Predictors of smoking cessation attempts and success following motivation-phase interventions among people initially unwilling to quit smoking.
2020
INTRODUCTION: Most people who smoke cigarettes are not willing (i.e., not ready) to make a quit attempt (QA) at any given time. Unfortunately, interventions intended to increase QAs and the success of QAs are only modestly effective. Identifying processes leading to QAs and quitting success could guide intervention development. METHODS: This is a secondary analysis of a randomized factorial trial of 6 weeks of motivation-phase interventions among primary care patients (N=517) who were initially unwilling to quit but were willing to reduce their smoking. Using logistic regression, we controlled for treatment condition and tested whether baseline or change in smoking-related constructs after 6 weeks of treatment predicted: 1) making a >/= 24 hour QA between weeks 6 and 26, and 2) quitting success at week 26 (7-day point-prevalence abstinence among those who made a QA). Predictors included cigarettes/day, time-to-first cigarette, motivation to quit, quitting self-efficacy, anticipated urges to smoke if quit, positive affect, negative affect, and time spent around others who smoke. RESULTS: In multivariable models that included all smoking-related constructs, changes in the following variables predicted initiating a QA above and beyond other variables: greater baseline time to first cigarette (OR=1.60), increases in time to first cigarette (OR=1.27) and increases in quitting self-efficacy (OR=1.14). Increased motivation to quit predicted conversion of a QA into quitting success at 26 weeks (OR=1.36). CONCLUSION: Predictors of making a QA differed from predictors of quitting success. Predictors of QAs and success could each serve as important treatment targets of motivation-phase interventions.
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