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Barriers to quitting smoking among medically ill smokers

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Abstract

Few studies examine predictors of smoking cessation among medically ill smokers, despite their high smoking prevalence. We prospectively examined barriers to smoking cessation in medically ill smokers, with age as a hypothesized moderator. Participants were smokers (N = 237, M age = 56.1, 53.6% females) receiving home-based nursing care. Baseline self-report questionnaires assessed barriers to cessation (demographics, smoking history, psychosocial, and medical factors). Smoking status was biochemically verified at 2- and 6-months post-intervention. Compared with younger smokers, older smokers had significantly lower levels of nicotine dependence, stress, and depressed mood and a greater prevalence of smoking-related diseases. Older smokers were more likely to achieve biochemically verified abstinence at 6-month follow-up (7.8%) than younger smokers (3.1%) though this difference was not significant. Higher levels of depressed mood and lower levels of perceived stress were associated with a greater likelihood of cessation at both follow-up points, but only for younger smokers. For younger smokers, higher self-efficacy to quit and the presence of a smoking-related disease increased the odds of abstinence. These findings could help guide treatment development for this high-risk group of smokers.

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Notes

  1. Continuous abstinence was used as the outcome measure per the recommendations of Hughes, 2003. It should be noted that 7-day point-prevalence (7-day ppa) was also calculated for the analyses in the current study. The findings for 7-day ppa were similar to the main findings at the 2- and 6-month follow-ups. At 2-months, two interactions were significant when using 7-day ppa, but not when using continuous abstinence as the dependent variable (social support × age, and income × age). The interaction of CESD by age was absent at 6-months when ppa was used as a dependent variable.

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Acknowledgments

The authors would like to thank Dr. Shira Dunsiger for her statistical advice on these analyses presented in this manuscript. This research was supported by a grant from the National Cancer Institute (R01 CA74553, Dr. B. Borrelli, PI).

Conflict of interest

The authors do not have any conflicts of interest to report regarding this research.

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Authors and Affiliations

  1. VA Boston Healthcare System, 940 Belmont Street, Brockton, MA, 02301, USA

    Kristin Gregor

  2. Centers for Behavioral and Preventive Medicine, Brown Medical School, The Warren Alpert Medical School of Brown University, 1 Hoppin Street, Providence, RI, 02903, USA

    Belinda Borrelli

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  1. Kristin Gregor
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  2. Belinda Borrelli
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Correspondence to Kristin Gregor.

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Gregor, K., Borrelli, B. Barriers to quitting smoking among medically ill smokers. J Behav Med 35, 484–491 (2012). https://doi.org/10.1007/s10865-011-9376-y

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  • DOI: https://doi.org/10.1007/s10865-011-9376-y

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