Understanding Emerging Adults’ Decision-Making Process When Selecting a Smoking Cessation Approach: A Grounded Theory Study

Abstract

Rates of cigarette smoking have been markedly reduced in recent decades, but young adults (or emerging adults) continue to have the highest rate of tobacco use in Ontario, Canada. Though preventing smoking initiation is optimal, positive outcomes of cessation early in the lifespan make it clear that cessation support for smokers in this age group is critical. Despite research into the effectiveness of quitting approaches and smokers’ preferred approaches to quitting, it remains largely unclear how smokers characterized as emerging adults (Arnett, 2000) make and act upon “real-world” decisions about which cessation approach to use. To learn more about this important aspect of the quitting process, this study investigated emerging adults’ experiences of choosing their approach to quitting. Twenty-six recent quitters between the ages of 19-29 participated in semi-structured interviews. Grounded theory methods were used to develop a framework explaining the decision-making process successful quitters engaged in when choosing a smoking-cessation approach. The newly proposed “Choosing How To Quit” Framework shows a decision making process that includes three distinct phases: Awareness of Approaches; Personal Reflection; Making a Choice. Successful emerging-adult quitters chose a quitting approach by drawing on a variety of sources for information and exploring personal facets including their past experiences, real-life daily-living considerations and an understanding of their present and future-selves. The Framework offers emerging adults and cessation supporters new realistic avenues to consider or explore when making the decision about a cessation approach, potentially leading to a greater likelihood of success. As a preliminary theory, the CHQ Framework requires further investigation, including into which components may be most essential to the decision-making process.