Smoking Abstinence Self-efficacy Research Articles

Associations between compliance with very low nicotine content (VLNC) cigarettes, abstinence self-efficacy, and quit outcomes in a pilot smoking cessation trial

BackgroundSwitching to Very Low Nicotine Content (VLNC) cigarettes reduces toxicant exposure and nicotine dependence, and may improve smoking cessation. However, non-compliance with VLNCs is often high, which may reduce their effectiveness. Here, we conducted secondary analyses of a pilot smoking cessation trial utilizing VLNCs to examine associations between pre-cessation VLNC compliance and changes in smoking rate, dependence, and abstinence self-efficacy, as well as quit outcomes. MethodsPeople who smoke daily (n=35) engaged in a 4-week pre-cessation intervention including VLNCs, transdermal nicotine patch, and behavioral counseling. After quit date, participants received 8 weeks of nicotine replacement therapy and 4 additional behavioral sessions, and were followed for 10 weeks to assess abstinence. Compliance with VLNCs was assessed biweekly during pre-cessation using timeline follow-back. Statistical analyses examined associations between VLNC compliance and a) changes in smoking rate, dependence and abstinence self-efficacy over the course of study cigarette use; and b) time to relapse, controlling for other smoking variables. ResultsGreater compliance during the second half of study cigarette use was associated with subsequent improvement in self-efficacy (p<.05). Increased self-efficacy and VLNC compliance both predicted lower likelihood of relapse. Nicotine dependence and cigarettes per day both decreased following study cigarette use, but were unrelated to compliance or relapse. ConclusionsCompliance with VLNCs prior to quitting increased abstinence self-efficacy and predicted better quit outcomes above and beyond baseline smoking characteristics. Although preliminary, these findings suggest that identifying strategies to promote exclusive use of VLNCs during a brief pre-cessation window may be beneficial.

Mediation of Smoking Abstinence Self-Efficacy on the Association between Nicotine Dependence and the Intention to Quit Smoking

Mediation of Smoking Abstinence Self-Efficacy on the Association between Nicotine Dependence and the Intention to Quit Smoking

Long-Term Outcomes of a Comprehensive Mobile Smoking Cessation Program With Nicotine Replacement Therapy in Adult Smokers: Pilot Randomized Controlled Trial.

Increased smartphone ownership has led to the development of mobile smoking cessation programs. Although the related body of evidence, gathered through the conduct of randomized controlled trials (RCTs), has grown in quality and rigor, there is a need for longer-term data to assess associated smoking cessation durability. The primary aim was to compare smoking cessation outcomes at 52 weeks in adult smokers randomized to a mobile smoking cessation program, Pivot (intervention), versus QuitGuide (control). The secondary aims included comparison of other smoking-related behaviors, outcomes and participant feedback, and exploratory analyses of baseline factors associated with smoking cessation. In this remote pilot RCT, cigarette smokers in the United States were recruited on the web. Participants were offered 12 weeks of free nicotine replacement therapy (NRT). Data were self-reported via a web-based questionnaire with videoconference biovalidation in participants who reported 7-day point-prevalence abstinence (PPA). Outcomes focused on cessation rates with additional assessment of quit attempts, cigarettes per day (CPD), self-efficacy via the Smoking Abstinence Self-Efficacy Questionnaire, NRT use, and participant feedback. Cessation outcomes included self-reported 7- and 30-day PPA, abstinence from all tobacco products, and continuous abstinence. PPA and continuous abstinence were biovalidated using witnessed breath carbon monoxide samples. Exploratory post hoc regression analyses were performed to identify baseline variables associated with smoking cessation. Participants comprised 188 smokers (n=94, 50% in the Pivot group and n=94, 50% in the QuitGuide group; mean age 46.4, SD 9.2 years; n=104, 55.3% women; n=128, 68.1% White individuals; mean CPD 17.6, SD 9.0). Several cessation rates were higher in the Pivot group (intention to treat): self-reported continuous abstinence was 20% (19/94) versus 9% (8/94; P=.03) for QuitGuide, biochemically confirmed abstinence was 31% (29/94) versus 18% (17/94; P=.04) for QuitGuide, and biochemically confirmed continuous abstinence was 19% (18/94) versus 9% (8/94; P=.046) for QuitGuide. More Pivot participants (93/94, 99% vs 80/94, 85% in the QuitGuide group; P<.001) placed NRT orders (mean 3.3, SD 2.0 vs 1.8, SD 1.6 for QuitGuide; P<.001). Pivot participants had increased self-efficacy via the Smoking Abstinence Self-Efficacy Questionnaire (mean point increase 3.2, SD 7.8, P<.001 vs 1.0, SD 8.5, P=.26 for QuitGuide). QuitGuide participants made more mean quit attempts (7.0, SD 6.3 for Pivot vs 9.5, SD 7.5 for QuitGuide; P=.01). Among those who did not achieve abstinence, QuitGuide participants reported greater CPD reduction (mean -34.6%, SD 35.5% for Pivot vs -46.1%, SD 32.3% for QuitGuide; P=.04). Among those who reported abstinence, 90% (35/39) of Pivot participants and 90% (26/29) of QuitGuide participants indicated that their cessation program helped them quit. This pilot RCT supports the long-term effectiveness of the Pivot mobile smoking cessation program, with abstinence rates durable to 52 weeks. ClinicalTrials.gov NCT04955639; https://clinicaltrials.gov/ct2/show/NCT04955639.

Mechanism of community quitters' psychological traits on their smoking cessation effects: Based on a study of community intervention.

We study the relationship between psychological traits of smokers and their smoking cessation effects, and provide more scientific evidence for smoking cessation intervention. The study was conducted as a nested case-control study. Smokers who participated in the community smoking cessation intervention projects in Beijing in 2018-2020, were selected as the research participants and divided into two groups: a successful smoking cessation and unsuccessful smoking cessation group, according to their smoking cessation effects at 6 months. Psychological traits of quitters including smoking abstinence self-efficacy, willingness to quit smoking, and trait coping style, were compared between the two groups, and a structural equation model was established for confirmatory factor analysis to analyze their mechanisms. There were differences in smoking cessation results between the successful smoking cessation group and the unsuccessful smoking cessation group in terms of smoking abstinence self-efficacy and willingness to quit smoking. Willingness to quit smoking (OR=1.06; 95% CI: 1.008-1.118) is a risk factor, while smoking abstinence self-efficacy in habit/addiction situations (OR=0.77; 95% CI: 0.657-0.912) is a protective factor. The results of the structural equation model showed that smoking abstinence self-efficacy (β=0.199, p=0.002) and trait coping style (β= -0.166, p=0.042) could influence smoking cessation effects. The structural equation model was well fitted, which showed that smoking abstinence self-efficacy (β=0.199, p=0.002) and trait coping style (β= -0.166, p=0.042) might have influenced the effect of smoking cessation among smokers. Willingness to quit smoking has a positive impact on the smoking cessation effect, while smoking abstinence self-efficacy in habit/addiction situations and negative trait coping style have a negative impact. Smoking abstinence self-efficacy and trait coping styles can significantly affect smoking cessation outcomes.

Effects of an Interactive Smoking Cessation Coaching Program on Smoking in Female College Students

Purpose: This study aimed to examine the effects of an interactive smoking cessation coaching program on smoking cessation motivation, smoking knowledge, smoking shame, urine cotinine levels, tobacco craving and smoking abstinence self-efficacy. The conceptual framework of the study applied Cox’s interaction model of client health behavior for female college students who smoked.Methods: This was a before-and-after experimental design study with a non-equivalent control group. The participants were smoking female college students, who were assigned either to an experimental group (n=22) or a control group (n=24). The interaction model of client health behavior was the theoretical basis. The core tactic of smart management and strategy for health was applied as a coaching technique. The experimental group attended 11 sessions of an interactive smoking cessation coaching program, (60 to 120 minutes per session) for 6 weeks, and the control group received education regarding smoking cessation after the program finished. The data collection period was from January 23, 2019 to March 7, 2019.Results: This study showed differences in smoking cessation motivation (F=71.09, &lt;i&gt;p&lt;/i&gt;&lt;.001), smoking knowledge (F=20.77, &lt;i&gt;p&lt;/i&gt;&lt;.001), smoking shame (t=5.11, &lt;i&gt;p&lt;/i&gt;&lt;.001), urine cotinine levels (t=-9.58, &lt;i&gt;p&lt;/i&gt;&lt;.001) and smoking abstinence self-efficacy (t=11.68, &lt;i&gt;p&lt;/i&gt;&lt;.001). However, no difference in tobacco cravings (t=-1.57, &lt;i&gt;p&lt;/i&gt;=.127) was found.Conclusion: As a result of the interactive smoking cessation coaching program, statistically significant differences were found in smoking cessation motivation, smoking knowledge, smoking shame, urine cotinine levels and smoking abstinence self-efficacy. However, further research is needed because there was no statistically significant difference in tobacco cravings.

Health warning messages on cigarette packs: how young smokers process it.

SummaryOne of the major smoking prevention strategies has been to educate the public and increase people’s awareness, using health-warning messages. However, many young people continue smoking without paying attention to health risk messages on cigarette packets in Iran. Hence, this study was conducted to examine the processing route of anti-smoking messages and influencing cognitive factors based on the Elaboration Likelihood Model. This cross-sectional study was correlational in nature. The non-probability sample consisted of 387 tobacco smokers in the age range of 18 to 30 years old. The study was conducted between July and November of 2018 in Tabriz, Iran. A researcher-designed questionnaire was used for the purpose of data collection. No causal inferences were drawn due to the non-experimental nature of the investigation. It was found that tobacco smokers often processed the health warning messages through the central route. Perceived severity, smoking abstinence self-efficacy, and psychological dependence were predictors of message processing through the central route. The results supported the conceptual model of cognitional predictors of the processing route. To design and execute effective health warning messages to quit smoking, it is recommended to consider cognitive factors as a means to enhance critical thinking about the content of the health-warning message.

Factors associated with smoking in low-income persons with and without chronic illness.

INTRODUCTIONTobacco disparities persist among low-income smokers who seek care from safety-net clinics. Many of these patients suffer from chronic illnesses (CILs) that are associated with and exacerbated by smoking. The objective of the current study was to examine the differences between safety-net patients with and without CILs in terms of nicotine dependence and related factors (such as depression, anxiety) and self-efficacy regarding ability to abstain from smoking.METHODSSixty-four low-income smokers who thought about or intended to quit smoking were recruited from the San Francisco Health Network (SFHN) and assessed for CILs, nicotine dependence, depression, anxiety, and smoking abstinence self-efficacy. Four one-way analyses of variance were used to examine the difference between those with and without CIL on the latter four variables.RESULTSThe CIL group had significantly higher anxiety (CIL: 8.0 ± 5.35; non-CIL: 4.44 ± 3.48; p=0.02) and tended to have higher nicotine dependence (CIL: 5.40 ± 2.58; non-CIL: 3.88 ± 2.28; p=0.04). In the CIL group, nicotine dependence was positively correlated with anxiety [r(62)=0.39; p<0.01] and negatively correlated with smoking abstinence self-efficacy [r(62)= -0.38; p<0.01]. Both depression (Spearman’s rho=0.39; p<0.01) and anxiety (Spearman’s rho=0.29; p<0.05) were associated with total number of CIL categories.CONCLUSIONSSafety-net patients who smoke and suffer from CILs may be suffering from higher levels of anxiety and have less confidence in their ability to quit smoking. Incorporating mood management and developing interventions that increase a sense of self-efficacy for refraining from smoking may be necessary to help low-income smokers quit smoking.

日本語版禁煙自己効力感尺度の作成 Smoking Abstinence Self-efficacy Questionnaireの日本語版作成とその信頼性と妥当性の検討

日本語版禁煙自己効力感尺度の作成 Smoking Abstinence Self-efficacy Questionnaireの日本語版作成とその信頼性と妥当性の検討

Examination of test-retest reliability of Japanese version of Smoking Decisional Balance Scale/ Japanese version of Smoking Abstinence Self-Efficacy Scale

Examination of test-retest reliability of Japanese version of Smoking Decisional Balance Scale/ Japanese version of Smoking Abstinence Self-Efficacy Scale

Relationships among smoking abstinence self-efficacy, trait coping style and nicotine dependence of smokers in Beijing.

INTRODUCTIONPsychological, physiological and social factors play an important role in the initiation, persistence, dependence and relapse of smoking behaviors, and coping style and smoking abstinence self-efficacy can all affect nicotine dependence.METHODSA cross-sectional sample of 568 quitters from 19 communities in Beijing in 2019 was surveyed. Demographic information and psychological characteristics of smokers were collected by an interview questionnaire, and psychological traits scales including the Smoking Abstinence Self-Efficacy (SASE) and the Trait Coping Style Questionnaire (TCSQ). We compared differences in psychological traits across demographic information and explored the relationship between nicotine dependence and coping styles and self-efficacy in refusing to smoke.RESULTSSignificant differences were identified in self-efficacy in refusing to smoke and across dimensions among quitters by gender, job type, education level, and monthly income level (all p<0.05). Males had lower self-efficacy in the habitual/addictive context than females; retirees had better overall self-efficacy and self-efficacy in the negative/emotional context than business service workers and professionals; and high-educated, high-income quitters had lower self-efficacy in the negative/emotional context. There are significant differences in positive coping styles among quitters of different ages, levels of education, and types of work (all p<0.05). The results further showed that the underage population, highly educated population, and practitioners other than those in retirement, are less likely to use positive coping styles. Interventional effects analysis showed that a higher sense of self-efficacy in addictive contexts can counteract some of the negative coping styles that induce smoking.CONCLUSIONSSelf-efficacy played an indirect mediating role between negative coping style and nicotine dependence; individuals who used more negative coping styles were more likely to engage in smoking and therefore were more nicotine dependent. Hence, it is necessary to reduce the use of negative coping strategies and improve the self-efficacy of smoking abstinence in the face of addiction.

Effects of Resistance Training on Smoking Abstinence Self-Efficacy in Sedentary Smokers

Introduction: Cigarette smoking is prevalent with 40 million Americans smoking and one in five deaths attributed to this behavior. Aims: This study examined effects of a resistance training (RT) program on smoking abstinence self-efficacy. Methods: Forty (40) participants were randomized into intervention or control groups. Smoking abstinence self-efficacy, withdrawal symptoms, and smoking behavior were measured. Results/Findings: RT group presented with statistically significant greater increases in self-efficacy compared to control. RT group participants also presented with non-significantly greater decreases in smoking behavior and withdrawal symptoms compared to control. Conclusions: This study demonstrates effectiveness of RT in improving smoking abstinence self-efficacy.

Development and Validation of Smoking Abstinence Self-efficacy Scale among Iranian Female Adolescents

Background: Among different factors, self-efficacy is one of the most suitable components for predicting smoking behavior among adolescents. Therefore, it is essential to design a native tool to measure this high-risk behavior in adolescents and implement prevention programs in this age group. Aim: This study aimed to design and validate a smoking abstinence self-efficacy questionnaire in female adolescents. Method: In this methodological study, a comprehensive literature review was conducted, and the available similar questionnaires were used to prepare the items. In total, 351 female schoolchildren were selected by convenience sampling in Mashhad, Iran, between October 2017 and January 2018. Face and content validity and construct validity were applied for psychometric evaluation of the developed tool. The reliability of the tool was tested by internal consistency. Results: The final version of the smoking abstinence self-efficacy scale in Iranian female adolescents includes 16 items after a psychometric evaluation. The content validity of the tool was obtained at 0.99. Moreover, exploratory factor analysis explored three factors of emotional, social, and high-risk situations explaining 60% of the variance. Cronbach's alpha coefficient of the questionnaire was estimated at 0.94. Implications for Practice: The smoking abstinence self-efficacy scale is a valid and reliable tool among Iranian female adolescents derived from the native context of this group of people which can examine smoking abstinence self-efficacy in three dimensions of emotional, social, and high-risk situations. Moreover, it can identify adolescents with different levels of smoking abstinence self-efficacy.

Students’ Smoking Abstinence Self-efficacy toward Early Maladaptive Schemas

Introduction: Smoking abstinence self-efficacy is a factor that plays a key role in preventing addiction or its revival tendency after quitting. This study attempted to analyze the relationship between the early maladaptive schemas and smoking abstinence self-efficacy among the sophomore high school students in the city of Gorgan, Iran. Methods: This was a descriptive study and its population (n= 9955) included all second grade high school students in the city of Gorgan in the school year 2015-2016. The multi- stage cluster sampling method was used to select 369 participants. The required data were collected using the maladaptive schema questioners and the smoking abstinence self-efficacy questionnaire. Pearson correlation and Multi- variable regression methods were also used to analyze data. Results: The results of the current study indicated a significant, yet reverse relationship of the early maladaptive schemas with smoking abstinence self-efficacy. Furthermore, 51 percent change in self-efficacy variance is derived from the components of early maladaptive schemas. Among components of the early maladaptive schemas, components of the abandonment / alienation, the strongest predictor was students smoking abstinence self-efficacy. Conclusion: Early self- efficacy schemas are among the individual and psychological causes with especial importance in studies on smoking dependency and its consumption. Such early schemas lead to biases in an individual’s interpretation of the events. These biases are represented as distorted attitudes, false speculations, unrealistic aims and perspectives, and high- risk behaviors such as smoking.

Emotion regulation difficulties and social control correlates of smoking among pregnant women trying to quit

Approximately 15% of US women currently smoke during pregnancy. An important step toward providing effective smoking cessation interventions during pregnancy is to identify individuals who are more likely to encounter difficulty quitting. Pregnant smokers frequently report smoking in response to intrapersonal factors (e.g., negative emotions), but successful cessation attempts can also be influenced by interpersonal factors (i.e., influence from close others). This study examined the association between emotion regulation difficulties, positive and negative social control (e.g., encouragement, criticism), and smoking cessation-related variables (i.e., smoking quantity, withdrawal symptoms) among pregnant smokers. Data were drawn from the pretreatment wave of a smoking cessation trial enrolling low-income pregnant women who self-reported smoking in response to negative affect (N = 73). Greater emotion regulation difficulties were related to greater smoking urges (b = 0.295, p = .042) and withdrawal symptoms (b = 0.085, p = .003). Additionally, more negative social control from close others was related to fewer smoking days (b = −0.614, p = .042) and higher smoking abstinence self-efficacy (b = 0.017, p = .002). More positive social control from close others interacted with negative affect smoking (b = −0.052, p = .043); the association between negative affect smoking and nicotine dependence (b = 0.812, p < .001) only occurred at low levels of positive social control. Findings suggest that emotion regulation difficulties may contribute to smoking during pregnancy by exacerbating women's negative experiences related to smoking cessation attempts. Negative social control was related to lower smoking frequency and greater confidence in quitting smoking, suggesting that it may assist pregnant smokers' cessation efforts. Positive social control buffered women from the effects of negative affect smoking on nicotine dependence. Trial registrationClinicalTrials.gov, NCT01163864

A novel experience-based internet intervention for smoking cessation: feasibility randomised controlled trial.

BackgroundThe internet is frequently used to share experiences of health and illness, but this phenomenon has not been harnessed as an intervention to achieve health behaviour change. The aim of this study was to determine the feasibility of a randomised trial assessing the effects of a novel, experience-based website as a smoking cessation intervention. The secondary aim was to measure the potential impact on smoking behaviour of both the intervention and a comparator website.MethodsA feasibility randomised controlled single-blind trial assessed a novel, experience-based website containing personal accounts of quitting smoking as a cessation intervention, and a comparator website providing factual information. Feasibility measures including recruitment, and usage of the interventions were recorded, and the following participant-reported outcomes were also measured: Smoking Abstinence Self-Efficacy Questionnaire, the single-item Motivation to Stop Scale, self-reported abstinence, quit attempts and health status outcomes. Eligible smokers from two English regions were entered into the trial and given access to their allocated website for two weeks.ResultsEighty-seven smokers were randomised, 65 completed follow-up (75 %). Median usage was 15 min for the intervention, and 5 min for the comparator (range 0.5–213 min). Median logins for both sites was 2 (range 1–20). All participant-reported outcomes were similar between groups.ConclusionsIt was technically feasible to deliver a novel intervention harnessing the online sharing of personal experiences as a tool for smoking cessation, but recruitment was slow and actual use was relatively low, with attrition from the trial. Future work needs to maximize engagement and to understand how best to assess the value of such interventions in everyday use, rather than as an isolated ‘dose of information’.Trial registration ISRCTN29549695 DOI 10.1186/ISRCTN29549695. Registered 17/05/2013.

Postpartum smoking abstinence self-efficacy and partner supportive behaviors

Postpartum smoking abstinence self-efficacy and partner supportive behaviors

Exercise and Counseling for Smoking Cessation in Smokers With Depressive Symptoms: A Randomized Controlled Pilot Trial

Objective: Despite various strategies to help smokers with depressive disorders to quit, the smoking relapse rate remains high. The purpose of this pilot study was to estimate the effects of adding an exercise and counseling intervention to standard smoking cessation treatment for smokers with depressive disorders. We hypothesized that the exercise and counseling intervention would lead to improved abstinence, reduced depressive symptoms, and increased physical activity. Methods: Seventy smokers with current depressive disorders were randomly assigned to standard smoking cessation treatment plus exercise and counseling (n = 35) or standard treatment plus a time-to-contact control intervention on health education (n = 35). Both programs involved 10 sessions over 8 weeks. The primary outcome was continuous abstinence since the quit date and was measured at week 8 (end of the intervention) and again at 12-, 24-, and 52-week follow-ups. Results: Nearly 60% of participants were female (n = 41), 38 (52.3%) were single, 37 (52.9%) had education beyond high school, and 32 (45.7%) met criteria for major depressive disorder or dysthymia. Participants in the two treatment conditions differed at baseline only in marital status (χ2 = 4.28, df = 1, p =.04); and smoking abstinence self-efficacy, t(66) = -2.04, p =.04). The dropout rate did not differ significantly between groups and participants attended 82% and 75% of the intervention and control sessions, respectively. Intention-to-treat analysis showed that, at 12 weeks after the beginning of the intervention, continuous abstinence did not vary significantly between the intervention and control groups: 48.5% versus 28.5%, respectively, ORadj = 0.40, 95% CI [0.12–1.29], p =.12. There were no group differences in depressive symptoms, but the intervention group did outperform the control group on the 6-minute walking test (Mint = 624.84, SD = 8.17, vs. Mcon = 594.13, SD = 8.96, p =.015) and perceived physical control (Mint = 2.84, SD = 0.16, vs. Mcon = 2.27, SD = 0.18, p =.028). The sample was not large enough to ensure adequate statistical power. Conclusions: This finding, while preliminary, suggests that an exercise and counseling intervention may yield better results than health education in improving smoking abstinence. This study is registered at www.clinincaltrials.gov under # NCT01401569.

A pilot randomized controlled trial on the effectiveness of a 'lung age' intervention on smoking cessation: study protocol.

To evaluate the effectiveness of the 'lung age' intervention on smoking cessation rates, smoking abstinence self-efficacy, nicotine dependence and behavioural change among the smoking population in Singapore. Tobacco use has been linked to several preventable chronic diseases, such as cardiovascular diseases, stroke, cancers and respiratory diseases. Despite numerous health education attempts to promote smoking cessation, there has been a sustained increase in smoking rates worldwide, including in Singapore. A pilot randomized controlled trial. A convenience sample of 108 smoking individuals will be recruited from population health screenings conducted by a tertiary public hospital in Singapore, with 54 participants in the experimental group and 54 in the control group. Participants in the experimental group will receive a lung age intervention, consisting of lung age determination and education as well as smoking cessation advice, while the researchers will provide those in the control group with the usual smoking education. Outcome measures include smoking cessation rates, smoking abstinence self-efficacy, nicotine dependence and assessment of the stages of behavioural change. Data will be collected at the baseline and again at the 3- and 6-month follow-ups. This study offers an additional intervention to improve smoking cessation rates in Singapore. It aims to reduce or delay the onset of smoking-related chronic diseases such as coronary heart diseases and cancer, which would eventually reduce the healthcare burden in an increasingly ageing society. ISRCTN15839687.

Relationship between age and smoking abstinence self-efficacy

To investigate the relationship between smoking abstinence self- efficacy (SASE) and age. A cross-sectional questionnaire survey in form of face-to-face interview was performed. The SASE level was assessed by using the Smoking Abstinence Self-Efficacy Scale. Univariate two-degree fractional polynomials (FPs) regression model was used to explore the relationship between SASE and age after adjusting of potential confounders: marital status, occupation and education. The relationship between SASE and age showed a U-shaped curve with the nadir at 60 years old. The distribution of SASE is not consistent among age groups; middle aged person has lower level of SASE than both the younger and the elder.

Mediation of smoking abstinence self-efficacy on the association of nicotine dependence with smoking cessation.

The nicotine dependence (ND) has negative and smoking abstinence self-efficacy (SASE) has positive effects on successful smoking cessation, but scant data is now available for what is the mediating role of SASE on the relationship between ND and successful smoking cessation. The aim of this study was to assess the abovementioned mediation. A case-control study was conducted with 642 successful spontaneous quitters as the cases, and 700 failed spontaneous quitters as the controls. ND and SASE were evaluated by Fagerström Test for Nicotine Dependence (FTND) scale and SASE scale, respectively. Propensity score as covariate in the regression model was used to adjust for potential confounders of age, age of smoking initiation, occupation, educational level and marital status. Total effect was decomposed into direct and indirect (mediating) effect using logistic regression based on the KHB method proposed by Holm et al. After adjusting for the aforementioned potential confounders, the mediating effects among the total effect of ND on successful spontaneous smoking cessation were 32.90%, 12.14%, 35.64% and 83.03% for the total score of SASE and its three context-specific situation scores, i.e. positive/social situation, negative/affective situation and habit/addictive situation, respectively. This study indicates that SASE has a partial mediating effect on the association of ND with successful spontaneous smoking cessation. To boost the smokers' SASE could increase the probability of successful smoking cessation.