# From Diagnosis to Behaviour Change: Applying the Health Action Process Approach to Smoking Cessation After Head and Neck Cancer

## TL;DR

This study explores how psychological factors predict smoking cessation in head and neck cancer patients, highlighting the importance of action control in quitting smoking after diagnosis.

## Contribution

The study provides the first longitudinal evidence supporting the Health Action Process Approach (HAPA) framework for smoking cessation after cancer.

## Key findings

- HAPA constructs significantly improved prediction of tobacco dependence compared to sociodemographic and clinical variables.
- Action Control Efficacy was the only independent predictor of smoking cessation.
- Higher Risk Perception and Outcome Expectancies were associated with greater cigarette dependence.

## Abstract

Smoking cessation after a cancer diagnosis is a key determinant of prognosis, yet the psychological mechanisms underlying cessation remain poorly understood. Building on a recently validated Health Action Process Approach (HAPA) scale, this study examined whether baseline HAPA constructs predicted short-term smoking cessation and tobacco dependence in patients with head and neck cancer. Eighty-nine patients completed assessments at diagnosis (T0) and one-month follow-up (T1). Six HAPA constructs were measured at T0: Risk Perception, Outcome Expectancies, Recovery Self-Efficacy, Behavioral Intention, Coping Planning, and Action Control Efficacy. Smoking outcomes at T1 included cigarette dependence (CDS-12) and smoking status. Hierarchical linear regression showed that sociodemographic and clinical variables did not predict dependence, whereas adding HAPA constructs significantly improved prediction (ΔR2 = 0.28, p < 0.001). Higher Risk Perception and Outcome Expectancies were associated with greater dependence, while logistic regression identified Action Control Efficacy as the only independent predictor of smoking cessation. These findings provide the first longitudinal evidence supporting the application of the HAPA framework to smoking cessation after cancer diagnosis and underscore the critical role of volitional processes in early cessation. Targeting action control may therefore enhance the effectiveness of smoking cessation interventions in oncology settings.