Abstract
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.
Highlights
Motivation to initiate a smoking cessation attempt and motivation to maintain abstinence can be conceptualized as separate constructs, independently influencing long-term cessation success [1]
Our results indicate that the AbstinenceRelated Motivational Engagement scale (ARME) is a reliable, valid, and psychometrically sound measure of abstinence-related motivational engagement among both smokers and successful abstainers
The ARME was correlated with a traditional measure of smoking cessation self-efficacy among smokers, abstinence-related motivational engagement appears to be independent of self-efficacy, with unique predictive power on future abstinence among smokers prior to cessation or after relapse
Summary
Motivation to initiate a smoking cessation attempt and motivation to maintain abstinence can be conceptualized as separate constructs, independently influencing long-term cessation success [1]. A smoking cessation attempt is a dynamic, phasic process [2] characterized by fluctuations in motivation to quit smoking and maintain abstinence. Cessation-related motivation has been assessed at a single time point and often with single-item measures, usually at the initiation of a quit attempt (e.g., Contemplation Ladder [3]). The AbstinenceRelated Motivational Engagement scale (ARME) was developed to expand upon assessment of simple desire to quit smoking [1], and further assess abstinence-related engagement throughout the course of a quit attempt. In a preliminary development and administration study of the ARME, the 16-item version of the scale possessed excellent internal consistency and was associated with current length of smoking abstinence [1]. The ARME was found to have a stronger relationship with length of abstinence than single-item measures of motivation to quit. Measurement of motivational engagement over time could provide insight into the dynamics of the cessation and maintenance processes, which could be utilized to enhance smoking cessation interventions
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