Social cognitive predictors of smoking cessation intentions among smoker employees: the roles of anticipated regret and social norms

Testicular self-examination: The role of anticipated relief and anticipated regret

OBJECTIVE

Anticipated regret has been implicated in health-related decision-making. Recent work on influenza vaccination has suggested that anticipated relief, too, may influence individuals' decisions to engage in positive health behaviours. To explore these affective components further and address the generality of possible mechanisms underlying these associations, we examined whether anticipated relief and anticipated regret independently predict testicular self-examination (TSE) intention and behaviour. Given claims about differences in their nature and function, we distinguished between counterfactual relief (relief that a worse outcome did not obtain) and temporal relief (relief that an unpleasant experience is over).

DESIGN

Prospective correlational.

METHODS

At Time 1 (July 2022), 567 cis-gendered males were asked to complete measures of anticipated regret, anticipated counterfactual and temporal relief, measures of the Theory of Planned Behaviour and measures of anxiety and shame. One month later, the same participants were recontacted and asked about their engagement in TSE in the previous month.

RESULTS

Anticipated counterfactual relief and anticipated regret are independent, positive, predictors of intention to engage in TSE and, indirectly, TSE behaviour itself. Interestingly, anticipated temporal relief was negatively associated with intention to engage in TSE and, indirectly, behaviour.

CONCLUSIONS

Our results suggest that it may be the counterfactual nature of anticipated regret and anticipated relief that underlies their positive association with TSE and other health-promoting behaviours. Interventions designed to increase engagement in preventive health behaviours, such as TSE, may benefit from the consideration of both positively and negatively valenced counterfactual emotions.

Episodic Future Thinking Increases Quitting Intention and Reduces Cigarette Consumption: The Role of Anticipated Regret

Background: Episodic future thinking (EFT), which refers to people simulating possible future life events, has been suggested as a promising intervention for substance use disorders. Objectives: To examine the effect of gain-oriented and loss-oriented EFT on smoking cessation and its underlying mechanisms. Results: Two online experiments were conducted (Total N = 362). The results suggested that engaging in EFT led to increased short-term quitting behavior among smokers by bolstering their intentions to quit smoking (indirect effect = 0.10, bootstrap = 5000, bias-corrected 95% CI [0.0008, 0.2353]). Furthermore, the influence of EFT on quitting intention was mediated by anticipated regret (indirect effect = 0.37, bootstrap = 5000, bias-corrected 95% CI [0.2062, 0.5321]). There were no significant differences observed between the effects of gain-oriented and loss-oriented EFT on quitting intention (F = 0.28, p = .60). Importance: Our findings contribute to a growing body of literature on the adaptive functioning of EFT and lend support to the regret regulation theory. Health practitioners may consider integrating EFT into clinical interventions to help smokers quit smoking.

Examining the impact of perceived psychological distances of quitting and continuing tobacco smoking on antismoking intention: a cross-sectional study

To date, little research has been conducted to understand the role of psychological distances on smoking behaviour. Construal Level Theory posits that individuals mentally construe events, objects, or ideas based on their perceived distance in terms of spatial, temporal, social, and hypothetical dimensions, influencing their judgments and decision-making processes. The aim of the current study was (1) to provide a comprehensive exploration of psychological distances of costs and benefits of tobacco smoking and antismoking intention and (2) to examine whether smoking can be attributed to rational behaviour based on the psychological distance weighted balance of perceived costs and benefits of quitting and continuing smoking. Mediation models delineating the relationships among temporal and hypothetical psychological distances, personal relevance and antismoking intention were tested on cross-sectional survey data of 1486 smokers (880 men, Mage = 39.9 years, SD = 13.36). Psychological distances were shown to be important factors in the cognitive evaluation process of smoking behaviour. Perceived temporal distance to smoking continuation/cessation was related to personal importance and hypothetical psychological distances, which were associated with anti-smoking intention. Furthermore, antismoking intention was related to the psychological distance-weighted gain-cost balance of quitting and continuing smoking. The current findings enhance our knowledge of the cognitive evaluation of the outcomes of smoking, indicating that the choice of not quitting smoking may be partially based on a biased rational decision-making process.

The State of Norm-Based Antismoking Research: Conceptual Frameworks, Research Designs, and Implications for Interventions

This synthesis review examined 189 qualified studies on norms and smoking in terms of conceptual frameworks, types of social norms, research designs, dependent variables, independent variables and covariates, and findings related to norms. Results show that 7.9% were experimental, and the remaining were cross-sectional. By far, the reasoned action approach (RAA) was the most-cited theory, but RAA was not used to guide experimental designs. The social norms approach, norm focus theory, social cognitive theory guided the intervention experiments. Harmful norms were more frequently examined than healthful norms. Pro-smoking norms positively predicted smoking intentions and behaviors, whereas antismoking norms positively predicted antismoking intentions and behaviors. The over-application of RAA in cross-sectional antismoking research has yielded repetitive findings. Norm-based experiments can adopt other theoretical perspectives to offer insights into antismoking interventions. The RAA constructs are still applicable and can be integrated into intervention designs.

Antecedents and Consequences of Smoking Cessation Intention in the Context of the Global COVID-19 Infodemic

A growing body of scientific studies has been published to inform responses to the ongoing coronavirus pandemic, and some have claimed that cigarette smoking has a beneficial or mixed effect on the prevention and treatment of COVID-19. The presentation of such findings, unfortunately, has created an infodemic. This study integrated the theory of planned behavior and the health belief model and incorporated findings on addiction from the medical literature to predict cessation intention and support for tobacco control measures in the context of the COVID-19 infodemic. The study found that cessation intention partially mediated the effect of perceived severity and fully mediated the effects of perceived benefits, self-efficacy, and addiction on support for control measures. In addition, a positively-valenced message of the effect of smoking on the prevention and treatment of COVID-19 vs. a mixedly-valenced message was significant in predicting cessation intention, and the positively-valenced message of smoking indirectly predicted support for tobacco control measures. Perceived susceptibility, barriers, and subjective norms, however, exerted neither direct nor indirect effects on the two outcome variables.

History and Correlates of Smoking Cessation Behaviors Among Smokers With Serious Mental Illness

INTRODUCTION

Individuals with serious mental illness (SMI) smoke at rates two to three times greater than the general population but are less likely to receive treatment. Increasing our understanding of correlates of smoking cessation behaviors in this group can guide intervention development.

AIMS AND METHODS

Baseline data from an ongoing trial involving smokers with SMI (N = 482) were used to describe smoking cessation behaviors (ie, quit attempts, quit motivation, and smoking cessation treatment) and correlates of these behaviors (ie, demographics, attitudinal and systems-related variables).

RESULTS

Forty-three percent of the sample did not report making a quit attempt in the last year, but 44% reported making one to six quit attempts; 43% and 20%, respectively, reported wanting to quit within the next 6 months or the next 30 days. Sixty-one percent used a smoking cessation medication during their quit attempt, while 13% utilized counseling. More quit attempts were associated with lower nicotine dependence and carbon monoxide and greater beliefs about the harms of smoking. Greater quit motivation was associated with lower carbon monoxide, minority race, benefits of cessation counseling, and importance of counseling within the clinic. A greater likelihood of using smoking cessation medications was associated with being female, smoking more cigarettes, and receiving smoking cessation advice. A greater likelihood of using smoking cessation counseling was associated with being male, greater academic achievement, and receiving smoking cessation advice.

CONCLUSIONS

Many smokers with SMI are engaged in efforts to quit smoking. Measures of smoking cessation behavior are associated with tobacco use indicators, beliefs about smoking, race and gender, and receiving cessation advice.

IMPLICATIONS

Consideration of factors related to cessation behaviors among smokers with SMI continues to be warranted, due to their high smoking rates compared to the general population. Increasing our understanding of these predictive characteristics can help promote higher engagement in evidence-based smoking cessation treatments among this subpopulation.

Real-world unassisted quit success and related contextual factors: a population-based study of Chinese male smokers

OBJECTIVES

To examine the association of exposure to secondhand smoke (SHS) and tobacco advertising with unassisted smoking cessation among Chinese male smokers.

METHODS

A questionnaire was administered to 6500 male adult smokers from six cities in China selected in a cross-sectional multistage sampling design. The survey collected self-reported demographic characteristics, smoking and cessation status, SHS exposure and tobacco advertising exposure, with 5782 valid questionnaires included in this study. Multiple logistic regression analysis was used to assess the association of unassisted smoking cessation with exposure to SHS and tobacco advertising.

RESULTS

42.1% of smokers who made unassisted quit attempts achieved abstinence (95% CI 32.5% to 51.7%). SHS (adjusted OR (aOR) 0.36; 95% CI 0.18 to 0.71; p=0.033) and tobacco advertising exposure (aOR 0.63; 95% CI 0.37 to 0.95; p=0.039) were negatively associated with unassisted smoking cessation.

CONCLUSION

The vast majority of Chinese male smokers rely on unassisted methods to quit smoking. Success prevalence is high, which is very beneficial to health. This study suggests that exposure to secondhand smoking and tobacco advertising hinders the success of unassisted cessation. These findings speak to the need for environmental tobacco control measures to promote unassisted smoking cessation among Chinese adult male smokers.

Social Tobacco Warnings Can Influence Implicit Associations and Explicit Cognitions

Previous research showed that fear-inducing graphic warning labels can lead to cognitive dissonance and defensive responses. Less threatening, social-related warning labels do not elicit these defensive responses, making them more effective in preventing smoking in adults. Given that smoking numbers are still too high among youngsters, it is crucial to investigate how warning labels should be designed to prevent teenagers from starting smoking in the first place. In two studies, we investigated whether comparable effects of social-related warning labels could be observed in a group of teenagers (14-17 years) who are not yet legally allowed to smoke. In addition, we tried to replicate earlier findings with smoking and non-smoking adults. Participants were presented with either health warning labels, social warning labels, or no warning labels. Subsequently, their explicit cognitions (i.e., risk perception, attitude toward smoking) and their implicit associations of smoking with healthiness/unhealthiness (Study 1a and Study 1b) and with positivity/negativity (Study 2a and Study 2b) were assessed. Results showed that in both studies, adult smokers had a higher risk perception and a more positive attitude toward smoking than adult non-smokers. Additionally, social warning labels lead to stronger implicit associations between smoking and negativity in Study 2 in the adult groups. In the teenage group, social warning labels lead to more positive attitudes than health warning labels in Study 2. No further effects on risk perception or implicit associations were found in the teenage group. Possible explanations are discussed.

Incorporating environmental variables as precursor background variables of the theory of planned behavior to predict quitting-related intentions: a comparative study between adult and young adult smokers

BACKGROUND

As previous studies suggest that the theory of planned behavior (TPB) is open to the inclusion of further predictors, identifying a number of additional background variables within the context of the TPB may help improve the predictive power of the theory. The purpose of this study is to incorporate environmental variables as precursor background variables of the TPB to predict quitting-related intentions.

METHODS

This study consists of two sub-studies. Sub-study 1 and 2 analyzed different data sets and were conducted using the similar methodology for the comparison. A total of 395 Texas adult smokers (sub-study 1) and 379 university student smokers (sub-study 2) were analyzed using multiple structural equation modeling.

RESULTS

The extent of agreement with regulating smoking in public places had positive indirect effects on intention to quit through subjective norm among both Texas adult smokers (β = 0.03, p < .01) and university students (β = 0.01, p < .05), and through attitude among Texas adult smokers only (β = 0.02, p < .01). The number of smokers among 5 closest friends had negative indirect effect on intention to take measures to quit through subjective norm among Texas adult smokers (β = - 0.02, p < .05).

CONCLUSIONS

The results of this study indicate that environmental variables need to be considered as precursor background variables of the TPB to predict quitting-related intentions.

Regret-Based Decision-Making Style Acts as a Dispositional Factor in Risky Choices

People who anticipate the potential regret of one’s decisions are believed to act in a more risk-averse manner and, thus, display fewer risk-taking behaviors across many domains. We conducted two studies to investigate whether individual differences in regret-based decision-making (a) reflect a unitary cognitive-style dimension, (b) are stable over time, and (c) predict later risk-taking behavior. In Study 1, 332 participants completed a regret-based decision-making style scale (RDS) to evaluate its psychometric qualities. In Study 2, participants ( N = 119) were tested on two separate occasions to assess the association between RDS and risk-taking. At Time 1, participants completed the RDS, as well as trait measures of anxiety and depression. One month later, they completed the Balloon Analogue Risk Task (BART) and state mood (Positive/Negative affect) scales. The RDS had a sound unidimensional factorial structure and was stable over time. Further, higher reported RDS scores were significantly associated with less risk-taking on the BART, holding other variables constant. These studies suggest that individual differences in regret-based decision-making may lead to a more cautious approach to real-world risk behaviors.

[Smoking cessation and social deprivation]

Smoking is a major of public health policy issue; one in two lifelong smokers will die from a disease related to tobacco use. In France, smoking is responsible for more than 70,000 deaths every year. The benefits linked to stopping smoking include reduced mortality and morbidity related to the use of tobacco. Recent data show an increase in the prevalence of smoking in the lowest socioeconomic population. Tobacco control needs a better understanding of the determinants of smoking in this population, which are also factors in the failure of cessation attempts. Based on international literature, this review specifies the educational and socioeconomic factors involved in tobacco smoking and in the result of an attempt to quit. Its aim is to propose ways to improve the management of smoking cessation in a socially deprived population.

The importance of affectively-laden beliefs about health risks: the case of tobacco use and sun protection

Affect is gaining prominence in health behavior research. However, little is known about the relative influence on behavior of specific affectively-laden beliefs about health risks (affective likelihood, worry, anticipated regret), particularly in comparison to cognitive likelihood beliefs. We investigated this issue in relation to two very different cancer-related behaviors. In two prospective studies [tobacco use (N = 1,088); sunscreen use (N = 491)], hierarchical linear and logistic regression analyses revealed that affectively-laden risk beliefs predicted intentions and behaviors more strongly than cognitive likelihood beliefs. Cognitive likelihood contributed independently only for sunscreen use intentions. Smoking-related outcomes were most strongly associated with anticipated regret. Sunscreen-related outcomes were most strongly associated with affective likelihood. Affectively-laden beliefs might be stronger predictors of some cancer-related behaviors than traditional cognitive likelihood measures. Including affective aspects of health risk beliefs in health behavior interventions and theoretical models, including investigating their interrelationships in different behavioral contexts, could advance both theory and practice.

Transitions in smoking behaviour and the design of cessation schemes

The intake of nicotine by smoking cigarettes is modelled by a dynamical system of differential equations. The variables are the internal level of nicotine and the level of craving. The model is based on the dynamics of neural receptors and the way they enhance craving. Lighting of a cigarette is parametrised by a time-dependent Poisson process. The nicotine intake rate is assumed to be proportional with the parameter of this stochastic process. The effect of craving is damped by a control mechanism in which awareness of the risks of smoking and societal measures play a role. Fluctuations in this damping may cause transitions from smoking to non-smoking and vice versa. With the use of Monte Carlo simulation the effect of abrupt and gradual cessation therapies are evaluated. Combination of the two in a mixed scheme yields a therapy with a duration that can be set at wish.