Objective   To investigate the relationship between smoking decisional balance and intention to quit smoking among male smokers, and to promote implementation and efficiency of smoking cessation in male smokers.

  Methods  We recruited 326 male smokers who volunteered to participate a questionnaire survey via network from March to April 2016. General Demographic Information and Smoking Questionnaire, Fagerstrom Test for Nicotine Dependence, Intention to Quit Smoking Questionnaire, and Decisional Balance Scale were adopted in the survey.

  Results   The score of perceived smoking benefits (2.82 ± .66) was significantly lower than that of perceived smoking hazards (3.09 ± .61) (t = 6.37, P<0.001). There were 60.74% of the participants reporting a higher level of perceived smoking hazards than that of perceived smoking benefits, 27.61% reporting a lower level of perceived smoking hazards than that of benefits, and 11.66% reporting equal levels of perceived smoking hazards and benefits. The score of willingness to quit smoking was higher than that of planning to quit smoking (3.17 ± 1.11 vs. 2.42 ± 1.55; t = 9.10, P < 0.001). The smoking decisional balance was negatively correlated with willingness to quit smoking and planning to quit smoking (r = – 0.39 and – 0.24, P < 0.001). The smoking decisional balance showed a negatively predictive effect on willingness to quit smoking and planning to quit smoking.

  Conclusion  The attitude towards smoking is ambivalent and the intention to quit smoking is often in a state of high willingness but low planning among male smokers. Smoking decisional balance is an important predictor of intention to quit smoking in the male smokers.