Theories used in nursing research on smoking cessation

Theories tell how and why things work; how and why one variable is related to another. Research findings that are theory based can be placed in a framework that advances science further than findings that are unconnected to formal theory. However, much of the research in smoking cessation is atheoretical. This review of nursing research on smoking cessation published from 1989 through 2008 revealed that nearly half of the studies were based on explicit formal theories. The transtheoretical model and self-efficacy theory were the most frequently used explicit theories with most theories emanating from psychology. Five nursing theories were identified in this review. Studies that used implicit rather than explicit theories dealt with five major concepts: nicotine dependence, social support, high-risk situations, mood-affect, and the influence of clinical diagnosis. Largely missing from this set of studies were investigations based on biobehavioral models, including genetics and neuroscience. The relevance of the theories and concepts identified in this review to current clinical guidelines on smoking cessation is discussed. With their grounding in theory and their expert knowledge of clinical issues, nurses are in an excellent position to develop theories that will help researchers in every discipline make sense of smoking cessation.