Quitting smoking: Strategies used and variables associated with success in a stop-smoking contest.

154 participants (mean age 34 yrs) in a communitywide stop-smoking contest were assessed via telephone interviews on entry into the contest (before the quitting date) and within a week of the conclusion of the month-long contest. Ss initially provided information on demographic characteristics, smoking history, smoking patterns, degree of nicotine addiction, perceived stress, and level of general social support, which were used to prospectively predict success at quitting. The follow-up interview collected short-term retrospective reports of cognitive, behavioral, and general smoking modification strategies used and amount of social support received specific to stopping smoking. Ss reported using a variety of cognitive strategies but relatively few behavioral techniques during their attempts to quit. Although discriminant function analyses to differentiate quitters and nonabstinent Ss were statistically significant, few individual variables were strongly associated with smoking status. The only variable to prospectively predict success was degree of perceived stress. Successful abstainers used self-reward strategies and positive self-statements more often than did less successful Ss. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress and unaided smoking cessation: A prospective investigation.

A prospective design was used to determine the outcomes associated with unaided smoking cessation and the influence of stress on cessation. Heavy smokers (N?=?308) completed stress-related measures and were then recontacted at 1, 6, and 12 mo. At each follow-up, they indicated their smoking status (which was confirmed by collateral report and biochemical tests) and completed several stress-related questionnaires. Results indicate that 33% of Ss smoked continuously throughout the year, 39% quit briefly but subsequently relapsed, and 15% quit (confirmed biochemically). An additional 7% reported they had quit, but this could not be confirmed, and 6% were lost to follow-up. Compared with nonquitters, quitters reported less perceived stress, greater self-efficacy, greater use of problem solving and cognitive restructuring, and less reliance on wishful thinking, self-criticism, and social withdrawal. A model to forecast quitting was built and cross-validated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Partner smoking status and pregnant smoker's perceptions of support for and likelihood of smoking cessation.

Perceptions of support for cessation of smoking during pregnancy, likelihood of quitting, and partner smoking status were explored in a sample of 688 pregnant smokers (372 baseline smokers and 316 baseline quitters). Women with nonsmoking partners were significantly more likely to be baseline quitters than women with partners who smoked. Baseline quitters reported significantly more positive support from their partners than did continuing smokers (p?=?.02). Neither partner smoking status nor partner support at baseline was associated with cessation or relapse later in pregnancy. Women reported greater support, both positive and negative, from nonsmoking partners than from partners who smoked (p?=?.001). Among partner smokers, those who were trying to quit were perceived to be particularly supportive. Cessation interventions for expectant fathers may increase pregnant women's success at quitting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoking cessation among self-quitters.

Examined cessation among 630 smokers who quit abruptly on their own. Continuous, complete abstinence rates were 33% at 2 days, 24% at 7 days, 22% at 14 days, 19% at 1 mo, 11% at 3 mo, 8% at 6 mo postcessation, and 3% at 6 mo with biochemical verification. Slipping (smoking an average of less than 1 cigarette/day) was common (9% to 15% of Ss) and was a strong predictor of relapse; however, 23% of long-term abstainers slipped at some point. Results challenge beliefs that most smokers can initially stop smoking and that most relapse occurs later on postcessation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Case management

BACKGROUND: Effecting smoking cessation among adolescents provides an opportunity to reduce smoking levels among teens and among the adults those teens are soon to become. Better understanding of high school students' cessation behavior is needed to inform the development of effective strategies to support teen quitting. METHODS: Data from 1,210 established smokers among 6,427 12th graders from rural and suburban communities in Washington State were used to determine the frequency of a declared intention to quit, one or more quit attempts in the past year, ongoing quitting, and the attainment of long-term cessation. Logistic regression models investigated the association of these outcomes with the extent of peer smoking, age of becoming a regular smoker, sex, and grade point average (GPA). RESULTS: A serious intention to quit was declared by 67% of established smokers, and at least one attempt to quit was made in the past 12 months by 60%. However, only 21% of those who had attempted to quit in the past year were still abstaining at the time of the survey, and overall, merely 3% had achieved cessation beyond 12 months. The likelihood of success of quit attempts was strongly dependent on the extent of smoking among peers. Subjects who had become regular smokers at the youngest ages were more likely to undertake a quit attempt than those who started older. Females were less successful than males in attaining ongoing abstinence. Cessation behavior showed no clear association with students' GPA. CONCLUSIONS: A high fraction of high school smokers want to quit, but are unsuccessful in doing so. Thus, there is a need for programs to provide cessation skills to young smokers already motivated to quit.     

Do good samaritans discourage helpfulness? Self-perceived altruism after exposure to highly helpful others.

Determined whether being exposed to paragons of helpfulness might reduce an important source of intrinsic motivation for helping: self-perceived altruism. 64 undergraduates served as Ss. Applying self-perception theory, it was suggested that individuals who help after being exposed to highly helpful models may perceive the models' helpfulness to be a source of extrinsic pressure that, to some extent, compelled them to help. If so, these individuals should be less likely to attribute their decision to help to their own intrinsic altruism. Ss were exposed to either highly helpful others or only moderately helpful others and then were either induced to offer help or were not given an opportunity to help. As predicted, Ss who were exposed to highly helpful models and then agreed to help perceived themselves to be less altruistic than did Ss who agreed to help after being exposed to moderately helpful models. Also as predicted, the helpfulness of models manipulation had no effect on self-perceived altruism of Ss not asked to help. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rated helpfulness and partner-reported smoking cessation support across the pregnancy-postpartum continuum.

Support interventions have not changed smoking cessation rates significantly. The pregnancy-postpartum continuum presents a unique opportunity to examine patterns of support. Expectant couples (N = 477) were surveyed twice during pregnancy and 3 times postpartum. Partners reported positive and negative smoking-specific support; women reported the helpfulness of partner support. Linear trends suggest that women viewed support as more helpful during pregnancy than during postpartum. Partners' provision of positive support across the continuum depended on their smoking; provision of negative support depended on women's smoking. Partners who smoked provided lower levels of both positive and negative support, especially postpartum. Women who smoked throughout the pregnancy perceived their partner's negative support as helpful. Implications are that partners who smoke may need help staying engaged in the support process. Partners may provide negative support in response to women's smoking cues. Women who are struggling with cessation may not view negative support as negative. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal analysis of unaided smoking cessation.

A sample of 153 smokers who attempted to quit smoking without treatment was followed for 2 years. Follow-up assessment occurred at 1 month, 4 months, 1 year, and 2 years postquit. A subsample of 69 individuals was also interviewed prior to their quit date. The majority of participants (77%) achieved at least 24 hr of abstinence by the 1-month follow-up. However, subsequent relapse rates were high: Only 13% of the sample was abstinent at 1 year, and 19% reported abstinence at the 2-year follow-up. Variables related to short-term outcome were generally unrelated to long-term outcome. Individuals who succeeded at initial cessation were more likely to be men and to be lighter smokers. Among those who initially quit, abstainers at 1 month were less likely to have participated in prior treatment, to report smokers among their friends, and to live with other smokers. At 2 years, abstainers were younger and had smoked for fewer years. The use of multiple strategies for cessation was associated with abstinence at the 2-year follow-up. A strong motivation to quit was found to be important for both initial success and long-term maintenance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A preliminary investigation of rapid smoking as a lapse-responsive treatment for tobacco dependence.

Lapses within the first 2 weeks of a smoking cessation attempt are strongly associated with a return to regular smoking (S. L. Kenford et al., 1994). Unfortunately, little is known about how to prevent an initial lapse from progressing to a full relapse, and presently there are no validated lapse-responsive therapeutic interventions. The present study tested the efficacy and feasibility of rapid smoking plus counseling as a novel lapse-responsive intervention. Sixty-seven participants enrolled in a smoking treatment program involving brief counseling and a 9-week course of bupropion. Beginning on the quit day, participants' smoking behavior was tracked daily for 14 days. Once an early smoking lapse was identified, participants were randomly assigned to receive either 3 sessions of rapid smoking plus counseling or no intervention (usual care). Consistent with previous research, participants who smoked during the first 2 weeks of the quit attempt had significantly poorer 6-month outcomes (3% abstinent) than did those who did not smoke (64% abstinent). Compared with early abstainers, early lapsers were more nicotine dependent and reported greater cravings and lower confidence in their ability to abstain from smoking during the first 48 hours of abstinence. As expected, rapid smoking produced a variety of aversive effects, including increased nausea, dizziness, and vomiting as well as sharply decreased cravings to smoke. However, rapid smoking did not improve abstinence outcomes relative to usual care. Although rapid smoking has been shown to be an effective treatment for initial smoking cessation, in this preliminary study the authors failed to demonstrate its effectiveness as a lapse-responsive treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in self-efficacy resulting from unaided attempts to quit smoking.

Investigated changes in smoking self-efficacy as a result of successful and unsuccessful quit attempts. The sample consisted of 182 smokers (aged 19–70 yrs) who planned to quit smoking without professional assistance. Prior to a self-selected quit date, smoking self-efficacy was assessed. Quit status was determined 1, 6, and 12 mo after the quit date. Self-efficacy was reassessed at the 12-mo follow-up. At 12 mo the sample consisted of 44 quitters, 24 continuous smokers, 102 relapsers, and 12 Ss whose smoking status was uncertain. Self-reports of cessation were corroborated by collateral report and confirmed by saliva cotinine analysis. As predicted, quitters increased their self-efficacy, and continuous smokers decreased their self-efficacy from the prequit baseline to the 12-mo follow-up. Relapsers' self-efficacy also dropped significantly. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analytic comparison of the effectiveness of smoking cessation methods.

Meta-analysis was used to cumulate the results from 633 studies of smoking cessation, involving 71,806 Ss, that reported the proportion of successful quits. Self-care methods do not appear to be as effective as formal intervention methods. Instructional programs involving physicians were not more effective than other instructional programs. Conditioning-based techniques such as aversive methods had success rates similar to those of instructional methods, and among the instructional methods, those incorporating social norms and values were more successful than those relying solely on didactic approaches. Cumulation of quit rates from all available control groups indicated that, on average, 6.4% of the smokers could be expected to quit smoking without any intervention. This figure must be subtracted from the raw success rate to obtain the net success rate for each program. Directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and smoking cessation and maintenance.

Examined the role of social support in smoking cessation and maintenance in 2 longitudinal, prospective studies with 64 Ss each (mean ages 38.4 yrs and 38.8 yrs). Three kinds of support factors were assessed: support from a partner directly related to quitting, perceptions of the availability of general (i.e., nonsmoking) support resources, and the presence of smokers in Ss' social networks. Ss were smokers in cessation programs. Corroborated smoking status was obtained through 12 mo posttreatment. There was evidence for all 3 support factors, but they operated at different points in the process of cessation and maintenance. High levels of partner support and of the perceived availability of general support were associated with cessation and with short-term (to 3 mo posttreatment) maintenance of abstinence. The presence of smokers in Ss' social networks was a hindrance to maintenance and significantly differentiated between relapsers and long-term (12-mo) abstainers. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiovascular reactivity as a predictor of relapse in male and female smokers.

Examined the role of psychophysiological reactivity to general stressors measured before smoking cessation as a predictor of relapse in individuals who quit for a minimum of 12 hrs and were then followed for a 12-mo interval. The study group consisted of 132 (56.9%) female and 100 (43.1%) male participants in a formal smoking cessation program. The reactivity measures were taken while the Ss were still smoking. Heart rate and blood pressure measurements were taken while Ss were resting, performing mental arithmetic, and delivering a speech and after Ss had been standing for 2 min. In the sample as a whole and for women, a higher level of systolic blood pressure reactivity to the cognitive challenge was associated with a shorter time to relapse. In men, greater systolic blood pressure decline to standing was significantly associated with a shorter time to relapse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The maverick effect: Increased communicator credibility as a result of abandoning a career.

Used questionnaire responses to select 200 undergraduates who did not hold extreme opinions on the topics of unidentified flying objects and ecology. Ss were assigned to 1 of 4 groups and heard a communicator deliver messages either for or against 1 of the 2 issues. One-half of the Ss in each of 4 conditions heard a message from a "maverick" who had quit an organization over the issue he was now discussing. The other 1/2 heard a person who was a member of an organization and who delivered a message in line with the official position of that organization. The "mavericks" were perceived as fairer and more trustworthy than the "nonmavericks," but not as more expert. The mavericks' conclusions were perceived as better justified by the facts, and more opinion change was elicited toward their positions, as measured by the percentage of Ss changing and by the pre-post communication position of audiences. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective predictors of quit attempts and smoking cessation in young adults.

This study examined prospective predictors of attempts to quit smoking and successful quitting among those who attempted to quit (n?=?700), using a long-term longitudinal study of the natural history of cigarette smoking in a midwestern community sample. Participants, originally surveyed in 6th-12th grade (1980–1983), were followed up in 1987 and 1994. Results showed that amount of smoking, gender, education, health beliefs about smoking, value on healthy lifestyle, motives for smoking, reasons for quitting, and occupancy of young adult social roles were significant predictors of cessation. However, there were different predictors of attempts to quit and successful quitting among those who attempted to quit. From a public health perspective, both predictors of quit attempts and predictors of successful quitting among attempters are useful targets for intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of a national Quit and Win contest: determinants for successful quitting

BACKGROUND: Within the CINDI framework, a European "Quit and Win" contest was organized in 1994. In Finland the number of participants was 5,879 (0.6% of smokers). In the CINDI demonstration area, North Karelia (NK), the participants numbered 618 (2.0% of smokers). This study compared abstinence maintenance among the participants in NK with the rates found elsewhere in Finland and analyzed determinants for successful quitting. METHODS: A follow-up study was conducted 12 months after the quit date with a sample of 2,114 participants. Response rates of 67-68% were achieved (n = 1,419). The abstinence was assessed at 1, 6, and 12 months. Two estimates are presented: (1) the proportion of abstainers among the respondents and (2) the proportion of abstainers among the sample, considering all nonrespondents smokers. The determinants for maintenance of smoking cessation were analyzed with logistic regression. RESULTS: Using the first estimate, the rates at 1/6/12 months were 75/36/28% in NK and 70/28/21% elsewhere (P < 0.01). Using the second estimate, the corresponding rates were 50/24/19% in NK and 46/19/14% elsewhere. The most significant determinants for successful quitting were sex, age, marital status, level of withdrawal symptoms, previous quitting attempts, and support received. CONCLUSIONS: The recruitment of smokers and the maintained cessation were more successful in the demonstration area. The difference between areas was explained by differences in the combined professional and lay support and by the sex and age distributions.     

Characteristics of Air Force personnel who choose pharmacological aids for smoking cessation following an involuntary tobacco ban and tobacco control program.

Objective: The objective of this study was to compare characteristics of smokers who did and did not report use of cessation aids as part of a tobacco control program in a military setting (n = 8994). Design: The study is a longitudinal epidemiological study where the relationship between smoking status at follow-up and use of pharmacologic aids to quit smoking were assessed. Main Outcome Measures: Smoking cessation, post baseline use of cessation aids to quit smoking. Results and Conclusions: Individuals remaining abstinent were 70% less likely to have used NRT/pharmacological aids compared to those that relapsed. NRT/pharmacological aid users were more likely to report plans to smoke after military training, to have friends who smoke, and to accept a cigarette from a friend. NRT/pharmacological aid users were more likely to believe that using NRT was safer than smoking and to have engaged in harm reduction strategies. Our findings suggest that selection bias related to such characteristics may explain some of the discrepancies between effect sizes reported in efficacy compared to effectiveness studies of NRT and smoking outcomes currently reported in the literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression and smoking cessation: Characteristics of depressed smokers and effects of nicotine replacement.

Previous research has linked depression to difficulties in smoking cessation. The authors followed 269 smokers who attempted to quit smoking for 3 months. Participants were given nicotine gum (2 or 4 mg) or placebo gum and brief counseling. The study found that 34% of the smokers met the criterion for current depression using the Center for Epidemiological Studies Depression Scale. Depressed smokers relapsed significantly earlier than the nondepressed. Nicotine gum was significantly more effective than placebo gum among all smokers. The benefits of nicotine gum were particularly apparent among the depressed. Only 12.5% of depressed smokers quit successfully with placebo gum for 3 months, whereas 29.5% quit with nicotine gum. Depressed smokers reported more stress, less coping resources, more physical and psychological symptoms, and more frequent smoking in the presence of negative affect than did the nondepressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chorioretinal damage caused by the excision of choroidal neovascularization

BACKGROUND: In recent years many longitudinal studies have examined the predictors of smoking acquisition. However, only a few studies have focused on the precursors of smoking cessation. The current study is one of the first concentrating on longitudinal predictors of young people's smoking cessation. METHODS: Subjects were 215 smokers ages 14-15 years who were reinterviewed 3 years later. These smokers were allocated to four groups based on their motivation to quit and actual quitting behavior at the last wave. Independent variables were smoking-specific cognitions, social influences, and aspects of smoking habits. RESULTS: Univariate comparisons between the four groups showed that those with a positive attitude toward smoking and lower self-efficacy were less likely to be motivated to quit 3 years later. No long-term effects of environmental influences were found. Aspects of smoking habits, such as intensity and frequency of smoking, and the context of cigarette use affected the motivation to quit. Logistic regression analyses were conducted to examine differences in predictors between the groups in more detail. These analyses revealed that differences mainly in attitudes and self-efficacy affected whether subjects were absolutely not motivated to quit or had actually quit 3 years later. Differences in smoking behavior affected the allocation to the more closely related groups (e.g., preparing versus quitting). CONCLUSIONS: Adolescents' motivation to quit is affected by smoking-related cognitions and habitual factors. More research is needed to decide whether the relation between intensity and frequency of smoking and the likelihood to quit later on should be interpreted in terms of differences in smoking initiation or in terms of preparation to quit.