Task and barrier self-efficacy among treatment-seeking smokers with current, past or no psychiatric diagnosis

Individuals with a lifetime diagnosis of mental illness smoke at rates greater than the general population, and have more difficulty quitting. Cessation self-efficacy has been linked with positive cessation outcomes and can be assessed as either task (confidence to quit) or barrier self-efficacy (confidence to quit in the face of obstacles). We investigated differences in self-efficacy among smokers with a current, past or no lifetime diagnosis of psychiatric illness.

737 treatment-seeking smokers provided demographic info and smoking history, and were assessed for nicotine dependence, motivation to quit, and task and barrier self-efficacy (Smoking Self-Efficacy Questionnaire; SEQ-12) for smoking cessation. Current and past psychiatric diagnoses were assessed with the Mini International Psychiatric Interview (M.I.N.I. 6.0). ANOVA, chi-square and correlations were calculated for the smoking-related variables across the psychiatric categories.

Those with a current diagnosis smoked more cigarettes and were highly nicotine dependent. These individuals had lower barrier self-efficacy compared to those with past or no diagnosis; no differences between groups were observed on task self-efficacy. Motivation to quit was significantly correlated with task self-efficacy in all 3 groups, but with barrier-self efficacy only among those with no lifetime diagnosis of psychiatric illness.

Our results highlight the differences in task and barrier cessation self-efficacy in treatment-seeking smokers. Those with a current psychiatric diagnosis have less confidence in their ability to quit when confronting barriers, especially those reflecting internal states. These results highlight the need for targeted interventions to improve cessation self-efficacy, an important determinant of health behavior change.