Self-efficacy and relapse in smoking cessation: a replication and extension.

Abstract

In an effort to replicate and extend previous findings, the relationship of a measure of self-efficacy to posttreatment smoking status was assessed. End-of-treatment self-efficacy scores were significantly correlated with follow-up smoking status at 3-month (r = —.50) and 6-month (r = —.36) follow-up, but not at 1 year. When only subjects who were abstinent at termination were considered, self-efficacy still correlated significantly with 3-month follow-up (r = .37) but not with 6-month or 1-year smoking status. Smoking during treatment was associated with lower end-of-treatment efficacy scores. It is well known that cigarette smoking is resistant to enduring modification. Unfortunately, this resistance is not well understood. More knowledge about the factors affecting maintenance or relapse is needed before effective treatment programs can be developed. Self-efficacy was proposed by Bandura (1977) as a common cognitive mechanism that underlies psychological change. With respect to smoking, self-efficacy may be defined as the confidence in one's ability to remain abstinent in a given situation. Successful interventions should increase a person's efficacy expectations to resist urges to smoke in various situations, and these altered expectations should predict follow-up maintenance or relapse. Condiotte and Lichtenstein (1981) developed the Confidence Questionnaire to make self-efficacy for smoking cessation operational and found a correlation of .59 between self-efficacy at the end of treatment and smoking status at the 3-month follow-up period. This study extends the Condiotte and Lichtenstein study in several ways. First, selfreports of smoking were validated by informants and by a biochemical measure. Second, 6-month and 1-year follow-up data were obtained to determine if end-of-treatment efficacy scores were related to more distal events. Third, separate analyses were conducted on a subgroup of subjects who were abstinent after treatment, thereby controlling for possible differences in performance.