Self-efficacy and the stages of self-change of smoking

Abstract

Efficacy expectations are postulated to mediate all behavior change. This study examined the construct of self-efficacy in the self-change of smoking behavior. A 31-item measure of self-efficacy was used that included ratings of both temptation (cue strength) and confidence (efficacy). The subjects were 957 volunteers representing five stages of self change: (1) immotives, (2) contemplators, (3) recent quitters, (4) long-term quitters, and (5) relapsers. Subjects were assessed initially and at a 3- to 5-month follow-up. The self-efficacy scale proved to be an extremely reliable and coherent instrument with identifiable but not clearly interpretable subcomponents. Groups of subjects demonstrated significant differences in total self-efficacy scores. Efficacy expectations demonstrated small but significant relationships with smoking history variables and the pros and cons of smoking, but not with demographic, life stress, or persistence measures. Subject's efficacy evaluations at the initial assessment were related to changes in status for recent quitters and contemplators at the follow-up. The relationship between temptation and efficacy ratings is complex and varies for subjects in the various stages of change. Correlations between total self-efficacy and temptation scores were largest for contemplators (r = −.65) and relapsers (r = −.67) and smallest for the recent quitters (r = −.18). Finally, the magnitude of the difference between temptation and efficacy increased with length of abstinence for subjects in maintenance.