De-Mystifying Willpower in Unassisted Smoking Cessation: A Qualitative Analysis Reveals a Systematic Profile of Situational and Cognitive Strategies

Objective: This study explores the self-regulation strategies and Behavior Change Techniques (BCTs) employed by individuals who successfully quit smoking unassisted, aiming to understand the processes behind their cessation journeys. Methods: A qualitative content analysis was conducted on semi-structured interviews with 32 unassisted quitters. Data were analyzed inductively to identify themes related to the challenges faced, and deductively to map strategies used onto existing frameworks, including the Process Model of Self-Regulation and the BCT Taxonomy. Results: Participants employed a variety of strategies to manage cravings and avoid smoking triggers, including changing their environments, diverting attention, reappraising situations, and leveraging social support. The analysis revealed that participants engaged in polyregulation, whereby they used multiple strategies concurrently. The most frequently used strategies were situation selection/modification (51.9%) and cognitive change (28.3%), with behavior substitution and habit reversal being common BCTs. Conclusion: Unassisted quitters drew from a sophisticated array of strategies beyond the traditional notion of willpower, suggesting a “toolbox” approach to self-regulation and behavior change. These findings can inform public health policies and interventions to better support smoking cessation by promoting practical, learnable strategies for individuals attempting to quit without formal assistance. Keywords: Unassisted smoking cessation, self-regulation strategies, behavior change techniques, polyregulation, public health policy