Elsevier

Addictive Behaviors

Volume 34, Issue 12, December 2009, Pages 1005-1009
Addictive Behaviors

Smokers' beliefs about the inability to stop smoking

https://doi.org/10.1016/j.addbeh.2009.06.013Get rights and content

Abstract

We recruited 367 current daily smokers via the Internet and randomized them to rate the causes of an inability to stop smoking, inability to stop problem alcohol use, or inability to lose excess weight in a fictional scenarios. Most smokers attributed inability to stop smoking to addiction (88%), habit (88%) and stress (62%). Surprisingly, equal numbers of smokers agreed and disagreed that inability to stop smoking was due to lack of willpower or motivation. Most disagreed that it was due to biological factors, denial, family/upbringing, genetics, mental disease, personality problem, psychological problems, or weakness of character. Many expected correlations among perceived causes were not found; e.g. endorsement of addiction was not inversely related to endorsement of willpower. Most smokers endorsed treatment. Higher ratings of addiction were related to endorsing treatment, and higher ratings of motivation were related to endorsing no need for treatment; however, these relationships were of small magnitude. Ratings of almost all the causes varied across the three problems; e.g. ratings of addiction were greater for smoking than for problem alcohol use. In summary, smokers appear to view the inability to stop smoking as multicausal; however, their views of causes are only weakly related to attitudes towards treatment. Given the several unexpected findings, qualitative research into smokers' conceptualizations about smokers' inability to stop smoking is indicated.

Introduction

Continued use of a substance despite its causing problems has been attributed to addiction, habit, lack of willpower, etc. Which perceived causes are endorsed varies across drugs, places, subcultures and time periods (Peele, 1989). Such perceived causes may be important because they may influence treatment seeking; e.g., those who more readily endorse addiction as a cause of problems stopping smoking would be expected to more likely seek treatment.

The current study determined a) which perceived causes smokers report for an inability to stop smoking, b) whether these causes are logically related to each other, c) whether the causes predict treatment endorsement and d) whether perceived causes vary across disorders. Several prior studies have empirically examined how the lay public conceptualizes why people smoke and whether this differs from other drug disorders (Cunningham et al., 1994, Cunningham et al., 1996, Eiser et al., 1977, Weinstein et al., 2004, Fabricius et al., 1997, Kozlowski et al., 1989, Cunningham et al., 1993, Hughes, 2005, Humphreys et al., 1996). Although these studies present intriguing results, none focuses specifically on smokers' perceptions of the causes of other smokers' inability to stop smoking. Other studies have focused on why smokers believe they themselves cannot stop smoking (Balmford & Borland, 2008). We focused instead on smokers' perceptions of a modal smoker because oftentimes persons believe they do not conform to the norms for a group they belong to (e.g. smokers often state that they are at less risk of death from smoking than the modal smoker) (Weinstein et al., 2004).

Section snippets

Methods

We recruited smokers using the Zoomerang website (www.zoomerang.com) which has a database of 3 million US consumers who have agreed to complete online surveys in return for points redeemable for services and merchandise. We emailed an invitation to a random subsample of known current smokers that stated “Smokers wanted to complete a brief online survey (5–10 min) about your views of alcohol or cigarette use or obesity in return for Zoomerang points.” The website obtained informed consent and

Endorsements for the inability to stop smoking

Smokers endorsed addiction, habit, and stress as causes of continued smoking (nb—we use “inability to stop” and “continued smoking” as synonyms) but disagreed that inability to stop was due to a mental disease, personality problem, weakness of character, lack of motivation, family/upbringing, biological factors, genetics, denial or psychological problems (Table 1). Similar proportions of smokers agreed and disagreed that lack of willpower and lack of motivation were reasons for continued use.

Discussion

Smokers attributed continued smoking despite problems to addiction, habit and stress (Cunningham et al., 1994, Eiser et al., 1977, Balmford and Borland, 2008). This suggests that smokers see inability to stop as due to multiple different causes. In the study most similar to ours, done over 25 years ago, 71% of the general public stated tobacco use was an addiction (cf our 88% in our more recent sample of smokers only) and 75% stated it was a “habit, not disease” (cf. our 88%) (Cunningham et al.,

References (37)

  • W.V. Fabricius et al.

    Concepts of drugs: Differences in conceptual structure across groups with different levels of drug experience

    Addiction

    (1997)
  • K. Fagerstrom et al.

    A comparison of the Fagerstrom Test for Nicotine Dependence and smoking prevalence across countries

    Addiction

    (2008)
  • K.M. Flegal et al.

    Prevalence and trends in obesity among US adults, 1999–2000

    Journal of the American Medical Association

    (2002)
  • H. Frenk et al.

    A critique of nicotine addiction

    (2000)
  • G.A. Giovino

    Epidemiology of tobacco use in the United States

    Oncogene

    (2002)
  • J.R. Hughes

    Data to estimate similarity of tobacco research samples to intended populations

    Nicotine and Tobacco Research

    (2004)
  • J.R. Hughes

    Should criteria for drug dependence vary across drugs?

    Addiction

    (2005)
  • K. Humphreys et al.

    Reliability, validity, and normative data for a short version of the understanding of alcoholism scale

    Psychology of Addictive Behaviors

    (1996)
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