BACKGROUND: Previous research has demonstrated that social norms influence quitting intention, with smokers being less likely to quit when they perceive higher smoking prevalence and greater acceptability of smoking behavior. Moreover, smokers' identity may lead them to adopt attitudes that rationalize smoking, thereby inhibiting cessation. This study aims to explore the relationship between smoking social norms and quitting intentions, as well as the chain mediating role of identity and smoking rationalization beliefs.
METHODS: A cross-sectional online survey was conducted in China among 835 current smokers using the self-developed Smoking Social Norms Scale, which includes four dimensions: descriptive norms (DN), injunctive norms (IN), moral norms (MN), and tobacco culture norms (CN), as well as the adapted Smoker Identity Scale (“I have a lot in common with other smokers”...) and a simplified version of the Smoking Rationalization Belief Scale(“Smoking can eliminate fatigue and be refreshing”...). ​Participants were recruited through proportional sampling stratified by regional population to ensure representativeness.
RESULTS: While the public demonstrated strong anti-smoking attitudes toward IN and MN, they tended to overestimate smoking prevalence in DN and exhibited high approval rates for CN. Mediation analysis revealed that both the direct effect (95% CI: -1.10 to -0.15) and the indirect effect (95% CI: -0.60 to -0.10) were significant. The indirect effects occurred through two pathways: one through identity and smoking rationalization beliefs (effect = -0.15, 95% CI: -0.28 to -0.05), and the other through smoking rationalization beliefs alone (effect = -0.26, 95% CI: -0.46 to -0.09).
CONCLUSIONS: ​The findings emphasize the role of cognitive factors related to smoking and provide the foundation for a psychosocial processing model of smoking cessation. Future tobacco control strategies should focus on reshaping anti-smoking social norms, altering smokers’ identity, and correcting smoking rationalization beliefs to foster the development of a smoke-free society.