Mechanisms linking socioeconomic status to smoking cessation: A structural equation modeling approach.

Objective: Although there has been a socioeconomic gradient in smoking prevalence, cessation, and disease burden for decades, these disparities have become even more pronounced over time. The aim of the current study was to develop and test a conceptual model of the mechanisms linking socioeconomic status (SES) to smoking cessation. Design: The conceptual model was evaluated using a latent variable modeling approach in a sample of 424 smokers seeking treatment (34% African American; 33% Latino; 33% White). Hypothesized mechanisms included social support, neighborhood disadvantage, negative affect/stress, agency, and craving. Main Outcome Measure: The primary outcome was Week 4 smoking status. Results: As was hypothesized, SES had significant direct and indirect effects on cessation. Specifically, neighborhood disadvantage, social support, negative affect/stress, and agency mediated the relation between SES and smoking cessation. A multiple group analysis indicated that the model was a good fit across racial/ethnic groups. Conclusion: The present study yielded one of the more comprehensive models illuminating the specific mechanisms that link SES and smoking cessation. Policy, community, and individual-level interventions that target low SES smokers and address the specific pathways identified in the current model could potentially attenuate the impact of SES on cessation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measurement of smoking outcome expectancies in children: The Smoking Consequences Questionnaire-Child.

A measure of smoking outcome expectancies was developed for children ages 7-12 years. Confirmatory factor analysis (CFA) was used to determine whether a 1-, 2-, 3-, or 4-factor solution was most appropriate for the data set. CFA revealed that the 3-factor model produced the most adequate fit (Positive Reinforcement, Negative Consequences, and Weight Control). The resulting 15-item measure was named the Smoking Consequences Questionnaire-Child (SCQ-C). The fit of the 3-dimensional structure was then examined separately for 3 age groups representing young (7- to 8-year-old), middle (9- to 10-year-old), and old (11- to 13-year-old) children. Overall, the 3-factor structure fit the data well for the 3 groups. As such, we examined the relations of the 3 scales with antecedent variables for the entire sample. The Positive Reinforcement scale was associated with children's smoking behavior and having a family member or peers who smoked. The Negative Consequences scale was inversely related to having a family member or peer who smoked. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relative impact of nicotine dependence, other substance dependence, and gender on Bechara Gambling Task performance.

Individuals with substance use disorders (SUDs) tend to focus more on immediate, rather than cumulative, consequences of their actions on measures of decision-making. This type of decision-making may contribute to continued substance use. The present study compared the performance of four groups of individuals on one measure of decision-making, the Bechara Gambling Task (BGT). The groups were (a) heavy smokers with comorbid substance dependence (n = 40), (b) heavy smokers with no history of substance dependence (n = 19), (c) substance dependent never smokers (n = 26), and (d) never smokers with no history of substance dependence (n = 34). Analysis revealed that there were no significant main effects of gender or SUD status. However, a significant gender by SUD status interaction was found, such that men with an SUD performed more poorly on the BGT than men without an SUD history. Women with and without an SUD both performed poorly on this task. Unexpectedly, no differences in BGT performance were found between smokers and nonsmokers. Overall, findings indicate that having an SUD, other than nicotine dependence, is correlated with poor BGT performance in men only. The BGT did not differentiate between women with and without SUDs, and therefore, may not be an appropriate measure of decision-making in women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized clinical trial of a palmtop computer-delivered treatment for smoking relapse prevention among women.

Relapse is the rule rather than the exception among smokers attempting to quit, and compared to men, women may have higher relapse rates. The current study was a randomized clinical trial testing a palmtop computer-delivered treatment (CDT) for smoking relapse prevention among women. The intervention was individualized based on key theoretical constructs that were measured using ecological momentary assessment (EMA). All participants (N = 302) received standard smoking cessation treatment consisting of nicotine replacement therapy and group counseling, and completed EMA procedures for one week after quitting. At the completion of the group counseling sessions and EMA procedures, participants were randomized to either CDT or no further computer-delivered treatment or assessment (EMA-Only). CDT participants received a palmtop computer-delivered relapse prevention treatment for one additional month. CDT did not improve abstinence rates relative to EMA-Only. Process analyses suggested that heavier smokers were more likely to use CDT and that greater use among CDT participants may be associated with more positive outcomes. The rapid pace of technological advances in mobile computer technology and the ubiquity of such devices provide a novel platform for developing new and potentially innovative treatments. However, the current study did not demonstrate the efficacy of such technology in improving treatment outcomes. (PsycINFO Database Record (c) 2011 APA, all rights reserved)