Attitudes, social influences and self-efficacy expectations across different motivational stages among immigrant smokers: Replication of the empty set pattern

Background Information about the factors that determine motivation to quit in immigrant populations is needed to enable the development of tailored smoking cessation programs for them. Dutch studies in the general population suggest that attitudes are important for motivating persons to change and self-efficacy for helping motivated persons to change. We analyzed whether this pattern also exists among Surinamese immigrants. Methods Structured face-to-face interviews were held among 1100 Surinamese people in Amsterdam (The Netherlands), including measures of attitudes towards smoking (cessation), social influences and self-efficacy expectations (between 2001 and 2003). Results The majority of the smokers were not motivated to quit and in the pre-contemplation phase (73%). Pre-contemplators perceived significantly weaker advantages of quitting than contemplators and preparators. Self-efficacy expectations of Surinamese pre-contemplators were lower than those of smokers preparing to quit within a month. Conclusion Similar attitudinal and self-efficacy patterns as those in the general population were found in an immigrant population. However, the items constituting the factors are culturally sensitive. Furthermore, many Surinamese smokers were unmotivated to quit smoking.