Psychological reactance in smoking cessation among inner Mongolian students

Smoking negatively affects physical and psychological well-being. Smoking cessation is a pressing health concern in the Republic of China. This study aimed to examine differences among the effects of individual- and group-level psychological variables in contributing to smoking cessation among students in Inner Mongolia. We implemented a health survey administered to 3,947 students. Of these, 429 who were present smokers or had quit smoking were included in the analysis. Participants were evaluated on items measuring variables based on the theory of planned behavior. These included intention, attitude, subjective norms, perceived behavioral control, and stage of change in smoking cessation. Among the levels of students, ratios of those who reported having smoked were 14.3% for junior high school students, 5.4% for high school students, and 19.3% for university students. Multilevel analysis including an intra-class correlation coefficient and multilevel structural equation modeling showed that, overall, the variables contributed to quitting smoking on an individual level. The subjective norm was negatively associated with behavioral intention in group-level analysis. Increasing the group subjective norm showed potential for inducing psychological reactance. Consequently, an individualized or personalized approach is a potentially effective strategy for encouraging smoking cessation in Inner Mongolian students.