Smoking Self-Efficacy Scales

Abstract

The Smoking Self-Efficacy Scales (SSES) are psychological instruments designed to measure an individual’s confidence in their ability to refrain from smoking across various high-risk situations. Developed primarily by DiClemente and colleagues, these scales are grounded in the principles of Self-Efficacy Theory and the Transtheoretical Model (TTM) of behavior change. The SSES assesses situation-specific confidence, which is a critical predictor of successful long-term smoking cessation and relapse prevention. The scales are available in a comprehensive 20-item version and a shorter, more practical 9-item version, both organized around three core factors representing different types of relapse triggers.

Keywords

Smoking Self-Efficacy Scales, Transtheoretical Model, TTM, smoking cessation, relapse prevention, self-report, psychological assessment, addiction, confidence

Authors

Carlo C. DiClemente, James O. Prochaska, Wayne F. Velicer, Marco Gibertini

Purpose

The primary purpose of the Smoking Self-Efficacy Scales is to quantify the degree of confidence a smoker or recent ex-smoker possesses regarding their ability to maintain abstinence when confronted with specific, challenging situations. This measurement is crucial for researchers and clinicians utilizing the Transtheoretical Model (TTM), as self-efficacy is hypothesized to be a key determinant of progression through the stages of change, particularly during the Action and Maintenance stages of quitting. By identifying low-confidence situations, targeted interventions can be developed to prevent relapse.

The SSES helps distinguish between individuals who are prepared to quit and those who may require additional support regarding specific triggers. The instrument provides a detailed profile of an individual’s perceived vulnerability across emotional, social, and physiological contexts, informing personalized treatment plans for smoking cessation programs.

Construct

The SSES specifically measures situation-specific self-efficacy related to smoking behavior. Self-efficacy, as defined by Bandura, refers to an individual’s belief in their capacity to execute behaviors necessary to produce specific performance attainments. In the context of smoking, this is the conviction that one can resist the urge to smoke in situations that have historically been associated with tobacco use.

The construct is operationalized across three key subdomains of high-risk situations, reflecting common reasons for relapse among smokers: 1) Negative Affect, 2) Social/Positive situations, and 3) Habitual/Craving triggers. These factors align with classic models of relapse, emphasizing the interplay between internal emotional states, social pressure, and physiological dependence.

Validity

The SSES demonstrates strong construct validity, particularly its integration with the Stages of Change within the TTM. Research, such as that by DiClemente, Prochaska, and Gibertini (1985), has consistently shown that self-efficacy scores increase linearly as individuals progress through the stages of change (from Precontemplation to Maintenance). Higher self-efficacy scores are associated with greater success in quitting and lower rates of relapse.

Predictive validity is evidenced by the scale’s ability to forecast future smoking status. Individuals reporting higher confidence across the three factors (Negative Affect, Social/Positive, Habit/Addictive) are significantly more likely to maintain abstinence over time compared to those with lower confidence scores, establishing the SSES as a robust prognostic tool in addiction research.

Reliability

The SSES exhibits excellent internal consistency reliability, indicating that the items within each subscale measure the same underlying construct effectively. Based on findings reported by Velicer, DiClemente, et al. (1990), the internal consistency coefficients (Cronbach’s Alpha) for the 20-item version factors were exceptionally high:

• Negative Affect: .95
• Social/Positive: .93
• Habit/Addictive: .92

These values suggest that the SSES is a highly reliable measure for assessing self-efficacy across various relapse-provoking contexts, ensuring stable and consistent measurement in clinical and research settings.

Factor Analysis

Exploratory and confirmatory Factor Analysis conducted on the SSES confirmed a robust three-factor structure, which organizes the high-risk situations into conceptually distinct categories. This structure is consistent across both the 20-item and 9-item versions, supporting the theoretical model of relapse situations.

The three factors identified are:

1. Negative Affect: Items related to coping with negative emotional states (e.g., anger, frustration, depression, stress, emotional crisis).
2. Social/Positive: Items related to social settings, celebrations, and exposure to other smokers (e.g., parties, bars, being around friends who smoke).
3. Habitual/Craving: Items related to physiological addiction, routine behaviors, and general cravings (e.g., first thing in the morning, needing a lift, realizing quitting is difficult).

This factor structure allows researchers and clinicians to assess specific areas of vulnerability, rather than relying solely on a global self-efficacy score.

Instrument

Test Type: Self-report questionnaire/Inventory

Format: The respondent rates their confidence in resisting smoking across various situations using a 5-point Likert scale. The response options are:

1. Not at all confident
2. Not very confident
3. Moderately confident
4. Very confident
5. Extremely confident

Language Available: Primarily English; translated versions may exist in research literature.

Population Group: Adult smokers and recent ex-smokers engaged in or contemplating smoking cessation.

Age Group: Typically 18 years and older (Adult population).

Population Details: Used extensively in clinical trials and public health studies focusing on tobacco dependence treatment, behavioral medicine, and health psychology.

Test Methodology: The scale is administered to assess perceived confidence regarding the ability to maintain abstinence. Scores are calculated for the total scale and for the three primary subscales (Negative Affect, Social/Positive, and Habitual/Craving). Higher scores indicate greater self-efficacy and a higher probability of successful behavior change.

Keywords

Self-Efficacy, Smoking Self-Efficacy Scales, Nicotine dependence, behavioral change, Transtheoretical Model, TTM, addiction measurement, psychological instrument

Authors

Author ORCID Identifier: Information not provided in the source material.

Affiliation Email addresses: Information not provided in the source material.

Correspondence Address: Information not provided in the source material. Correspondence is typically directed to the primary author, Carlo C. DiClemente, Ph.D., whose work is often associated with the University of Maryland, Baltimore County (UMBC).

Permissions & Fee and Test Year

Test Year: The original conceptualization and publication of the scale were in 1985 (DiClemente, Prochaska, & Gibertini, 1985).

Permissions & Fee: The scale is generally considered available for non-commercial research and clinical use. The instrument can be accessed online at the habits lab website. Users should seek formal permission from Dr. Carlo C. DiClemente or the associated research laboratory (e.g., UMBC Habits Lab) for specific usage protocols or commercial applications. The instrument can be found at: http://habitslab.umbc.edu/self-efficacy-scales/

Reference’s

• DiClemente‚ C.C.‚ Prochaska‚ J.O.‚ and Gibertini‚ M. (1985). Self-Efficacy and the Stages of Self-Change of Smoking. Cognitive Therapy and Research‚ 9‚ 2‚ 181-200.
• DiClemente‚ C. C. (1986). Self-Efficacy and the addictive behaviors. Journal of Social and Clinical Psychology‚ 4‚ 302-315.
• Prochaska‚ J.O.‚ Velicer‚ W.F.‚ DiClemente‚ C.C.‚ & Fava‚ J. (1988). Measuring Processes of Change: Applications to the Cessation of Smoking. Journal of Consulting and Clinical Psychology‚ 56‚ 4‚ 520-528.
• Velicer‚ W.F.‚ DiClemente‚ C.C.‚ Rossi‚ J. S.‚ Prochaska‚ J. O. (1990). Relapse situations and self-efficacy: An integrative model. Addictive Behaviors‚ 15‚ 271-283.
• DiClemente‚ C. C.‚ Fairhurst‚ S. K.‚ & Piotrowski‚ N. A. (1995). Self-Efficacy and addictive behaviors. In J. E. Maddux‚ ed.‚ Self-Efficacy‚ adaptation‚ and adjustment: Theory‚ research‚ and application (pp. 109-141). New York: Plenum.
• Perz‚ C.A.‚ DiClemente‚ C.C.‚ & Carbonari‚ J.P. (1996). Doing the right Thing at the Right Time? The Interaction of Stages and Processes of Change in Successful Smoking Cessation. Health Psychology‚ 15‚ 6‚ 462-468.
• DiClemente‚ CC & Haug‚ N. (October‚ 2001) Smoking Cessation: Helping Patients through the Process. Journal of COPD Management. 2(4)‚ 4-9.
• Delahanty‚ J.C.‚ DiClemente‚ C.C.‚ Havas‚ S.‚ & Langenberg‚ P. (2008). Smoking status and stages of change for dietary behaviors among WIC women. American Journal of Health Behavior‚ 32(6)‚ 583-593.

Items of the Smoking Self-Efficacy Scales

20 items

1. At a bar or cocktail lounge ha‎ving a drink.
2. When I am desiring a cigarette.
3. When things are not going the way I want and I am frustrated.
4. With my spouse or close friend who is smoking.
5. When there are arguments and conflicts with my family.
6. When I am happy and celebrating.
7. When I am very angry about something or someone.
8. When I would experience an emotional crisis‚ such as an accident or a death in the family.
9. When I see someone smoking and enjoying it.
10. Over coffee while talking and relaxing.
11. When I realize that quitting smoking is an extremely difficult task for me.
12. When I am craving a cigarette.
13. When I first get up in the morning.
14. When I feel I need a lift.
15. When I begin to let down on my concern about my health and am less physically active.
16. With friends at a party.
17. When I wake up in the morning and face a tough day.
18. When I am extremely depressed.
19. When I am extremely anxious and stressed.
20. When I realize I haven’t smoked for a while.

9 items – Short Form

1. With friends at a party.
2. When I first get up in the morning.
3. When I am very anxious and stressed.
4. Over coffee while talking and relaxing.
5. When I feel I need a lift.
6. When I am very angry about something or someone.
7. With my spouse or close friend who is smoking.
8. When I realize I haven’t smoked for a while.
9. When things are not going my way and I am frustrated.