Understanding perspectives on smoking cessation based on Self-Determination Theory: A qualitative study

Abstract

INTRODUCTION Implementing and maintaining smoking cessation requires high motivation. This study examines the role of Self-Determination Theory (SDT) in enhancing smoking cessation strategies by highlighting the significance of psychological needs for lasting behavioral change. We aimed to explore how participants perceive the importance of SDT's basic psychological needs – autonomy, competence, and relatedness – in the context of smoking cessation treatment and support (SCTS). METHODS This qualitative study, employing SDT-driven content analysis, utilized a co-design workshop held in Finland in 2019, where 12 participants engaged in group dialogues. The workshop dialogues were examined to determine whether SDT influenced participants’ responses regarding SCTS. RESULTS The qualitative analysis emphasized the respondents' need for autonomous motivation. The study highlighted the importance of acknowledging individual differences and psychological needs for effective support in SCTS. We identified ten categories: Addiction, Aids and appliances, Characteristics, Collective quitting, Expert advice, Follow-up data, Personal experience, Rewards, Health political decision-making, Ways of quitting smoking. All were linked to basic psychological need. The desire for autonomy was the most common theme (41.2%) followed by competence (34.6%) and relatedness (24.2 %). CONCLUSIONS Health practitioners should recognize and address the basic psychological needs of autonomy, competence, and relatedness when assisting smokers in their cessation efforts. By offering meaningful choices to support autonomy and enhance competence, and by providing positive, informative feedback while empathizing with the smoker’s situation, professionals can improve the effectiveness of SCTS interventions. To be truly effective, support must be tailored to individual differences and needs.