The effects of counterfactual thinking on readiness to change smoking-related behaviors

Date of Award


Degree Name

M.A. in General Psychology


Department of Psychology


Advisor: Melissa A. Berry


Cigarette smoking continues to be the leading preventable cause of death in the United States, according to the U.S. Centers for Disease Control. In the current study, counterfactual thinking was investigated as an intervention to encourage readiness to consider quitting smoking. Additionally, individual difference variables were examined to explore their potential roles in smoking behavior change. Participants completed the Consideration of Future Consequences Scale, Optimism/Pessimism Instrument, Fagerstrom Test for Nicotine Dependence, Contemplation Ladder, modified Powe Fatalism Inventory, Beliefs in Fate scale, and Smoking Consequences Questionnaire. Participants were then given a written scenario and instructed to envision it as a prognosis from their doctor. They also received one of four counterfactual conditions and were asked to generate corresponding alternative behaviors. Participants returned one week later and were again given the Fagerstrom Test, the Contemplation Ladder, and the Smoking Consequences Questionnaire. Participants were also given a self-report measure about their efforts to decrease their smoking and were asked if they would be willing to participate in a lung-capacity test, the behavioral measure of intention to quit. The analyses revealed no significant effect of the direction or structure of counterfactual condition on readiness to consider quitting smoking, as measured by the Contemplation Ladder. A significant Direction x Lung Capacity interaction indicated that participants in downward counterfactual conditions (53.5%) were more likely to sign up for a lung-capacity test than those in upward counterfactual conditions (31.7%), x2diff (1, N = 84) = 4.11, p = .043, Cramer's V = .22. No significant effect of counterfactual structure on willingness to schedule a lung-capacity test was found. Additionally, no significant effect of the personality variables on the receptivity to the counterfactual thinking interventions was detected. Page and Colby (2003) investigated counterfactual thinking as an effective anti-smoking strategy, finding that additive counterfactuals influenced willingness to participate in a lung-capacity test. The current findings, however, indicated no effect of structure but did reveal that participants in the downward counterfactual condition were more likely to sign up for a lung-capacity test. Potential explanations for the failure to replicate previous results and suggestions for futured research are addressed.


Smoking cessation Psychological aspects, Cigarette smokers Rehabilitation Psychological aspects, Cigarette smokers Attitudes, Psychology; counterfactual thinking; smoking cessation; consideration of future consequences; optimism and pessimism; readiness to change; fatalism

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Copyright © 2013, author