Reversal theory states and cigarette availability predict lapses during smoking cessation among adolescents


  • Rebecca F. Burris,

    Corresponding author
    1. Arkansas Tech University, Russellville, Arkansas
    • Department of Nursing, Arkansas Tech University, Russellville, AR 72801.
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    • Associate Professor and Department Head of Nursing.

  • Kathleen A. O'Connell

    1. Teachers College, Columbia University, New York, New York
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    • Professor.

  • The authors would like to acknowledge the assistance of Dr. Joseph Schwartz and Steve Grossman for help with the multilevel random-effects logistic regression analysis.


Although 67% of adolescent smokers say they want to quit, only 7% are able to do so. The purpose of this study was to use metamotivational states as described in reversal theory to predict whether adolescents who are trying to quit smoking will lapse (smoke a cigarette) or will resist smoking in highly tempting situations. Reversal theory holds that individuals switch between telic (serious-minded) and paratelic (playful) metamotivational states. Questionnaires and semistructured interviews were administered to 62 adolescents ages 14–19 who had participated in a smoking cessation program. Interviews were coded according to the Metamotivational State Interview and Coding Schedule, and the resulting data were analyzed using logistic regression analysis. Adolescents in the paratelic metamotivational state (OR = 15.34; 95% CI: 5.3, 43.6) or with cigarettes readily available (OR = 4.6; 95% CI: 1.6, 13.2) were more likely to lapse than were adolescents in the telic state or who required effort to obtain cigarettes. The variables telic/paratelic state and cigarette availability accurately predicted the outcome of highly tempting situations 80% of the time. Using reversal theory constructs to develop state-specific strategies shows promise as an additional tool for those in this age group coping with the temptation to smoke. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26:263–272, 2003