived self-efficacy for tolerating distress both fluctuate dynamically over time (Veilleux et al., 2021, Veilleux et al., 2018, Veilleux and Skinner, 2020). Theoretically, shifts in self-regulation alter motivation (Inzlicht and Schmeichel, 2012, Kroese and de Ridder, 2015), which suggests that when people generally feel less capable of self-regulation, they may also likely to feel less motivated to quit smoking.

According to the Health Action Process Approach (HAPA) theory (Schwarzer, 2008), motivation is a pre-intentional process that occurs before people form intentions to change a health behavior. For example, motivation to quit smoking reflects the desire to be smoke-free (e.g., “I wish I weren’t a smoker anymore”), and intention is a stated plan to enact the desire, such as “I will stop smoking on Monday.” A prior study found that higher motivation predicted stronger intentions to quit (Veilleux, 2019), and we propose these relationships are likely to be found in daily life (e.g., via ecological momentary assessment [EMA]). In addition, as prior work has shown that instability in motivation disrupts intentions (Nordgren et al., 2008), it may be that greater variability in momentary quit motivation is associated with lower quit intentions.

The purpose of this study was to examine the dynamics of momentary quit motivation in smokers who are considering (but not actively attempting) quitting. EMA is an ideal method for this aim as it involves asking people to report on their thoughts, feelings, and situations throughout their day (Shiffman et al., 2008). We predicted that motivation to quit smoking would be elevated alongside higher negative affect and higher craving (Veilleux, 2019). We also predicted that people would generally feel more motivated to quit when reporting greater perceived momentary self-regulation (greater willpower, lower distress intolerance, higher craving controllability). Finally, we expected that higher quit motivation and lower variability in quit motivation would predict greater nightly quit intentions. All data and syntax are available here: https://osf.io/9jszb/?view_only=4025104c8d314db5951845aa47a8774d.

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