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This study uses protection motivation theory (PMT) to examine the quitting intentions and behaviours of smokers who have varying levels of nicotine dependence. Our goals are to identify the psychological factors that influence smoking cessation and to provide valuable evidence to promote theory-guided interventions. This is a cross-sectional study that was conducted from July to August 2020. Participants were randomly selected on the streets of 26 provinces on mainland China. Data were collected via face-to-face interviews. Our analysis was conducted in three steps. First, we employed descriptive statistics to present the overall characteristics of our sample. Second, we analysed the association between PMT constructs and quitting intentions stratified by nicotine dependence. Third, we tested how quitting intentions were associated with quitting behaviours in each subgroup using logistic regression models. For intention, almost all the PMT constructs were significantly associated with quitting intention in the low-dependence group. For the moderate- and high-dependence groups, only perceived vulnerability (coefficient = 0.35, P = 0.04) was positively associated with quitting intention. For behaviour, we found a stronger association between quitting intention and behaviour in the low-dependence group (Coef. = 1.67, P = 0.00) than for the other groups. We found a significant association between e-cigarette use and quitting behaviour only in the low-dependence group (Coef. = 1.34, P = 0.00). Coefficients for the moderate- and high-dependence groups were not statistically significant. Smokers at various levels of nicotine dependence have different psychological factors that influence their intentions to stop smoking. Quitting intention was more significantly associated with quitting behaviour for the low nicotine-dependence group than for the other groups. More convincing research is necessary to determine how e-cigarette use affects quitting behaviour in the long term.

Tobacco dependence affects determinants related to quitting intention and behaviour