Over eight million people die from tobacco use annually, yet quitting remains difficult due to both physical and psychological addiction (WHO, 2022; Colin and Droulers, 2022). While previous models labeled individuals simply as “smokers” or “quitters,” newer frameworks attempt to capture motivational stages (DiClemente et al., 1991). However, the complex link between dependence and quitting is still unclear. This study explores how “symbolic self-completion” theory—a concept where identity is maintained through socially recognized symbols (Mead, 1934)—relates to quitting intentions, suggesting that cessation involves not only personal resolve but also social identity (Wicklund and Gollwitzer, 2013).

Research shows that strong smoker identity, reflecting how central smoking is to one’s self-image, may impact quit intentions. Our hypotheses include: (H1) higher nicotine dependence lowers quit intentions; (H2) lack of symbolic self-completion, where smoking isn’t central to identity, increases quit intentions; and (H3) symbolic self-completion mediates between dependence and quitting. Over time, addiction deepens smoking’s identity ties, increasing symbolic attachments (Gibbons and Eggleston, 1996). Thus, (H4) higher dependence heightens symbolic self-completion, making quitting more challenging as smoking becomes intertwined with social identity.

Methods

A survey of 1,020 adult participants in Türkiye, conducted from September 2022 to March 2023, used computer-aided telephone interviews to assess smoking behaviors and intentions to quit. The sample was representative of the gender and age distribution of smokers in the 12 NUTS-1 regions, aligning with Türkiye’s official statistics that 31.6% of the population smokes (WHO, 2023). Analyses were conducted using IBM SPSS v.26 and Hayes model #4 (Hayes, 2013) to test mediation effects, with no multicollinearity detected.

The Heaviness of Smoking Index (HSI) measured nicotine dependence based on cigarette consumption and time to first cigarette after waking (Borland et al., 2010). Quit intention (QI) was assessed as a continuum with questions about desire and determination to quit, while absence of symbolic self-completion (ASC) was measured by items designed for this study, such as “Smoking does not suit me” and “Ideally, I would not be a smoker” (Wicklund and Gollwitzer, 2013; Carr and Vignoles, 2011). A confirmatory factor analysis verified the measures, showing acceptable factor loadings and correlations among variables (Awang, 2015), highlighting complex relationships among dependence, self-concept, and quitting intentions.

Results and Discussion

This study explored the impact of nicotine dependence (HSI) on quit intention (QI) and found that higher dependence leads to lower quit intentions, supporting Hypothesis 1 (F=11.014; coeff=–.039; p<.01). Using Hayes model #4, results showed that a lack of symbolic attachment to smoking, or absence of symbolic self-completion (ASC), positively influenced quit intentions (coeff=.6118; p<.05), supporting Hypothesis 2. Further, ASC partially mediated the relationship between HSI and QI, confirming Hypothesis 3, with significant indirect effects (BootLLCI=‒0.0308 and BootULCI=‒0.0092).

The study highlights the role of smoking as a socio-cultural symbol, suggesting that quitting involves navigating social expectations and self-image, rather than just personal motivation (LeGrande et al., 2021). Smoking can lead to social addiction, where individuals feel affirmed as smokers or, conversely, seek social approval to quit (Suarez, 2014). Unlike “social smoking,” which involves smoking in social settings, this symbolic attachment is shaped by societal views and self-concept (Gollwitzer, 1986). As a result, policies focusing solely on health risks, such as graphic warnings, may be insufficient. Smoking initiation often occurs early due to social factors (Rugkåsa et al., 2001), so prevention strategies should also consider symbolic and social influences.

References

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