Smoking:
Self-Efficacy / Temptation
(Long Form) Listed below are situations that
lead some people to smoke. We would like to know HOW TEMPTED you may be to smoke in each
situation. Please answer the following questions using the following five point scale.
1 = Not at all tempted
2 = Not very tempted
3 = Moderately tempted
4 = Very tempted
5 = Extremely tempted
| 1. |
At a bar or cocktail lounge having a drink.
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| 2. |
When I am desiring a cigarette.
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| 3. |
When things are not going the way I want and I am
frustrated. |
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| 4. |
With my spouse or close friend who is smoking.
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| 5. |
When there are arguments and conflicts with my family. |
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| 6. |
When I am happy and celebrating.
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| 7. |
When I am very angry about something or someone. |
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| 8. |
When I would experience an emotional crisis, such as an
accident or death in the family. |
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| 9. |
When I see someone smoking and enjoying it.
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| 10. |
Over coffee while talking and relaxing.
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| 11. |
When I realize that quitting smoking is an extremely
difficult task for me. |
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| 12. |
When I am craving a cigarette.
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| 13. |
When I first get up in the morning.
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| 14. |
When I feel I need a lift.
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| 15. |
When I begin to let down on my concern about my health and
am less physically active. |
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| 16. |
With friends at a party.
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| 17. |
When I wake up in the morning and face a tough day. |
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| 18. |
When I am extremely depressed.
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| 19. |
When I am extremely anxious and stressed.
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| 20. |
When I realize I haven't smoked for a while.
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Scoring
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| Positive Affect / Social Situations |
1, 4, 6, 9, 10, 16 |
| Negative Affect Situations |
3, 5, 7, 8, 18, 19 |
| Habitual / Craving Situations |
11, 131 14, 15, 20 |
References
Velicer, W.F., DiClemente, C.C., Rossi, J.S., &
Prochaska, J.O. (1990). Relapse situations and self-efficacy: An integrative model. Addictive
Behaviors, 15, 271-283.
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