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Gallus S, Cresci C, Rigamonti V, Lugo A, Bagnardi V, Fanucchi T, Cirone D, Ciaccheri A, Cardellicchio S. Self-efficacy in predicting smoking cessation: A prospective study in Italy. Tob Prev Cessat 2023; 9:15. [PMID: 37125003 PMCID: PMC10141785 DOI: 10.18332/tpc/162942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Predicting the success of smoking cessation might be crucial to guide towards the treatment of smoking dependence in a clinical setting. We analyzed the potential determinants of successful smoking cessation with a specific focus on self-efficacy in predicting quitting smoking. METHODS All consecutive smokers (n=478; 224 men and 254 women) attending the Careggi University Hospital Smoking Cessation Service in Florence (Italy) in 2018-2019 provided information on self-efficacy in predicting smoking cessation, using a 1-10 rating scale during their first visit. Patients were followed up for success in quitting smoking at 3, 6 and 12 months, validated through CO exhaled measurement. To evaluate the association between self-efficacy and the probability of success, we estimated multivariable relative risks (RRs) and corresponding 95% confidence intervals (CIs) through log-binomial models for longitudinal data. RESULTS Overall, 47.9% of smokers succeeded in their attempt to quit at 3 months, 40.2% at 6 months, and 33.9% at 12 months. Compared to low self-efficacy (rating scale 1-5), the RR of success in quitting smoking was 1.40 (95% CI: 1.06-1.85) for intermediate self-efficacy (scale 6-7) and 1.64 (95% CI: 1.28-2.12) for high self-efficacy (scale 8-10). CONCLUSIONS Self-efficacy is an independent determinant of smoking cessation. We recommend to systematically collect self-efficacy, together with other relevant variables, to predict successful smoking cessation. Moreover, strategies to develop and maintain high levels of self-efficacy are essential to increase quit success and improve treatment.
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Affiliation(s)
- Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Chiara Cresci
- Anti-smoking center, Careggi University Hospital, Florence, Italy
- SOD of Alcohology, Careggi University Hospital, Florence, Italy
- Tuscan Regional Alcoholic Center, Careggi University Hospital, Florence, Italy
| | - Vera Rigamonti
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | | | - Donatello Cirone
- Tuscan Regional Alcoholic Center, Careggi University Hospital, Florence, Italy
| | - Angela Ciaccheri
- Anti-smoking center, Careggi University Hospital, Florence, Italy
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Mauduy M, Mauny N, Mange J. Tobacco Dependence Among French University Students: A Cluster Analytic Approach to Identifying Distinct Psychological Profiles of Smokers. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221107560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigates the combination of several psychological factors related to tobacco smoking to identify smokers’ psychological profiles among French university students. A cluster analysis was performed on smoking motives, psychosocial variables, and the smoker identity ( N = 909). Five profiles were identified and then compared regarding tobacco dependence and motivations to quit. “Normative” and “sociohedonist smokers” are characterized by two distinct social factors (normative influences and social motives) and moderate dependence. “Dependent identified smokers” have higher levels of dependence motives, smoker identity and tobacco dependence associated with low motivations to quit. “Inconsistent smokers” have weak smoker identity and weak smoking motives, a strong perceived control over resisting smoking, low dependence and motivations to quit. “Coping smokers” have strong sedative and addictive motives and exhibit moderate dependence and motivations to quit. This research encourages prevention programs to consider the diversity of student smokers with strategies adapted to their psychological profiles.
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Affiliation(s)
- Maxime Mauduy
- Psychology, LPCN, University of Caen Normandy, Caen, France
| | - Nicolas Mauny
- Psychology, LPCN, University of Caen Normandy, Caen, France
| | - Jessica Mange
- Psychology, LPCN, University of Caen Normandy, Caen, France
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3
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Quinn MH, Olonoff M, Bauer AM, Fox E, Jao N, Lubitz SF, Leone F, Gollan JK, Schnoll R, Hitsman B. History and Correlates of Smoking Cessation Behaviors Among Individuals With Current or Past Major Depressive Disorder Enrolled in a Smoking Cessation Trial. Nicotine Tob Res 2022; 24:37-43. [PMID: 34259871 PMCID: PMC8666119 DOI: 10.1093/ntr/ntab147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/12/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Smoking among adults with major depressive disorder (MDD) is at least double that of the general US population. More effective smoking cessation interventions for depressed smokers may be facilitated through a better understanding of the smoking and depression-related characteristics of this population. METHODS We used baseline data from 300 participants enrolled in randomized clinical trial for smokers with current or past MDD. We described history of smoking cessation behaviors (ie, quit attempts, quit motivation, and cessation treatment utilization) and used multivariate regression to identify demographic and depression-related correlates of these behaviors. RESULTS Sixty-eight percent of participants reported at least one quit attempt in the past year, nearly 51% reported motivation to quit in the subsequent 30 days, and 83% reported prior use of a nicotine replacement therapy. A greater readiness to quit smoking was associated with increased age (p = .04) and lower cigarettes per day (p = .01). Greater use of smoking cessation medication was associated with greater education and nicotine dependence, minority race, and greater use of complementary reinforcers (eg, activities associated with increased reinforcing value of smoking; p's < .05). CONCLUSIONS These data indicate that smokers with current or past MDD are highly motivated to quit smoking and have a history of engaging in efforts to quit. Interventions to promote smoking cessation behaviors should address younger and lighter smokers, who may perceive less risk from tobacco use, and efforts to promote smoking cessation medications and counseling should address minority smokers who are engaging in complementary reinforcers. IMPLICATIONS These data are inconsistent with the assumption that smokers with serious mental illness are not willing to quit smoking and suggest the need for studies that test behavioral interventions that address complementary reinforcers to treat tobacco use in this community.
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Affiliation(s)
- Mackenzie Hosie Quinn
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Matthew Olonoff
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Anna-Marika Bauer
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erica Fox
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Nancy Jao
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Su Fen Lubitz
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Frank Leone
- Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacqueline K Gollan
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Robert Schnoll
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brian Hitsman
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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4
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Jaen-Moreno MJ, Feu N, Del Pozo GI, Gómez C, Carrión L, Chauca GM, Guler I, Montiel FJ, Sánchez MD, Alcalá JA, Gutierrez-Rojas L, Molina V, Bobes J, Balanzá-Martínez V, Ruiz-Rull C, Sarramea F. Chronic obstructive pulmonary disease in severe mental illness: A timely diagnosis to advance the process of quitting smoking. Eur Psychiatry 2021; 64:e22. [PMID: 33632347 PMCID: PMC8057420 DOI: 10.1192/j.eurpsy.2021.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background This study has two main objectives: to describe the prevalence of undetected chronic obstructive pulmonary disease (COPD) in a clinical sample of smokers with severe mental illness (SMI), and to assess the value of the Tobacco Intensive Motivational Estimated Risk tool, which informs smokers of their respiratory risk and uses brief text messages to reinforce intervention. Method A multicenter, randomized, open-label, and active-controlled clinical trial, with a 12-month follow-up. Outpatients with schizophrenia (SZ) and bipolar disorder were randomized either to the experimental group—studied by spirometry and informed of their calculated lung age and degree of obstruction (if any)—or to the active control group, who followed the 5 A’s intervention. Results The study sample consisted of 160 patients (71.9% SZ), 78.1% of whom completed the 12-month follow-up. Of the patients who completed the spirometry test, 23.9% showed evidence of COPD (77.8% in moderate or severe stages). TIMER was associated with a significant reduction in tobacco use at week 12 and in the long term, 21.9% of patients reduced consumption and 14.6% at least halved it. At week 48, six patients (7.3%) allocated to the experimental group achieved the seven-day smoking abstinence confirmed by CO (primary outcome in terms of efficacy), compared to three (3.8%) in the control group. Conclusion In this clinical pilot trial, one in four outpatients with an SMI who smoked had undiagnosed COPD. An intensive intervention tool favors the early detection of COPD and maintains its efficacy to quit smoking, compared with the standard 5 A’s intervention.
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Affiliation(s)
- M J Jaen-Moreno
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Departamento de Ciencias Morfológicas y Sociosanitarias, Universidad de Córdoba, Córdoba, Spain
| | - N Feu
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - G I Del Pozo
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - C Gómez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Unidad de Gestión Clínica de Salud Mental, Complejo Hospitalario de Jaén, JaénSpain
| | - L Carrión
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Unidad de Gestión Clínica de Salud Mental, Hospital Infanta Margarita, Cabra, Spain
| | - G M Chauca
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Unidad de Gestión Clínica de Salud Mental, Hospital Infanta Margarita, Cabra, Spain
| | - I Guler
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Área de gestión de la investigación, Córdoba, Spain
| | - F J Montiel
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Unidad de Gestión Clínica de Salud Mental, Complejo Hospitalario de Jaén, JaénSpain
| | - M D Sánchez
- Unidad de Gestión Clínica de Salud Mental, Complejo Hospitalario de Jaén, JaénSpain
| | - J A Alcalá
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - L Gutierrez-Rojas
- Grupo de Investigación Psiquiatría y Neurociencias (CTS-549), Instituto de Neurociencias, Universidad de Granada, Granada, Spain
| | - V Molina
- Psychiatry Department, School of Medicine, University of Valladolid, Valladolid, Spain; Psychiatry Service, Clinical Hospital of Valladolid, Valladolid, Spain.,Neurosciences Institute of Castilla y Leon (INCYL), University of Salamanca, Salamanca, Spain; Instituto de Investigacion Biomedica de Salamanca (IBSAL), Salamanca, Spain.,CIBERSAM (Biomedical Research Network in Mental Health), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - J Bobes
- Faculty of Medicine and Health Sciences-Psychiatry, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - V Balanzá-Martínez
- Unitat Docent de Psiquiatría i Psicología Médica, Departament de Medicina, Universitat de València, CIBERSAM, Valencia, Spain
| | - C Ruiz-Rull
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Unidad de Gestión Clínica de Medicina Familiar y Comunitaria, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - F Sarramea
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Departamento de Ciencias Morfológicas y Sociosanitarias, Universidad de Córdoba, Córdoba, Spain.,Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Córdoba, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Oviedo, Spain
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Lubitz SF, Flitter A, Wileyto EP, Ziedonis D, Stevens N, Leone F, Mandell D, Kimberly J, Beidas R, Schnoll RA. History and Correlates of Smoking Cessation Behaviors Among Smokers With Serious Mental Illness. Nicotine Tob Res 2021; 22:1492-1499. [PMID: 31816049 DOI: 10.1093/ntr/ntz229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/06/2019] [Indexed: 12/16/2022]
Abstract
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.
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Affiliation(s)
- Su Fen Lubitz
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Alex Flitter
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - E Paul Wileyto
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA
| | - Douglas Ziedonis
- Department of Psychiatry, University of California, San Diego, CA
| | - Nathaniel Stevens
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Frank Leone
- Department of Medicine, Pulmonary, Allergy, & Critical Care Division, University of Pennsylvania, Philadelphia, PA
| | - David Mandell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - John Kimberly
- Department of Management, The Wharton School of Business, University of Pennsylvania, Philadelphia, PA
| | - Rinad Beidas
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA
| | - Robert A Schnoll
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Arana-Chicas E, Cupertino AP, Goggin K, Richter KP, Harris KJ, Catley D. Stress, Depression and Quit Attempt Outcomes among Unmotivated Smokers. Subst Use Misuse 2021; 56:1564-1568. [PMID: 34130595 PMCID: PMC8388196 DOI: 10.1080/10826084.2021.1936053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Stress and depressive symptoms have been linked to a reduced likelihood of sustaining smoking cessation. Because stress and depressive symptoms may negatively affect motivation to quit, stress and depression may also be important for whether or not smokers make a quit attempt. OBJECTIVE To examine the relationship between perceived stress and depressive symptoms and initiating a quit attempt in a smoking cessation induction trial. METHODS We conducted a secondary analysis of existing data from a randomized clinical trial (N = 255) comparing motivational interviewing to health education and brief advice for smoking cessation induction in smokers with low motivation to quit. RESULTS We observed positive associations between baseline predictors and quit attempts at week 12 (r = 0.192, p < 0.01 for depressive symptoms and r = 0.136, p < 0.05 for perceived stress). Logistic regression models revealed similar significant positive associations between baseline perceived stress and baseline depressive symptoms and making a quit attempt by week 12 (OR = 1.5, CI:1.03, 2.19 and OR = 1.03, 95% CI: 1.01, 1.06; respectively). CONCLUSION Unexpectedly, this study found generally small but consistently positive associations between baseline depressive symptoms and baseline perceived stress and making a quit attempt by week 12. The results can be viewed as encouraging in that interventions to encourage quit attempts do not appear counter-productive for individuals higher in stress and depressive symptoms, but these patients very likely will need additional supports to sustain abstinence.
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Affiliation(s)
- Evelyn Arana-Chicas
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
| | - Kathy Goggin
- Division of Health Services and Outcomes Research, Children's Mercy Kansas City, & Schools of Medicine and Pharmacy, University of Missouri - Kansas City, Kansas City, Missouri, USA
| | - Kimber P Richter
- Department of Preventive Medicine & Public Health, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kari J Harris
- School of Public & Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri, USA
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Hughes JR, Callas PW. Prevalence of withdrawal symptoms from electronic cigarette cessation: A cross-sectional analysis of the US Population Assessment of Tobacco and Health. Addict Behav 2019; 91:234-237. [PMID: 30033197 DOI: 10.1016/j.addbeh.2018.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 06/06/2018] [Accepted: 07/04/2018] [Indexed: 12/28/2022]
Abstract
Electronic cigarette use can produce rapid and high levels of nicotine and thus could produce or maintain a physical dependence on nicotine. No experimental and limited observational studies have tested whether cessation of e-cigarettes is associated with withdrawal symptoms. To examine withdrawal from electronic cigarettes and compare it to that from tobacco cigarettes, we searched the US Population Assessment of Tobacco and Health Survey to locate successful and unsuccessful attempts to stop electronic or tobacco cigarettes. We examined electronic cigarette-only users, tobacco cigarette-only users and dual users. A minority of e-cigarette users who stopped/reduced e-cigarettes reported withdrawal symptoms but reported fewer symptoms than tobacco cigarette users who stopped/reduced tobacco cigarettes. E-cigarette withdrawal was not significantly greater in those who tried but were unable to stop e-cigarettes. In dual users, continued tobacco use appeared to reduce e-cigarette withdrawal but the opposite was not true. Given our small sample size and use of retrospective recall, an experimental test of e-cigarette abstinence is needed to better describe the severity of electronic cigarette withdrawal.
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Pardavila-Belio MI, Canga-Armayor A, Duaso MJ, Pueyo-Garrigues S, Pueyo-Garrigues M, Canga-Armayor N. Understanding how a smoking cessation intervention changes beliefs, self-efficacy, and intention to quit: a secondary analysis of a pragmatic randomized controlled trial. Transl Behav Med 2019; 9:58-66. [PMID: 30590861 DOI: 10.1093/tbm/ibx070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although beliefs, self-efficacy, and intention to quit have been identified as proximal predictors of initiation or quitting in young adults, few studies have studied how these variables change after a smoking cessation intervention. To evaluate the changes in the beliefs, self-efficacy, and intention to avoid smoking and determine if these are potential mediators in quitting, following a smoking cessation intervention, aimed at tobacco-dependent college students. Single-blind, pragmatic randomized controlled trial with a 6-month follow-up. A total of 255 smoker students were recruited from September 2013 to February 2014. Participants were randomly assigned to intervention group (n = 133) or to control group (n = 122). The students in the intervention group received a multicomponent intervention based on the Theory of Triadic Influence (TTI). The strategies of this program consisted of a 50 min motivational interview conducted by a nurse and online self-help material. The follow-up included a reinforcing e-mail and group therapy. The smoking-related self-efficacy, belief, and intention scale was used to assess outcomes. Intention to quit smoking is partial moderator explaining 36.2% of the total effects in smoking cessation incidence. At 6 month follow-up, the differences in the mean scores of self-efficacy and intention related to stopping smoking were significantly higher in the intervention than in the control group. A multicomponent intervention based on the TTI, tailored to college students, positively increased the self-efficacy to avoid smoking and the intention to quit, suggesting intention as potential mediator of quitting.
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Affiliation(s)
- Miren I Pardavila-Belio
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
| | - Ana Canga-Armayor
- IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain.,Department of Nursing Care of the Adult Person, University of Navarra, Pamplona, Navarra, Spain
| | - María J Duaso
- Department of Adult Nursing, Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
| | - Sara Pueyo-Garrigues
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain
| | - María Pueyo-Garrigues
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain
| | - Navidad Canga-Armayor
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
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9
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Waters AF, Businelle MS, Frank SG, Hébert ET, Kendzor DE. Understanding the link between contingency management and smoking cessation: The roles of sex and self-efficacy. Addict Behav 2018; 84:99-105. [PMID: 29655134 DOI: 10.1016/j.addbeh.2018.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 03/10/2018] [Accepted: 03/11/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Little is known about the mechanisms linking contingency management (CM) treatment with smoking cessation, and recent research suggests that the CM approach is associated with better smoking cessation outcomes among females than males. The current study investigated self-efficacy as a potential mechanism through which CM treatment influences smoking cessation, and explored whether these relationships differed by sex. METHODS Participants (N = 139) were primarily Black (63.3%) and female (57.6%) adults enrolled in a safety-net hospital smoking cessation program. Participants received usual care (UC), which included pharmacotherapy and counseling sessions (n = 66) or a CM intervention (UC + 4 weeks of small, abstinence contingent financial incentives; n = 73). Self-efficacy for quitting was measured on the day after quitting with the Self-Efficacy Scale/Confidence (SESC) questionnaire. Mediation analyses were conducted to evaluate the indirect effects of treatment group on biochemically-verified abstinence (4-weeks post-quit) via self-efficacy, and moderated mediation analyses were conducted to evaluate the moderating role of sex. RESULTS Self-efficacy was not found to mediate the relations between CM treatment and smoking cessation in the overall sample. However, analyses indicated a significant moderating effect of sex on the indirect effect of treatment group on smoking cessation through self-efficacy (each of the 3 SESC subscales). Specifically, there was a stronger association between CM and greater self-efficacy among females than males. CONCLUSION Findings suggest that CM treatment had a differing impact on self-efficacy among males and females, which in turn influenced the likelihood of smoking cessation.
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10
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Green JP, Lynn SJ. A Multifaceted Hypnosis Smoking-Cessation Program: Enhancing Motivation and Goal Attainment. Int J Clin Exp Hypn 2017; 65:308-335. [PMID: 28506140 DOI: 10.1080/00207144.2017.1314740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Smoking cessation remains a major health priority. Despite public campaigns against smoking and widespread availability of smoking-cessation treatments, many people continue to smoke. The authors argue that the "problem of motivation," that is, suboptimal or fluctuating motivation to resist smoking urges and to comply with the demands of treatment, commonly undermines treatment seeking and adherence, appreciably reducing the success rates of smoking-cessation programs. The authors describe the history of the Winning Edge smoking-cessation program and discuss ways to enhance motivation before, during, and after formal treatment. They illustrate how hypnotic suggestions, administered in the context of their program, can promote cognitive, behavioral, and emotional commitment to treatment and enhance motivation to live a smoke-free life.
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11
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Fox AT, Martin LE, Bruce J, Moreno JL, Staggs VS, Lee HS, Goggin K, Harris KJ, Richter K, Patten C, Catley D. Executive function fails to predict smoking outcomes in a clinical trial to motivate smokers to quit. Drug Alcohol Depend 2017; 175:227-231. [PMID: 28458075 PMCID: PMC5425305 DOI: 10.1016/j.drugalcdep.2017.01.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/16/2016] [Accepted: 01/15/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Executive function (EF) is considered an important mediator of health outcomes. It is hypothesized that those with better EF are more likely to succeed in turning their intentions into actual health behaviors. Prior studies indicate EF is associated with smoking cessation. Experimental and longitudinal studies, however, have yielded mixed results. Few studies have examined whether EF predicts post-treatment smoking behavior. Fewer still have done so prospectively in a large trial. We sought to determine if EF predicts quit attempts and cessation among community smokers in a large randomized trial evaluating the efficacy of motivational interventions for encouraging cessation. METHODS Participants (N=255) completed a baseline assessment that included a cognitive battery to assess EF (Oral Trail Making Test B, Stroop, Controlled Oral Word Association Test). Participants were then randomized to 4 sessions of Motivational Interviewing or Health Education or one session of Brief Advice to quit. Quit attempts and cessation were assessed at weeks 12 and 26. RESULTS In regression analyses, none of the EF measures were statistically significant predictors of quit attempts or cessation (all ps>0.20). CONCLUSIONS Our data did not support models of health behavior that emphasize EF as a mediator of health outcomes. Methodological shortcomings weaken the existing support for an association between EF and smoking behavior. We suggest methodological improvements that could help move this potentially important area of research forward.
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Affiliation(s)
- Andrew T Fox
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS 66160, USA.
| | - Laura E Martin
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS 66160, USA; Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Jared Bruce
- Department of Psychology, University of Missouri - Kansas City, 5030 Cherry Hall, Room 313, Kansas City, MO, 64110, USA
| | - Jose L Moreno
- Department of Psychiatry, University of Texas Health Science Center - San Antonio,7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Vincent S Staggs
- Health Services and Outcomes Research, Children's Mercy Kansas City,2401 Gillham Road, Kansas City, MO 64108, USA; School of Medicine, University of Missouri - Kansas City,2411 Holmes Street Kansas City, MO 64108, USA
| | - Hyoung S Lee
- Interdisciplinary Arts and Sciences, University of Washington Tacoma, 1900 Commerce St, Tacoma, WA 98402-3100, USA
| | - Kathy Goggin
- Health Services and Outcomes Research, Children's Mercy Kansas City,2401 Gillham Road, Kansas City, MO 64108, USA; School of Medicine, University of Missouri - Kansas City,2411 Holmes Street Kansas City, MO 64108, USA
| | - Kari Jo Harris
- School of Public and Community Health Sciences, University of Montana,Skaggs Building Room 352, Missoula, MT 59812, USA
| | - Kimber Richter
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Christi Patten
- Department of Psychology and Psychiatry, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City,2401 Gillham Rd., Kansas City, MO 64108, USA
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12
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Layoun N, Salameh P, Waked M, Aoun Bacha Z, Zeenny RM, El Hitti E, Godin I, Dramaix M. Motivation to quit smoking and acceptability of shocking warnings on cigarette packages in Lebanon. Patient Prefer Adherence 2017; 11:331-342. [PMID: 28280306 PMCID: PMC5338928 DOI: 10.2147/ppa.s122877] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Health warnings on tobacco packages have been considered an essential pillar in filling the gap of knowledge and communicating the health risks of tobacco use to consumers. Our primary objective was to report the perception of smokers on the textual health warnings already appearing on tobacco packages in Lebanon versus shocking pictures about the health-related smoking consequences and to evaluate their impact on smoking behaviors and motivation. METHODS A pilot cross-sectional study was undertaken between 2013 and 2015 in five hospitals in Lebanon. Participants answered a questionnaire inquiring about sociodemographic characteristics, chronic respiratory symptoms, smoking behavior and motivation to quit smoking. Only-text warning versus shocking pictures was shown to the smokers during the interview. RESULTS Exactly 66% of the participants reported that they thought shocking pictorial warnings would hypothetically be more effective tools to reduce/quit tobacco consumption compared to only textual warnings. Also, 31.9% of the smokers who were motivated to stop smoking reported that they actually had stopped smoking for at least 1 month secondary to the textual warnings effects. A higher motivation to quit cigarette smoking was seen among the following groups of smokers: males (odds ratio [OR] =1.8, P=0.02), who had stopped smoking for at least 1 month during the last year due to textual warning (OR =2.79, P<0.001), who considered it very important to report health warning on cigarette packs (OR =1.92, P=0.01), who had chronic expectoration (OR =1.81, P=0.06) and who would change their favorite cigarette pack if they found shocking images on the pack (OR =1.95, P=0.004). CONCLUSION Low-dependent smokers and highly motivated to quit smokers appeared to be more hypothetically susceptible to shocking pictorial warnings. Motivation to quit was associated with sensitivity to warnings, but not with the presence of all chronic respiratory symptoms.
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Affiliation(s)
- Nelly Layoun
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, UniversitéLibre de Bruxelles, Brussels, Belgium
- Doctoral School of Sciences and Technologies, Lebanese University, Beirut, Lebanon
- Correspondence: Nelly Layoun, Nada Bakhous Building, 1st floor, Dekwaneh, Mount Lebanon, Lebanon, Tel +961 03 520 362, Email
| | - Pascal Salameh
- Doctoral School of Sciences and Technologies, Lebanese University, Beirut, Lebanon
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Mirna Waked
- Department of Pulmonology, St George Hospital University Medical Center; Faculty of Medicine, Balamand University, Beirut, Lebanon
| | - Z Aoun Bacha
- Department of Pulmonary and Critical Care Medicine, Hotel-Dieu de France, Beirut, Lebanon
| | - Rony M Zeenny
- Pharmacy Practice Department, School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Eric El Hitti
- Department of Pulmonology, St George Hospital University Medical Center; Faculty of Medicine, Balamand University, Beirut, Lebanon
| | - Isabelle Godin
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, UniversitéLibre de Bruxelles, Brussels, Belgium
| | - Michèle Dramaix
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, UniversitéLibre de Bruxelles, Brussels, Belgium
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13
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Hughes JR, Naud S. Abstinence expectancies and quit attempts. Addict Behav 2016; 63:93-6. [PMID: 27450906 DOI: 10.1016/j.addbeh.2016.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/11/2016] [Accepted: 07/13/2016] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Several scales have been developed to measure expectancies about smoking cessation. This secondary analysis tested the reliability and validity of one of the most commonly used expectancy measures - the Perceived Risks and Benefits of Quitting Scale (PRBQ). METHODS Smokers (n=143) who planned to quit at some point in the next 3months entered an observational study in which they called an Interactive Voice Response system nightly for 3months to report quit attempts and abstinence. They completed the PRBQ at baseline and the end of 1, 2 and 3months. No treatment was provided. RESULTS The Risks scores and Benefit scores of the PRBQ had high internal reliability (alpha=0.88-0.96 across administrations) and high test-retest stability (ICC=0.67-0.80), but poor to moderate concurrent validity (correlation with other cessation measures=0.09-0.52), and poor predictive validity (no significant prediction of quit attempts or duration of abstinence). Results were similar for men and women. CONCLUSIONS The PRBQ appears to be reliable but, similar to other scales of cessation expectancies, its validity appears to be poor. The face valid notion that expectations influence quitting requires further testing.
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Affiliation(s)
- John R Hughes
- Vermont Center for Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT 05401, United States; University of Vermont, Burlington, VT 05401, United States.
| | - Shelly Naud
- Department of Mathematics and Statistics, University of Vermont, Burlington, VT 05401, United States
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14
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Gause NK, Elliott JC, Delker E, Stohl M, Hasin D, Aharonovich E. Association between change in self-efficacy to resist drinking and drinking behaviors among an HIV-infected sample: Results from a large randomized controlled trial. J Health Psychol 2016; 23:829-839. [PMID: 27577039 DOI: 10.1177/1359105316664127] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Heavy drinking among HIV-infected individuals is associated with health complications. Health-behavior self-efficacy may be characteristically low among this population or negatively affected by HIV-infected status. We assessed whether self-efficacy to resist drinking increased during brief educational and motivational drinking-reduction interventions within HIV primary care and whether increases in self-efficacy predicted drinking among HIV-infected heavy drinkers. Results indicate that increases in self-efficacy from baseline to end-of-intervention inversely predicted drinking at end-of-intervention and at follow-up. Findings suggest that brief treatment interventions within HIV primary care may promote self-efficacy and that increases in self-efficacy predict initiation and maintenance of drinking reductions among HIV patients.
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Affiliation(s)
- Nicole K Gause
- 1 Department of Psychology, University of Cincinnati, USA.,2 New York State Psychiatric Institute, USA
| | - Jennifer C Elliott
- 2 New York State Psychiatric Institute, USA.,3 Department of Psychiatry, Columbia University Medical Center, USA
| | - Erin Delker
- 4 Department of Epidemiology, San Diego State University/University of California, USA
| | | | - Deborah Hasin
- 2 New York State Psychiatric Institute, USA.,3 Department of Psychiatry, Columbia University Medical Center, USA.,5 Department of Epidemiology, Mailman School of Public Health, Columbia University, USA
| | - Efrat Aharonovich
- 2 New York State Psychiatric Institute, USA.,3 Department of Psychiatry, Columbia University Medical Center, USA
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15
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Abstract
Smoking is highly prevalent among HIV+ individuals and studies indicate that it may be associated with poor ART adherence, though the relationship is poorly understood. In addition little is known about interest in quitting among HIV+ smokers who are having adherence difficulties. We examined smoking and ART adherence among 203 HIV+ individuals enrolled in a randomized trial of interventions to increase ART adherence. Prior analyses indicated there were no overall treatment group effects. Smoking status and motivation to quit was assessed at baseline and ART adherence was assessed at week 12, 24, 36, and 48. Longitudinal generalized estimating equation analysis that controlled for treatment group revealed that smoking status was not significantly related to adherence over time. Motivation to quit was high with 58 % intending to quit in the next 6 months and 25 % intending to quit in the next 30 days. Findings suggest that smoking is not associated with adherence among those with adherence difficulties. However it does not diminish importance of addressing both behaviors especially given HIV+ smokers substantial interest in changing smoking behavior.
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16
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Mead EL, Cohen JE, Kennedy CE, Gallo J, Latkin CA. The role of theory-driven graphic warning labels in motivation to quit: a qualitative study on perceptions from low-income, urban smokers. BMC Public Health 2015; 15:92. [PMID: 25880277 PMCID: PMC4349464 DOI: 10.1186/s12889-015-1438-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 01/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Use of communication theories in the development of pictorial health warning labels (graphic warning labels) for cigarette packaging might enhance labels' impact on motivation to quit, but research has been limited, particularly among low socioeconomic status (SES) populations in the U.S. This qualitative study explored perceptions of theory-based graphic warning labels and their role in motivation to quit among low-income smokers. METHODS A cross-sectional qualitative study was conducted with 25 low-income adult smokers in Baltimore, Maryland, who were purposively sampled from a community-based source population. Semi-structured, in-depth interviews were conducted from January to February 2014. Participants were asked about the motivational impact of 12 labels falling into four content categories: negative depictions of the health effects of smoking to smokers and others, and positive depictions of the benefits of quitting to smokers and others. Data were coded using a combined inductive/deductive approach and analyzed thematically through framework analysis. RESULTS Labels depicting negative health effects to smokers were identified as most motivational, followed by labels depicting negative health effects to others. Reasons included perceived severity of and susceptibility to the effects, negative emotional reactions (such as fear), and concern for children. Labels about the benefits of quitting were described as motivational because of their hopefulness, characters as role models, and desire to improve family health. Reasons why labels were described as not motivational included lack of impact on perceived severity/susceptibility, low credibility, and fatalistic attitudes regarding the inevitability of disease. CONCLUSIONS Labels designed to increase risk perceptions from smoking might be significant sources of motivation for low SES smokers. Findings suggest innovative theory-driven approaches for the design of labels, such as using former smokers as role models, contrasting healthy and unhealthy characters, and socially-oriented labels, might motivate low SES smokers to quit.
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Affiliation(s)
- Erin L Mead
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. .,Tobacco Center of Regulatory Science, Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, 20742-2611, USA.
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Caitlin E Kennedy
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Joseph Gallo
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
| | - Carl A Latkin
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
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17
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Magnezi R, Glasser S. Psychometric properties of the hebrew translation of the patient activation measure (PAM-13). PLoS One 2014; 9:e113391. [PMID: 25411841 PMCID: PMC4239053 DOI: 10.1371/journal.pone.0113391] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 10/22/2014] [Indexed: 01/30/2023] Open
Abstract
Objective “Patient activation” reflects involvement in managing ones health. This cross-sectional study assessed the psychometric properties of the Hebrew translation (PAM-H) of the PAM-13. Methods A nationally representative sample of 203 Hebrew-speaking Israeli adults answered the PAM-H, PHQ-9 depression scale, SF-12, and Self-efficacy Scale via telephone. Results Mean PAM-H scores were 70.7±15.4. Rasch analysis indicated that the PAM-H is a good measure of activation. There were no differences in PAM-H scores based on gender, age or education. Subjects with chronic disease scored lower than those without. Scores correlated with the Self-efficacy Scale (0.47), Total SF-12 (0.39) and PHQ-9 (−0.35, P<0.0001), indicating concurrent validity. Discriminant validity was reflected by a significant difference in the mean PAM-H score of those who scored below 10 (72.1±14.8) on the PHQ-9 (not depressed) compared to those scoring ≥10 (i.e. probable depression) (59.2±15.8; t 3.75; P = 0.001). Conclusion The PAM-H psychometric properties indicate its usefulness with the Hebrew-speaking Israeli population. Practice Implications PAM-H can be useful for assessing programs aimed at effecting changes in patient compliance, health behaviors, etc. Researchers in Israel should use a single translation of the PAM-13 so that findings can be compared, increasing understanding of patient activation.
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Affiliation(s)
- Racheli Magnezi
- Department of Management, Bar Ilan University, Ramat Gan, Israel
- * E-mail:
| | - Saralee Glasser
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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