Smoking Cessation Self-efficacy Research Articles

Boosting self-efficacy and improving practices for smoking prevention and cessation among South American cancer care providers with a web-based algorithm

BackgroundDigital technologies have positively impacted the availability and usability of clinical algorithms through the advancement in mobile health. Therefore, this study aimed to determine if a web-based algorithm designed to support the decision-making process of cancer care providers (CCPs) differentially impacted their self-reported self-efficacy and practices for providing smoking prevention and cessation services in Peru and Colombia.MethodsA simple decision-making tree algorithm was built in REDCap using information from an extensive review of the currently available smoking prevention and cessation resources. We employed a pre-post study design with a mixed-methods approach among 53 CCPs in Peru and Colombia for pilot-testing the web-based algorithm during a 3-month period. Wilcoxon signed-rank test was used to compare the CCPs’ self-efficacy and practices before and after using the web-based algorithm. The usability of the web-based algorithm was quantitatively measured with the system usability scale (SUS), as well as qualitatively through the analysis of four focus groups conducted among the participating CCPs.ResultsThe pre-post assessments indicated that the CCPs significantly improved their self-efficacy and practices toward smoking prevention and cessation services after using the web-based algorithm. The overall average SUS score obtained among study participants was 82.9 (± 9.33) [Peru 81.5; Colombia 84.1]. After completing the qualitative analysis of the focus groups transcripts, four themes emerged: limited resources currently available for smoking prevention and cessation in oncology settings, merits of the web-based algorithm, challenges with the web-based algorithm, and suggestions for improving this web-based decision-making tool.ConclusionThe web-based algorithm showed high usability and was well-received by the CCPs in Colombia and Peru, promoting a preliminary improvement in their smoking prevention and cessation self-efficacy and practices.

Abstract 2154: Actívatexto:Feasibility and acceptability of a mobile intervention that promotes smoking cessation and physical activity among Latinos

Abstract The purpose of this study was to assess the feasibility and acceptability of a mobile intervention that promotes smoking cessation and physical activity among Latinos. Twenty Latino adults who smoked and did not meet recommended levels of physical activity were recruited using community-based recruitment strategies. Participants received Actívatexto, a theory-based, culturally accommodated, 12-week text messaging intervention (available in English and Spanish) that promotes both smoking cessation and physical activity. Actívatexto integrates four components: 1) a text messaging program that promotes both smoking cessation and physical activity, 2) a wearable device to monitor physical activity, 3) an online dashboard where the research team manages participants’ incoming and outgoing data from both the text messaging program and wearable devices, and 4) smoking cessation pharmacotherapy (i.e., nicotine replacement therapies). We assessed self-reported 7-day point prevalence smoking abstinence (not smoking any cigarettes in the past seven days) at Month 3, weekly minutes of moderate to vigorous physical activity (MVPA), pharmacotherapy adherence, self-efficacy, and satisfaction. At baseline, participants’ mean age was 47.3 years old (SD 16.0), 55% of participants were female, 80% had completed high school or lower educational level, and 60% indicated that Spanish was their language of preference. Most participants (75%) smoked 1-10 cigarettes daily, 35% smoked their first cigarette within five minutes after waking up, and 60% used menthol cigarettes. At Month 3, 14 participants (70%) self-reported 7-day point prevalence smoking abstinence (90% follow-up rate). Fitbit-assessed mean minutes of MVPA per week increased from 113 (SD 127; range 0-399) at Week 1 to 177 (SD 163; range 0-513) at Month 3, although the difference was not statistically significant (p=0.15). Sixteen participants (88.9%, 16/18) reported NRT use in the past 90 days. Mean scores of self-efficacy for smoking cessation increased from 31.2 (SD 10.6) at baseline to 47.8 (SD 13.0) at Month 3 (p<0.01). Mean scores of self-efficacy for physical activity increased from 12.3 (SD 3.9) at baseline to 14.6 (SD 4.4) at Month 3 (p=0.2). Most participants reported being satisfied or extremely satisfied with the intervention (88.9%, 16/18). In conclusion, Actívatexto resulted in a noteworthy cessation rate at Month 3 (70%), increased mean minutes of MVPA per week, produced high use of NRT, increased self-efficacy for smoking cessation and physical activity, and was well received by participants. Additional testing in a formal randomized clinical trial is warranted to assess the efficacy of the intervention. Citation Format: Daimarelys Lara, Edgar I. Alaniz-Cantu, Arlette Chávez-Iñiguez, Daniel Fuller, Scott McIntosh, Deborah J. Ossip, Ana Paula Cupertino, Francisco Cartujano-Barrera. Actívatexto:Feasibility and acceptability of a mobile intervention that promotes smoking cessation and physical activity among Latinos [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2154.

Effectiveness of health education and counseling on stages of change, decisional balance, and smoking cessation self-efficacy: A prospective self-control study

ObjectiveTo examine the effectiveness of health education and counseling on the stages of change, decisional balance, and smoking cessations elf-efficacy in smokers with no intention of quitting. MethodsA prospective self-controlled design was conducted between December 2020 and December 2022. The research period was divided into a control stage (first to fourth weeks) and an experimental stage (fifth to eighth weeks). Patients with coronary artery disease (CAD) and habitually smoked were recruited. Pearson correlation and a one-factor repeated-measurement analysis were performed to assess the effectiveness of the intervention. ResultsIn total, 108 male CAD patients with a mean age of 58.1 years were recruited. After 4 weeks of the intervention, 55 (51%) exhibited behavior change (X 2 = 18.03, p = .001). The decisional balance and smoking cessation self-efficacy scores significantly improved in the experimental stage. No significant differences were observed in the control stage. ConclusionsFour weeks of health education and counseling could effectively improve participants’ stage of change, decisional balance, and smoking cessation self-efficacy. Practice implicationHealthcare professionals can play key roles in helping CAD patients successfully quit smoking through individual education and counseling.

Implicit Theories of Smoking and Intention to Quit: A Serial Mediation Model.

There is growing evidence that implicit theories of smoking (ITS)-whether smokers perceive smoking behavior as malleable or fixed-are significant predictors of quitting intentions. This cross-sectional study aims to investigate the underlying mechanisms of implicit theories on smoking in predicting smokers' intentions to quit. We conducted multiple linear regression with quitting intentions as the dependent variable, ITS as the independent variable, and sociodemographic variables, quitting attempts in the past year, and receiving quitting advice in the past 12 months as the covariates. The mediating role of consideration of future consequences (CFC) and self-efficacy in the relationship between implicit theories of smoking and quitting intentions was evaluated by mediation analyses. A total of 510 smokers were included in the final analyses. Smokers holding a higher incremental theory of smoking reported a higher likelihood of considering future consequences (β = 0.289, p < .001) and a weaker possibility of considering immediate results (β = -0.317, p < .001), which, in turn, enhanced their quitting self-efficacy and then led to stronger intentions to quit smoking (β = 0.261, p < .001). The current study enriched our understanding of the underlying mechanisms that connect smokers' ITS and their likelihood of smoking cessation such that higher incremental theories of smoking predict stronger intention to quit smoking, and the effect was serially mediated by smokers' likelihood of considering future consequences of their behavior and their perceived self-efficacy for smoking cessation. This study indicated the mediating role of CFC and self-efficacy for smoking cessation on the relationship between the ITS and quitting intentions. These two psychological factors and the pathways may be important points for understanding the model of implicit theories for smoking and improving the effectiveness of implicit theories-based intervention on smoking cessation.

Factors Influencing Sleep Disturbances in Adolescent Smokers in South Korea.

This study aimed to describe sleep disturbances and identify associated factors in adolescent smokers in South Korea. This study adopted a cross-sectional design and recruited 520 students aged 12-17 years from 35 schools to participate in a smoking cessation program. To compare demographic, smoking-related, psychological, and problem behavior characteristics between adolescent smokers with sleep disturbances and without sleep disturbances, chi-square tests and independent t tests were used. Logistic regression analysis was performed to identify the factors associated with sleep disturbances in adolescent smokers. Approximately 45.8% of adolescent smokers reported sleep disturbances. Sleep disturbances were more frequent among girls than among boys and more frequent among high school students than among middle school students. Other factors included cigarette use within 1 month, nicotine dependence, smoking cessation self-efficacy, depression, Internet addiction, and suicidal ideation. Gender (girls), school level (high school), depression, Internet addiction, and daily cigarette use (11 or more cigarettes) were significantly associated with sleep disturbances in adolescent smokers. To improve the sleep quality of adolescent smokers, health professionals should focus on sleep disturbances and associated factors and develop appropriate intervention programs.

Stages of Change for Hookah Smoking among High School Male Students

Background: Tobacco use is a significant and controllable risk factor for the spread of diseases, as well as a rise in morbidity and mortality, which leads to early death. Because of its popularity, the use of this substance is on the rise among children and adolescents. Aim: The aim of this study is to understand stages of change for hookah smoking among high school male students. Methodology: Part of the study was an experimental randomized controlled trial used to guide this study. The study was carried out at Tuz High School for males in Tuz Khurmatu District, Salah-Aldeen Governorate. The study included a simple random sample of 144 high school students. The study instrument includes students’ sociodemographic data. It also includes the Stages of Change Scale for Hookah Smoking, The Processes of Change Scale for Hookah Smoking, The Self-Efficacy/ Temptation Scale for Hookah Smoking, and The Decisional Balance Scale for Hookah Smoking. Data were collected using a self-reported method for the period from November 1st, 2021 to March 31th, 2022. Data were analyzed using the statistical package for social science (SPSS) for Windows, version 26. Results: There are significant differences in the values of the Processes of Change of hookah smoking over time for participants both in the study and control groups (F = 90.973, df = 2, p < .01 vs. F = 32.346, df = 2, p < .01). Conclusion: The lower the Stage of Change, the poorer the Self-Efficacy for hookah smoking cessation. In posttest II, the lower the Stage of Change, the more the used Processes of Change for hookah smoking cessation. The higher the Stages of Change, the greater the Self-Efficacy and Decisional Balance for hookah smoking cessation. Keywords: Hookah Smoking, High School Male Students

Using the Transtheoretical Model of Change to Understand High School Students’ Hookah Smoking Behavior

Objective(s): The aim of this study is to understand high school students’ hookah smoking behavior. Methodology: Part of the study was an experimental randomized controlled trial used to guide this study. The study was carried out at Tuz High School for males in Tuz Khurmatu District, Salah-Aldeen Governorate. The study included a simple random sample of 144 high school students. The study instrument includes students’ sociodemographic data. It also includes the Stages of Change Scale for Hookah Smoking, The Processes of Change Scale for Hookah Smoking, The Self-Efficacy/ Temptation Scale for Hookah Smoking, and The Decisional Balance Scale for Hookah Smoking. Data were collected using a self-reported method for the period from November 1st, 2021 to March 31th, 2022. Data were analyzed using the statistical package for social science (SPSS) for Windows, version 26. Results: The study results revealed that more than two-fifth of subjects in the study group were in the Precontemplation Stages of Change, followed by those who were in the Contemplation, and those in the Preparation Stage of Change. The administered intervention made subjects use more Processes of Change, enhanced their Self-Efficacy and Decisional Balance of hookah smoking cessation. Conclusion: The Stage-matched intervention efficaciously made students use more Processes of Change of hookah smoking, enhanced their Self-Efficacy/Temptation of hookah smoking, and Decisional Balance of hookah smoking. The lower the Stage of Change, the poorer the Self-Efficacy for hookah smoking cessation.

Smoking Status and Health Beliefs Related to Smoking of Nurses in Working a Cancer Hospital, in Turkey

Purpose: Few studies are available that evaluate oncology nurses’ health beliefs related to smoking and smoking status. The purpose of this study was to evaluate the health beliefs regarding smoking among nurses and status working in a cancer hospital. &#x0D; Methods: This descriptive study was conducted among 152 nurses in a cancer hospital in Turkey. Data were collected by using The Self-Report Questionnaire Regarding Health Beliefs and Smoking Cessation Self-Efficacy Questionnaire&#x0D; Results: Median age, body mass index, and working duration with cancer patients of the oncology nurses are 34.0, 23.9, and 9.0, respectively. Of the nurses, 54.1% stated that they have never smoked, while 27% smoke every day. Among regular smokers, 32.1% are in precontemplation stage. Of the participants, 91.9% noted that ‘smokers are more likely to have cancer, 45.9% that ‘it is difficult for smokers to quit smoking, and 52.3% that ‘tobacco bans are effective on quitting smoking. &#x0D; Conclusion: The majority of oncology nurses think that a healthy lifestyle is very important but a few of them follow the advice. Also even though the nurses mostly have healthy living beliefs they can’t reflect these on their behaviors. Nurses working with cancer patients must also be considered as risk groups when planning cancer prevention and tobacco control studies. It is important that nurses should be informed and supported to take part in smoking cessation interventions.

Factors Associated with the 30-Day and 1-Year Smoking Abstinence of Women in Korea: The Effect of Nicotine Dependency, Self-Efficacy, and Mental Illness.

Despite the success of tobacco control efforts in reducing smoking rates during the past 50 years, data on the factors contributing to quitting success are still lacking. Smoking-related mortality among women has also not declined. Therefore, this study aimed to characterize sociodemographic features, smoking-related behaviors, mental illness, and smoking cessation in woman smokers in Korea who were registered in the Quitline program. Furthermore, factors associated with 30-day and 1-year successful smoking cessation after enrollment in the Quitline program were investigated. A total of 3360 adult woman Quitline users from 2007 to 2018 were included in the final analysis, with information on their age, education level, marital status, body mass index, frequency of alcohol consumption per month, nicotine dependency, self-efficacy for smoking cessation, presence of a smoking cessation supporter, and mental health history collected upon registration with the Quitline program in Korea. Their cessation outcome was investigated with a 1-year follow-up until the end of 2019. A multiple logistic regression analysis was conducted to identify factors associated with smoking cessation at the 30-day and 1-year follow-ups. The results of the multiple logistic regression analysis indicated that lower nicotine dependency, higher self-efficacy, and the presence of a smoking cessation supporter improved the odds of smoking cessation at the 30-day and 1-year follow-ups. In contrast, users with a mental health condition were less likely to achieve smoking cessation. Incorporating methods to increase self-efficacy in women who decide to quit smoking will contribute to facilitating more attempts to quit and achieving greater success in smoking cessation among woman smokers.

Relationships among Self-Efficacy, Quality of Life, Perceived Vulnerability, and Readiness to Quit Smoking in People Living with HIV.

Smoking-related diseases (e.g., lung cancer) are the leading cause of mortality in HIV-infected patients. While many PLWH who smoke report a desire to quit, a majority of them have low readiness to quit. This study used logistic and linear regression to examine the relations among two (continuous vs. binary) measures of readiness to quit, smoking cessation self-efficacy (SE), quality of life (QoL), and perceived vulnerability (PV) using baseline data from 100 PLWH who smoke who participated in a clinical trial. Results showed no significant main effects (SE, QoL, and PV) or interaction effects (SE × QoL and SE × PV) on a continuous measure of readiness to quit. However, a follow-up analysis revealed that SE had a curvilinear effect on readiness to quit such that self-efficacy was positively associated with readiness to quit except at the highest levels of self-efficacy where readiness to quit declined. Greater SE significantly increased the likelihood of reporting readiness to quit (yes/no) among those with low QoL or high PV. For PLWH who smoke, improving self-efficacy may increase readiness to quit especially among those with lower quality of life. Psychoeducation tailored to PLWH designed to reduce unrealistic invulnerability to smoking-related diseases along with interventions that target self-efficacy may improve readiness to quit.

흡연 대학생의 니코틴 의존 수준에 따른 금연 자기효능감 영향요인

본 연구는 흡연 대학생의 니코틴 의존 수준에 따른 스트레스, 흡연에 대한 신념과 금연 자기효능감의 정도를 파악하고, 금연 자기효능감에 미치는 영향요인을 확인하기 위한 서술적 조사연구이다. J도 소재 대학의 흡연 대학생 246명을 대상으로 2020년 5월 1일부터 20일까지 자료를 수집하였다. 수집된 자료는 SPSS 25.0 프로그램으로 x², t-test, 다중회귀분석을 실시했다. 연구결과 니코틴 의존 수준에 따라 연령, 성별, 흡연하는 가족, 흡연기간, 흡연시작연령에 차이가 있었고, 흡연에 대한 신념과 스트레스는 고니코틴 의존군이 높았고, 금연 자기효능감은 저니코틴 의존군이 높았다. 금연 자기효능감의 영향요인은 저니코틴 의존군에서는 흡연에 대한 신념, 고니코틴 의존군은 흡연하는 가족과 스트레스로 나타났다. 추후 흡연 대학생의 금연성공을 위해 니코틴 의존 수준에 따라 차별화된 금연 프로그램 개발 및 효과평가를 위한 연구를 제언한다.

Results of a Feasibility Study of Helpers Stay Quit Training for Smoking Relapse Prevention.

Most smoking quit attempts end in relapse, and interventions focused on relapse prevention are lacking. Helpers Stay Quit (HSQ) is a novel behavioral relapse prevention intervention that teaches newly abstinent smokers to offer a "helping conversation" (HC) to help others quit tobacco. Pre-post intervention feasibility study with state quitline participants ≥14 days abstinent. Measures at baseline, 3 months, and 6 months included smoking status, offering HCs, and cessation self-efficacy. Primary outcomes: self-reported 7-day point prevalence abstinence; offering HCs. Cox models explored association of HCs with relapse. Preliminary effects analysis using propensity score matching compared 30-day abstinence of quitline clients with study sample at 7 months. Participants (N = 104) were as follows: mean age of 53 years (SD 13.9 years), 48.1% male, mean of cigarettes smoked/day of 16.2 (SD 9.7). Compared with participants who remained abstinent (n = 82), relapsers (n = 22) had fewer HCs over 6 months (2.6 vs 7.2; 95% confidence interval [CI]: 1.4, 7.8, p = .006). Using adjusted Cox regression, the hazard ratio of relapse for each HC was 0.85 (95% CI: 0.74, 0.99, p = .03). Compared with a matched sample of quitline clients not exposed to HSQ, study participants were 49% more likely to report 30-day abstinence at 7-month quitline follow-up (95% CI: 40%, 59%, p < .0001). HSQ, delivered to newly abstinent smokers who received standard quitline treatment, was associated with less self-reported relapse. These promising preliminary study results warrant further research to evaluate HSQ as a novel behavioral intervention to prevent smoking relapse. To date, behavioral interventions for smoking relapse prevention that teach abstainers cessation skills to apply to themselves have not shown effectiveness. This feasibility study examines the preliminary efficacy of a conceptually novel, "help others" behavioral intervention approach for relapse prevention in newly abstinent smokers recruited from a state quitline. HSQ teaches the newly abstinent smoker communication and listening skills to encourage other smokers in their personal social network to quit. Exploratory analysis using propensity score matching suggests that participants exposed to HSQ were significantly more likely to self-report 30-day abstinence at quitline 7-month follow-up than other quitline clients.

Effectiveness of Message Frame-Tailoring in a Web-Based Smoking Cessation Program: Randomized Controlled Trial.

BackgroundThe content of online computer-tailored interventions is often determined to match an individual’s characteristics, beliefs, and behavioral factors. These content-tailored interventions lead to better message processing and a higher likelihood of behavior change such as smoking cessation. However, a meta-analysis of online computer-tailored interventions showed that effect sizes, albeit positive, remain small, suggesting room for improvement. A promising strategy to enhance the effectiveness of online computer-tailored interventions is to tailor the message frame (ie, how a message is communicated) based on the preferred communication style of the user in addition to content-tailoring. One factor that determines an individual’s communication style preference is the need for autonomy; some individuals prefer an autonomy-supportive communication style (offering choice and use of suggestive language), whereas others might prefer a directive communication style, which is replete with imperatives and does not provide choice. Tailoring how messages are presented (eg, based on the need for autonomy) is called message frame-tailoring.ObjectiveThe aim of the present study was to test the effectiveness of message frame-tailoring based on the need for autonomy, in isolation and in combination with content-tailoring, within the context of an online computer-tailored smoking cessation intervention. The primary outcome measure was the 7-day point-prevalence of smoking abstinence. Secondary outcomes were perceived message relevance, self-determined motivation to quit smoking, and sociocognitive beliefs.MethodsA randomized controlled trial with a 2 (message frame-tailoring vs no message frame-tailoring) by 2 (content-tailoring vs no content-tailoring) design was conducted among adult smokers intending to quit smoking (N=273).ResultsStructural equation modeling revealed that the content-tailored condition increased smoking abstinence rates 1 month after the start of the intervention (beta=.57, P=.02). However, neither message frame-tailoring nor its interaction with content-tailoring significantly predicted smoking abstinence. In our model, message frame-tailoring, content-tailoring, as well as their interaction significantly predicted perceived relevance of the smoking cessation messages, which consequently predicted self-determined motivation. In turn, self-determined motivation positively affected attitudes and self-efficacy for smoking cessation, but only self-efficacy consequently predicted smoking abstinence. Participants in the control condition perceived the highest level of message relevance (mean 4.78, SD 1.27). However, messages that were frame-tailored for individuals with a high need for autonomy in combination with content-tailored messages led to significantly higher levels of perceived message relevance (mean 4.83, SD 1.03) compared to those receiving content-tailored messages only (mean 4.24, SD 1.05, P=.003).ConclusionsMessage frame-tailoring based on the need for autonomy seems to be an effective addition to conventional content-tailoring techniques in online smoking cessation interventions for people with a high need for autonomy; however, this is not effective in its current form for people with a low need for autonomy.Trial RegistrationDutch Trial Register (NL6512/NRT-6700); https://www.trialregister.nl/trial/6512

Influencing Factors on Job Stress of Adult Workers in Continuous Smoking Cessation

본 연구는 1년 이상 금연 유지에 성공한 성인 근로자의 직무스트레스 영향요인을 파악하고 분석하기 위해 시도되었다. 본 연구는 D시와 G도 지역의 금연프로그램에 참여한 후 현재 1년 이상 금연하고 있는 연구 참여자 98명을 대상으로 2018년 9월 1일부터 2018년 12월 31일까지 자료 수집하였다. 연구결과 대상자의 직무스트레스는 금연 자기효능감 정도와는 역 상관관계가 있었으며, 우울 및 니코틴 의존도와는 순 상관관계가 있는 것으로 나타났다. 직무스트레스에 영향을 미치는 유의한 요인은 우울, 직업 유형, 니코틴 의존도, 금연 자기효능감으로 이들 변수의 직무스트레스에 대한 설명력은 47.0%였으며, 직무스트레스에 가장 유의하게 영향을 미치는 요인은 우울임이 확인되었다. 성공적인 금연유지를 하고 있는 청년 및 중년 근로자의 직무 스트레스 감소를 위하여 우울을 우선적으로 중재하고, 그들이 경험하는 우울 정도, 니코틴 의존도, 금연 자기효능감과 직무스트레스를 주기적으로 사정하고 관리하기 위한 금연 중재 프로그램 개발이 필요할 것으로 사료된다.The aim at this study was to analyze the influencing factors on the job stress of adult workers in continuous smoking cessation. The participants of this study were 98 adult workers who took part in the smoking cessation program for 6 months and have ceased smoking successfully for more than a year. It is shown that job stress has a positive correlation with depression and nicotine dependence, but a negative correlation with smoking cessation self-efficacy. The significant factors influencing job stress include depression, type of occupation, nicotine dependence, smoking cessation self-efficacy, all of which explained 47.0% of the variance in job stress. Depression was one of the most significant factors for job stress among adult workers who succeeded for more than a year of continuous smoking cessation. The results demonstrate the need of developing smoking cessation intervention programs to reduce job stress in a way to reduce depression first and then periodically assess and manage the level of depression, nicotine dependence and smoking cessation self-efficacy.

Assessing multiple features of partner support for smoking cessation in dual-smoker couples.

The purpose of this study was to evaluate a new scale to measure multiple aspects of partner support for quitting smoking relevant to dual-smoker couples, called the Partner Support for Quitting Scale. The best model fit (N = 238 individuals in 119 couples) considers the frequency of, confidence in, and perceived usefulness of partner support behaviors. Path analysis revealed that the Partner Support for Quitting Scale factors were uniquely predicted by relationship commitment and nicotine dependence and, in turn, predicted self-efficacy for smoking cessation and desire to quit. Preliminary support was found for the Partner Support for Quitting Scales' value as an assessment tool for measuring partner support for smoking cessation among dual-smoker couples.

Changing multiple health behaviors in cancer survivors: smoking and exercise

ABSTRACTResearch regarding cross-behavioral relationships between the cognitive mechanisms motivating health behavior change is lacking for cancer survivors. This study investigated these relationships to inform the development of multiple health behavior change (MHBC) interventions for this at-risk population. Eligible participants included cancer survivors attending an intake appointment for smoking cessation services. This cross-sectional survey study assessed participants’ self-efficacy and motivation (stage of change) for smoking cessation and exercise, as well as self-reported health behaviors. Analyses evaluated cross-behavioral associations between cognitive mechanisms and their relationships with smoking and exercise behaviors. Seventy-six participants completed the survey questionnaire. The correlation between self-efficacy scores for smoking cessation and exercise was statistically significant (r = .45, 95% CI [.09, .67]), as were correlations between self-efficacy and reported levels of exercise ((r = .44, 95% CI [.20, .65]) strenuous); ((r = .36, 95% CI [.12, .59]) moderate), exercise self-efficacy and smoking behavior (r = −.27, 95% CI [−.46, −.05]), and smoking self-efficacy and smoking behavior (r = −0.41, 95% CI [−.61, −.18]). For cancer survivors, associations between exercise self-efficacy and smoking cessation self-efficacy may offer an opportunity to leverage MHBC; specifically, this positive association may facilitate exercise intervention in survivors seeking smoking cessation services..

Self-efficacy as a pathway to long-term smoking cessation among low-income parents in the multilevel Kids Safe and Smokefree intervention

BackgroundThis study investigated the effects of a multi-level smoking intervention on mediators of long-term abstinence in parental smokers, including smoking cessation self-efficacy, smoking urge coping, and perceived support to quit smoking. MethodsThis is a secondary analysis of data from a randomized trial that recruited parental smokers from pediatric clinics in low-income communities (N = 327, 83% women, 83% African American, 79% below poverty level). Following clinical practice guidelines for tobacco intervention (“Ask, Advise, Refer” [AAR]), pediatricians asked all parents about child tobacco smoke exposure (TSE), advised about TSE harms and benefits of reducing TSE, and referred smokers to cessation resources. Eligible parents were then randomized to additional telephone-based smoking behavior counseling (AAR + counseling) or nutrition education (AAR + control). Bioverified 7-day point prevalence smoking abstinence and perceived counselor support were assessed at 12-month follow-up; cessation self-efficacy and urge coping were assessed at 3-month follow-up. ResultsRelative to AAR + control, AAR + counseling was associated with higher self-efficacy, urge coping, and perceived support to quit (all p’s<.001). Self-efficacy, but no other mediators, had a significant positive effect on 12-month bioverified smoking abstinence (p < .001). The indirect effect of intervention on 12-month abstinence via self-efficacy suggested mediation via this pathway (p = .002). ConclusionResults suggest that all putative treatment pathways were improved more by the multi-level AAR + counseling than the clinic-level AAR + control intervention. Further, self-efficacy at end-of-treatment prospectively predicted long-term cessation, suggesting that building of self-efficacy through treatment may be key to sustained cessation.

금연효능감과 프레임이 금연광고 메시지의 설득효과에 미치는 영향 연구 : 흡연기간, 흡연량, 낙관적 편견 등 수용자 특성을 중심으로

담배가 끼치는 유해성은 널리 알려져 있으며, 전세계적으로 흡연율을 낮추기 위해 노력하고 있다. 그러나 이러한 노력에도 불구하고 남성 흡연율은 획기적으로 줄어들지 않고, 여성 흡연율은 오히려 증가하는 추세이다. 흡연자들은 매우 다양한 스펙트럼을 가지고 있기에, 금연 커뮤니케이션 공익광고를 집행함에 있어 수용자들을 한 덩어리로 보고 일괄적으로 메시지를 집 행한 것도 효과성을 떨어뜨렸던 한 요인이라 본다. 이에 본 연구에서는 흡연기간, 흡연량과 금연 효능감의 관계를 살펴보고, 금연효능감 및 메시지 프레임이 금연광고태도, 금연태도, 금연의도에 미치는 영향을 살펴보았다. 또한 성별과 연령에 따라 흡연기간과 흡연량에 차이가 있는지 알아 보고 그러한 차이가 낙관적 편견에 영향을 미치는지 알아보았다. 연구 결과, 금연효능감은 금연태도, 금연의도에 유의한 영향을 미쳐, 금연효능감이 높을수록 높 은 금연태도, 금연의도를 보이는 것으로 나타났다. 그러나 메시지 프레임은 영향을 미치지 못했 고, 상호작용 효과도 나타나지 않았다. 흡연기간과 흡연량은 금연효능감에 유의한 영향을 미쳐, 흡연기간이 길수록, 흡연량이 많을수록 낮은 금연효능감을 보였다. 성별, 연령, 흡연기간, 흡연량 은 낙관적 편견에 유의한 영향을 미쳐, 여성인 경우, 연령이 낮은 경우, 흡연기간이 짧은 경우, 흡연량이 적은 경우 낙관적 편견을 보였다. 이와 같은 연구결과는 향후 금연광고 메시지를 집행 함에 있어 흡연자들에 대한 이해를 돕는 데에 일조할 것이며, 흡연자들의 다양한 특성을 고려하 여 금연광고 메시지를 집행해야 함을 시사한다.

Factors Associated With Continued Smoking in Lebanese Patients With Acute Coronary Syndrome.

Smoking in patients with acute coronary syndrome (ACS) increases their risk for recurrent events and death. The aim of this study was to describe the smoking trajectory among patients hospitalized with ACS and associated factors. Forty patients with ACS who were smokers were interviewed in the hospital about smoking history, nicotine dependence, depression, self-efficacy, and social support. Phone interviews at 1, 3, 6, and 12 months after discharge assessed smoking status and related factors. Most patients (≥80%) were middle-aged married men, with high nicotine dependence (52.5%) and low self-efficacy for smoking cessation (mean [SD], 38.3 [27.19]) at baseline. Although 85% intended to quit after discharge, 62.5% continued smoking after 1 year. Persistent smoking was associated with lower self-efficacy (P < .01) and higher depression (P = .025). Smoking cessation intervention must start in the hospital and continue for 6 months. The program must target self-efficacy, manage depression, and involve the patient's family.

English

BACKGROUND The aim of the study is to determine self-efficacy of young adults across stages of waterpipe cessation. MATERIALS AND METHODS This cross-sectional study was conducted with participation of 1012 students from Shahid Beheshti University in Iran. Data was collected within two months from May to July 2016 using a self-administered questionnaire that consisted of three parts including demographic variables, stages of change for waterpipe cessation (derived from Prochaska and DiClemente), and self-efficacy. Validity and reliability of questionnaire was assessed and approved by appropriate methods. Data was analysed by SPSS 19 using chi-square, t-test, ANOVA, and Univariate test. RESULTS The mean age of participants in this study was 21.37 +/- 2.76 years. Out of 1012 students, 345 participants (34.1 ) had a history of waterpipe smoking at least once. In addition, current waterpipe smoking in students was 26.28. Overall 267 students (77.4) were categorised in passive stages (precontemplation, contemplation and preparation) and 78 students (22.6) in active stages of waterpipe cessation (action and maintenance). The mean score of self-efficacy had a significant relationship with stages of change (p<.001), gender (p=007), residence status (p=.013), and the type of smoking (p=.041). CONCLUSION Considering the high prevalence of waterpipe smoking in students, negative intention toward cessation, and low self-efficacy for waterpipe smoking cessation amongst students, we suggest informative interventions about hazards of waterpipe smoking to be done to increase self-efficacy and resistance to peer pressure.