I think I can: the relation of self-efficacy to cessation and relapse among smokers utiilizing a telephone quitline

When people pick up the phone to call a telephone quitline, they are taking an important step towards changing their smoking behavior. The current study investigated the role of a critical cognition in the cessation process--self-efficacy. Self-efficacy is thought to be influential in behavior change processes including those involved in the challenging process of stopping tobacco use. By applying basic principles of self-efficacy theory to smokers utilizing a telephone quitline, this study advanced our understanding of the nature of self-efficacy in a "real-world" cessation setting. Participants received between one and four intervention calls aimed at supporting them through their quit attempt. Concurrent with the initiation of this study, three items (confidence, stress, and urges) were added to the standard telephone protocol and assessed at each call. Two principal sets of hypotheses were tested using a combination of ANCOVAs and multiple regression analyses. The first set of hypotheses explored how self-efficacy and changes in self-efficacy within individuals were associated with cessation outcomes. Most research has found a positive linear relation between self-efficacy and quit outcomes, but this study tested the possibility that excessively high self-efficacy may actually reflect an overconfidence bias, and in some cases be negatively related to cessation outcomes. The second set of hypotheses addressed several smoking-related factors expected to affect self-efficacy. As predicted, higher baseline self-efficacy and increases in self-efficacy were associated with higher rates of quitting. However, contrary to predictions, there was no evidence that overconfidence led to diminished cessation success. Finally, as predicted, shorter duration of quit attempts, shorter time to relapse, and stronger urges all were associated with lower self-efficacy. In conclusion, understanding how self-efficacy and changes in self-efficacy affect and are affected by cessation outcomes is useful for informing both future research and current quitline intervention procedures.