Examining why smokers do not want behavioral support with stopping smoking

Objective: This article delineates theory-based determinants of the low use of behavioral stop-smoking support with a view to inform interventions to address the low use. Methods: Study 1 comprised interviews with 27 smokers recruited from a primary care centre in England. Study 2 used a nationwide sample of 212 smokers who completed a questionnaire informed by Study 1. Multiple regression and mediation analyses were used in Study 2 to discern the determinants of smokers' motivation to use behavioral stop-smoking support. Results: The best predictors of low motivation to use (a) group support, and (b) one-to-one support were expectations that stop-smoking support is ineffective at increasing chances of stopping smoking. In turn, expectations of ineffectiveness were predicted by expectations that both services provide insufficient support, as well as smokers' low self-efficacy to use them. A negative image of those attending groups was another predictor of group support. Conclusion: A substantial proportion of smokers hold expectations about stop-smoking support that are unlikely to facilitate motivation to use such support. Practice implications: Intervention studies are now needed targeting such expectations. (C) 2009 Elsevier Ireland Ltd. All rights reserved.