A psychosocial model of smoking cessation and maintenance of cessation

Abstract

The long-term cessation rates obtained in smoking control programs have been disappointing. In order to provide a better understanding of the problems of smoking cessation and maintenance of cessation, and to facilitate the development of more effective smoking control programs, a model of smoking cessation is offered in which stress, or "life events", is a major determinant of the success of this process. The model assumes that chronic smoking is a maladaptive behavior, helping the smoker to deal with the discomfort generated by stress by providing a means he can use to maintain a "vital balance". A smoker's ability to handle stress without cigarettes is conditioned by the presence of personal and social resources or "psychosocial assets". Personal security, an individual's belief that he can control what happens to him, an ability to respond to stress with a low level of negative affect, and the availability of social supports provide a cushion or buffer against the effects of stress. It is therefore the combined effect of stress and the psychosocial variables which determines whether or not a smoker can successfully eliminate smoking from his repertoire of coping responses.