Abstract
INTRODUCTION: Among dual-smoking couples, both partners have smoking-related motivations that may either facilitate or hinder cessation efforts. Existing research typically focuses on individual-level motivation, which may be inadequate for capturing aspects of concordance and discrepancy. This study characterized couples' motivational profiles and examined their associations with smoking cessation outcomes. METHODS: We conducted secondary analyses from a randomized controlled pilot study of 95 dual-smoking couples to examine how dyadic motivations to quit smoking predicted individual and joint point-prevalence abstinence at 3 months. Both partners reported their own motivation to quit (self-oriented) and their motivation for their partner to quit (partner-oriented). We examined dyadic motivation to quit smoking on abstinence across four goal characterizations: (1) Parallel Goals (partners' self-oriented motivations), (2) System-Oriented Goals (an individual's self- and partner-oriented motivation), (3) Shared Target Goals (both partners' motivation for one individual to quit), and (4) Parallel Partner-Oriented Goals (each partner's motivation for the other to quit). Using response surface analyses with logistic regression, we estimated the effects of alignment (a(1)) and misalignment (a(2)) in the couples'' motivation levels on individual and joint cessation outcomes. RESULTS: For individual cessation, quitting odds were higher when self-motivation or partner-oriented motivation aligned within the couple (Parallel goals: a(1) = 0.725; Shared Target goals: a(1) = 0.881; Parallel Partner-Oriented goals: a(1) = 0.729), when self-motivation exceeded partner's self-motivation (Parallel goals: a(3) = 0.453), or exceeded partner-oriented motivation (System-Oriented goals: a(3) = 1.094). Joint quitting was more likely when both partners had high self-motivation (Parallel goals: a(1) = 0.918), high self- and partner-oriented motivation (System-Oriented goals: a(1) = 0.310), high shared motivation for one partner to quit (Shared Target goals: a(1) = 0.673), or high partner-oriented motivation for each other (Parallel Partner-Oriented goals: a(1) = 0.965). All effects were statistically significant (P < .05). CONCLUSION: The findings highlight the role of dyadic motivations in predicting individual and dyadic abstinence among dual-smoking couples. Couple-based interventions that aim to increase and align partners' motivations to quit could improve cessation outcomes in this population.