Aims: To test if goals indicate motivation to quit smoking and predict which smokers will make a quit attempt.
Design: A 28-day natural history feasibility study of smoking cessation and reduction.
Setting: The study was conducted via telephone calls and mailings.
Participants: A total of 186 cigarette smokers.
Measurements: At baseline participants reported one of the following goals for the next 30 days: to quit abruptly, quit gradually, reduce but not quit, or not change their smoking. They also reported motivation to quit smoking on an Intention to Quit Ladder. Throughout the study they reported their cigarette consumption via daily telephone messages.
Findings: Self-reported motivation to quit differed among goals (F = 286.6, df = 3, P < 0.01). Goals significantly predicted the likelihood of making a quit attempt in the 28 days of the study. In comparison to smokers with the goal of not changing, smokers with a goal of quitting abruptly were more likely to make a quit attempt [relative risk (RR) = 9.6, P < 0.01], as were those with a goal of quitting gradually (RR = 4.5, P = 0.01). Those with a goal of reducing only appeared to be more likely to make a quit attempt than those with a goal of not changing, but the difference was not statistically significant (RR = 3.1, P = 0.15). Smokers with a goal of quitting abruptly were more likely to make a quit attempt than those with a goal of quitting gradually (RR = 2.1, P < 0.05).
Conclusions: Goals indicate not only preferred method of change but also motivation. Differences in gradual versus abrupt cessation outcomes may be due to motivational rather than methodological differences. Those who plan to quit gradually or reduce only may need additional motivational interventions.