October 13, 2026 | Erin Bluvas, bluvase@sc.edu
Researchers from across the Arnold School have teamed up to investigate smoking cessation from a new angle. Led by health promotion, education, and behavior (HPEB) associate professor Amanda Rebar and published in the Journal of Medical Internet Research, the scientists looked at smokers’ moment-to-moment attitudes toward smoking, confidence in cutting down, and motivation to quit/forgo cigarettes.
“Motivation to quit smoking plays a pivotal role in initiating quit attempts and is a predictor of eventual cessation success, yet motivational factors such as a person’s cognitive state, external demands, and social context fluctuate throughout the day,” says Rebar, who is an expert in motivation related to health behaviors and how to make and break habits. “Previous research has looked at these momentary fluctuations, but we need a better understanding of how these processes unfold over the course of a day.”
Despite decades of research and public health campaigns about smoking’s negative health effects, more than one in five adults around the world still smoke cigarettes regularly. With cigarettes as the most common method of consumption, tobacco use leads to cancer, heart disease, lung disease and type 2 diabetes – resulting in the premature deaths of more than 8 million people worldwide each year.
Fortunately, quitting before the age of 40 can reduce the risk of early mortality by up to 90%. In addition to motivation, microbehaviors (e.g., forgoing cigarettes), attitudes toward smoking (e.g., pleasurable and rewarding vs harmful and stigmatizing), and self-efficacy (i.e., confidence in their ability to reduce or stop smoking) are also important indicators of readiness to quit and successful cessation.
“The knowledge we’ve gained from prior studies helps inform cessation campaigns, but so far it has not accounted for the fact that motivation is dynamic, not fixed,” Rebar says. “With this study, we looked at the ways smoking-related thoughts, feelings, confidence, and motivation fluctuate in response to mood, environment, social situations, responsibilities, and daily experiences.”
The researchers examined data collected from 348 adults in central New York and central South Carolina who smoke at least 10 cigarettes per day. Using a smartphone app, the participants answered brief surveys related to confidence in cutting down, attitudes toward smoking, and motivation to quit after smoking selected cigarettes throughout the day. This method, ecological momentary assessment (i.e., collecting experiences in real time rather than relying on memory), resulted in data from more than15,000 momentary surveys.
The authors’ analysis revealed that confidence was the strongest predictor of quitting-related behavior. On days when participants felt confident about their ability to cut back, they were more likely to forgo one or more of their usual cigarettes. In fact, for every unit of additional self-efficacy they reported, participants doubled their likelihood of skipping a cigarette.
The team found that the trajectory of their confidence throughout the day mattered as well. Participants whose confidence increased as the day progressed – especially if it rose rapidly – were more likely to resist cravings. As expected, people who viewed smoking negatively were more likely to cut back than those who viewed it positively. Finally, they discovered that when attitudes about smoking swung back and forth, this unstable variability might lead to higher motivation but was associated with a lower likelihood of actually skipping cigarettes. They were also able to identify several patterns related to confidence/self-efficacy and attitudes that may help tailor future interventions to the individual.
“The findings from this project open up new possibilities for designing interventions that account for the dynamic nature of motivation, self-efficacy, and attitudes that people experience throughout the day,” Rebar says. “For example, employing adaptive questions, responses, messaging, and encouragement that bolster motivation during periods of low or declining self-efficacy could provide proactive support or coping prompts that may help individuals reduce or quit smoking.”