Differences and interactions between intrinsic and extrinsic motivations that drive smokers to quit and to continue smoking: a qualitative analysis

Background: Intrinsic, personal, or autonomous motivations are important in facilitating behavioral change. However, definitions of different motivations remain unclear, particularly when distinguishing between intrinsic and extrinsic motivations to quit smoking. This study describes the differences and interactions between motivations to both quit and smoke, aiming to facilitate better understanding and practice of increasing intrinsic motivation to quit smoking and other dependent behaviors. Methods: Qualitative analysis of adult smokers’ statements during the first session of smoking cessation group behavioral counseling. 719 participants (56 groups) were included. Statements were analyzed using general thematic analysis. Results: Two themes were identified: motives to quit and motives to continue smoking. Each theme was divided into intrinsic (smokers’ own choice) and extrinsic (smokers’ perceived coercion) motives. Any reason to quit or to smoke could be perceived as either intrinsic or extrinsic, depending on the intrinsic motivation to smoke. Extrinsically motivated quitters were left with a strong will to smoke which was not diminished by their will to quit. Intrinsic motivation to smoke may change to extrinsic and increase intrinsic motivation to quit smoking. Conclusion: Identifying motivations to continue smoking may help to distinguish between intrinsic/extrinsic motivations to quit smoking and increase intrinsic motivation to quit.