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Transition towards a 'non-smoker' identity following smoking cessation: an interpretative phenomenological analysis
1Cancer Research UK, Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, UK. e.vangeli@ucl.ac.uk
Objective:
A recent theory of motivation (PRIME theory) has proposed that the formation of a 'non-smoker' identity is necessary for long-term abstinence. This study aimed to explore how a smoker's sense of identity changes following smoking cessation.
Design:
This was a qualitative, semi-structured interview study with a purposive sample of individuals who had quit smoking. An interpretative phenomenological approach was taken to elicit in-depth accounts of the participants' understanding of smoking, stopping, and maintaining abstinence.
Methods:
Ten participants who quit smoking with the support of a National Health Service (NHS) stop-smoking service in England and were still abstinent a year later were interviewed. An interpretative phenomenological analysis of the interview transcripts was conducted. Prospective contextual detail of motivational and other variables pre-quit were also obtained from the clinic assessment form that participants completed at the first group session.
Results:
A process of identity change was observed towards that of a 'non-smoker', assisted initially by a transient identity of 'team stop-smoker' accompanied by a sense of achievement. All participants retained a residual attraction to smoking suggesting that the process was not complete and reflecting an 'ex-smoker' identity. Participants labelled themselves as non-smokers regardless of how much transition had occurred.
Conclusions:
It appears useful to distinguish two levels of 'non-smoker' identity: a surface level comprising the simple label and a deep level made up of often conflicting thoughts and feelings about oneself in relation to smoking. A total coherent 'non-smoker' identity does not appear to be necessary for long-term abstinence.
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