Search

Prior research indicates bisexual individuals have higher smoking and vaping rates and heightened vulnerability to negative health outcomes. Thus, we compared adult bisexual (n = 294) and heterosexual (n = 2412) participants enrolled in a smoking cessation trial on baseline smoking and vaping use behaviors, motivations, and expectancies/beliefs as well as follow-up smoking and vaping status. This is a secondary analysis of a large randomized controlled trial testing a smoking cessation intervention for dual users of combustible and electronic cigarettes (e-cigarettes) in the United States. Self-reported 7-day point prevalence smoking and vaping abstinence were collected at 3-, 12-, and 24-month assessments. Bisexual and heterosexual participants did not differ in sociodemographic variables or baseline smoking and vaping history and behavior. We found significant differences among bisexual and heterosexual individuals in smoking and vaping beliefs/expectancies. Specifically, bisexual participants expressed overall greater positive expectancies regarding smoking and vaping, such as smoking and vaping to reduce negative affect and stress. There were no differences in smoking at any follow-up assessment. Only at 3 months were bisexual individuals more likely to be abstinent from vaping and less likely to be dual users than heterosexual individuals. Despite similar smoking and vaping status over time, bisexual individuals reported greater positive expectancies regarding smoking and vaping. Our findings revealed few targets for tailoring cessation interventions to bisexual individuals; thus, it is possible that there may be greater utility in targeting the disparities in prevalence (i.e., via prevention efforts). [ABSTRACT FROM AUTHOR]

Aims: To identify subpopulations of dual users of combustible and electronic cigarettes using current smoking and vaping behaviors. Design: Secondary analysis of baseline data from a randomized controlled trial testing a smoking cessation intervention for dual users. Finite mixture modeling of frequency, quantity, and dependence on combustible and electronic cigarettes was used to identify classes. Demographics and additional smoking and vaping variables were used to further characterize the classes. Setting: United States. Participants: A total of 2896 adults who smoked weekly for the past year and vaped weekly for the past month. Measurements Self‐report baseline measures assessed demographics and smoking and vaping behaviors and characteristics including days of use per week, frequency of use within a day, time to first use after waking, urges to smoke, smoking cessation motivation, self‐efficacy to abstain from smoking, months since vaping initiation, reasons for initiating and maintaining vaping, and future plans to stop vaping. Findings Eight probabilistic classes were identified and well‐defined (relative entropy = 0.95, Lo–Mendell–Rubin adjusted likelihood ratio test P < 0.0001; class probabilities 0.89–0.97). In general, classes crossed two levels of smoking with four levels of vaping. The largest class (31%) had relatively high levels of smoking (72% daily, 56% 11+ cigarettes per day [CPD], 96% within 30 minutes of waking) and vaping (74% daily, 100% 20+ electronic‐CPD, 74% <30 minutes). The next largest class (27%) had relatively high levels of vaping (93% daily, 100% 20+ electronic‐CPD, 82% <30 minutes) and very low levels of smoking (28% daily, 12% 11+ CPD, 0% <30 minutes). The six smaller classes (3%–13%) also had distinct smoking and vaping behaviors. All eight classes exhibited distinguishing characteristics beyond current smoking and vaping behaviors. Conclusions: Dual users of combustible and electronic cigarettes are not a homogeneous population, having eight well‐defined prospective subpopulations. [ABSTRACT FROM AUTHOR]

The Abstinence-Related Motivational Engagement (ARME) scale was developed to assess motivation to remain abstinent after a smoking cessation attempt. The ARME demonstrated reliability and validity among a small sample of ex-smokers. This study expands the psychometric evaluation of the ARME and tests the ARME as a predictor of smoking status among a sample of participants quitting smoking. The parent trial tested the efficacy of a self-help smoking cessation intervention (N = 1874), with assessments every 6 months. Internal consistency and factor structure of the ARME was evaluated at each assessment to confirm use of the measure as designed. Discriminant validity was assessed by comparing the ARME to the Situation-specific Abstinence Self-Efficacy (SSE) scale via inter-correlations and prediction of future smoking status. Finally, the trajectories of both the ARME and SSE were compared among continuous abstainers and continuous smokers. A single-factor structure was observed at each assessment. Cronbach's alphas ranged from 0.88–0.91 for the total sample. Correlations between the ARME and the SSE ranged from 0.38–0.47 (ps <0.001) among smokers; and from 0.09–0.15 (most ps > 0.05) among abstainers. Among current smokers, the ARME and SSE were independent positive predictors of subsequent abstinence (AORs 1.28–2.29, ps <0.001). For those currently abstinent, only the SSE predicted subsequent abstinence (AORs 1.69–2.60, ps <0.05). GEE analyses showed different trajectories for the two measures, as well as between abstainers and smokers. In conclusion, the ARME is a reliable, valid measure with unique predictive utility for current smokers and a distinct trajectory among those who have successfully quit. [ABSTRACT FROM AUTHOR]

Background and Aims: Most e‐cigarette users who also smoke combustible cigarettes (dual users) begin vaping to quit smoking, yet only a subset succeeds. We hypothesized that reinforcing characteristics of e‐cigarettes (vaping reinforcement) would positively predict smoking cessation propensity (SCP) among dual users. Design Secondary analysis of cross‐sectional baseline data from dual users in an ongoing smoking cessation trial. Exploratory and confirmatory factor analysis (EFA and CFA) created latent variables for vaping reinforcement and SCP. A structural equation modeling (SEM) approach was used to test the hypothesis. Setting: United States. Participants: A national sample of dual users of combustible and electronic cigarettes who smoke and vape at least once per week (n = 2896) were enrolled (63% male; mean age = 29.9 years) into a randomized controlled trial in which they would receive either smoking cessation materials or no smoking cessation materials. Measurements Vaping reinforcement was indexed by vaping frequency (days/week vaping, times/day vaping, puffs/e‐cigarette use), e‐cigarette characteristics [numbers of modifications and tobacco or non‐tobacco flavors, nicotine content (mg) and positive e‐cigarette expectancies]. SCP was measured by items of confidence, commitment to being smoke‐free, cessation motivation (contemplation ladder), change in cigarettes per day since beginning e‐cigarette use and negative smoking expectancies. Findings Four factors emerged from the EFA: vaping propensity (vaping frequency, positive expectancies), vaping enthusiasm (e‐cigarette modifications, using non‐tobacco flavors, puffs per use), nicotine/tobacco flavor (nicotine strength, tobacco flavors) and SCP (negative expectancies about smoking, motivation to quit smoking, reduction in smoking). A CFA upheld the exploratory factor structure [root mean square error of approximation (RMSEA) = 0.046, CFI = 0.91]. An SEM with the three vaping latent variables directly predicting SCP had good model fit (RMSEA = 0.030, CFI = 0.97) with a positive relationship of vaping propensity (0.509, P < 0.001), and small negative relationships of vaping enthusiasm (−0.158, P = 0.014) and nicotine/tobacco flavor (−0.230, P < 0.001). Conclusions: Among e‐cigarette users who also smoke combustible cigarettes, frequent vaping combined with positive e‐cigarette expectancies appears to predict greater smoking cessation propensity. However, vaping enthusiasm (measured by e‐cigarette modifications, using non‐tobacco flavors and puffs per use), higher nicotine content and use of tobacco flavored solution may reduce cessation propensity. [ABSTRACT FROM AUTHOR]

Introduction: Far too few smokers receive recommended interventions at their healthcare visits, highlighting the importance of identifying effective, low-cost smoking interventions that can be readily delivered. Self-help interventions (e.g., written materials) would meet this need, but they have shown low efficacy. The purpose of this RCT was to determine the efficacy of a self-help intervention with increased duration and intensity.Design: Randomized parallel trial design involving enrollment between April 2010 and August 2011 with follow-up data for 24 months.Setting/participants: U.S. national sample of daily smokers (N=1,874).Intervention: Participants were randomized to one of three arms of a parallel trial design: Traditional Self-Help (TSH, n=638), Standard Repeated Mailings (SRM, n=614), or Intensive Repeated Mailings (IRM, n=622). TSH received an existing self-help booklet for quitting smoking. SRM received eight different cessation booklets mailed over a 12-month period. IRM received monthly mailings of ten booklets and additional material designed to enhance social support over 18 months.Main Outcome Measures: The primary outcome was 7-day point-prevalence abstinence collected at 6, 12, 18, and 24 months.Results: Data were analyzed between 2013 and 2015. A dose-response effect was found across all four follow-up points. For example, by 24 months, IRM produced the highest abstinence rate (30.0%), followed by SRM (24.4%) and TSH (18.9%). The difference in 24-month abstinence rates between IRM and TSH was 11.0% (95% CI=5.7%, 16.3%). Cost analyses indicated that, compared with TSH, the incremental cost per quitter who received SRM and IRM was $560 and $361, respectively.Conclusions: Self-help interventions with increased intensity and duration resulted in significantly improved abstinence rates that extended 6 months beyond the end of the intervention. Despite the greater intensity, the interventions were highly cost effective, suggesting that widespread dissemination in healthcare settings could greatly enhance quitting.Trial Registration: This study is registered at www.clinicaltrials.gov NCT01352195. [ABSTRACT FROM AUTHOR]

Objective The primary aim of this study was to assess smoking characteristics and cessation motivation prior to and after initiation of multidisciplinary chronic pain treatment. A secondary aim was to identify predictors of cessation motivation among smokers initiating treatment for chronic pain. Design We used a prospective, nonrandomized, repeated measures design. Setting The study was conducted in a multidisciplinary specialty pain treatment program at a veterans hospital. Patients Smokers (N = 90) referred to a multidisciplinary pain program for the treatment of chronic pain. Measures Patients completed questionnaires assessing pain-related and smoking-related factors prior to (baseline) and 8 weeks post (follow-up) specialty pain treatment initiation. Primary outcome measures were the Contemplation Ladder and the Stages of Change ( SOC) algorithm. Results At baseline, patients reported moderate levels of cessation motivation, and 69% were in the contemplation stage or higher on the SOC. Motivation to quit smoking was higher at follow-up compared with baseline on both continuous, t(89) = 2.11, P < 0.05, and stage-based, z = 3.69, P < 0.01, measures. At follow-up, participants reported greater interest in receiving cessation interventions, and 7.8% of patients had quit smoking. Pain-related predictors of motivation (e.g., pain intensity) were subsumed by more general predictors (e.g., nicotine dependence). Conclusions Patients in this sample were more motivated to quit smoking a few weeks after, as compared with before initiating specialty pain treatment. Future research into pain-specific predictors of cessation motivation is warranted to inform the development of interventions that address pain patients' unique needs. [ABSTRACT FROM AUTHOR]

Introduction:: Although a great deal of research has focused on measuring motivation and readiness to quit smoking, little research has assessed gross motivational changes after a smoker has made an attempt to quit smoking. Unlike previous single-item global measures of motivation to remain abstinent, we developed the abstinence-related motivational engagement (ARME) scale to evaluate the degree to which abstinence motivation is reflected by an ex-smoker’s daily experience in areas that include cognitive effort, priority, vigilance, and excitement. The aim of this study was to collect reliability and initial construct validity data on this new measure. [ABSTRACT FROM PUBLISHER]

Abstract: Introduction: The Health Action Process Approach (HAPA) posits a distinction between pre-intentional motivation processes and a post-intentional volition process that leads to the actual behavior change. For smoking cessation, the HAPA predicts that increased risk perceptions would foster a decision to quit smoking. From a cross-sectional perspective, the HAPA predicts that those who do not intend to quit (non-intenders) should have lower risk perceptions than those who do intend to quit (intenders). Method: Adult smokers participated in a cross-sectional survey. Multiple measures of motivation to quit smoking and risk perceptions for smoking were assessed. ANOVA and contrast analysis were employed for data analysis. Results: The results were generally supportive of the HAPA. Non-intenders had systematically lower risk perceptions compared to intenders. Most of these findings were statistically significant. Conclusion: The results demonstrated that risk perceptions distinguish non-intenders from intenders. These results suggest that smokers low in motivation to quit could benefit from information and reminders about the serious health problems caused by smoking. [Copyright &y& Elsevier]