The Impact of Expectations and Satisfaction on the Initiation and Maintenance of Smoking Cessation: An Experimental Test

Objective: Our primary objective was to test the thesis that the initiation of behavior change is dependent on favorable expectations, whereas maintaining a change in behavior is dependent on satisfaction with the outcomes afforded by behavior change. These hypotheses were tested in the context of a smoking cessation intervention. Design: Adult smokers were randomized to an 8-week smoking cessation program designed to induce either optimistic or modest expectations about cessation. Participants were encouraged to quit smoking after Week 4 and were followed for 15 months after the end of the program. Main Process and Outcome Measures: The authors focused on participants' expectations about cessation, satisfaction with cessation, and smoking status. Results: The effect of the expectation manipulation on smokers' beliefs about cessation was moderated by their prior cessation success. Those led to hold favorable expectations about cessation were more likely to initiate cessation. Although satisfaction was not affected by initial expectations, it predicted maintained cessation. Conclusions: Results highlight the challenge of altering how smokers think about cessation and the need for further research on intervention strategies that target different factors for the initiation and maintenance of cessation.