Smoking Consequences Questionnaire-Adult Research Articles

Association and Possible Correlations Between Tobacco Smoking and Symptoms of ADHD in an Egyptian Medical College Students’ Sample

Objectives: Attention deficit and hyperactivity disorder (ADHD) and tobacco smoking start in near same developmental life stages and are highly comorbid disorders. Little research has focused on this comorbidity and its correlates, especially in the Arab world. This study aimed to find the relation between tobacco smoking and ADHD symptoms and to understand how ADHD profile can affect its persistence. Materials and Methods: We recruited our sample from fifth year medical students attending their psychiatry undergraduate training program at the Institute of Psychiatry, Faculty of Medicine, Ain Shams University Hospitals, Cairo, Egypt. All attending students for 3 rounds were approached and asked to participate. All candidates were above 20 years old and from both sexes. For the purpose of this study, tobacco smoking included cigarettes, water pipe (sheesha), Cigar, and/or pipe smoking. All the participants were assessed using 1, General Health Questionnaire (GHQ-28); 2, The Adult ADHD Self-Report Scale (ASRS); 3, Fagerstrom Test for Nicotine Dependence (FTND); 4, Smoking Consequences Questionnaire-Adult (SCQ-A). Results: An overall 12.7% had symptoms of ADHD. Participants who were tobacco smokers and had symptoms of ADHD showed nicotine dependence scores higher than the non-ADHD symptom smokers. There was significant correlation between ASRS inattention and hyperactive-impulsive subscale scores and FTND scores (P=0.003 and 0.04), respectively. Moreover, there were statistically significant correlations between ASRS scores and smoking outcome variables with P-value of ≤0.00. Conclusion: ADHD symptoms were correlated to adult tobacco smoking outcome variables, providing further evidence of a likely link between ADHD symptoms and tobacco smoking risk.

Examining outcome expectancies for smoking vs. abstinence among adult daily smokers

In a motivational interviewing (MI) framework of decision-making, we consider potential outcomes for both a primary choice and an alternative choice (DiClemente & Velazquez, 2002). Thus, we would expect that motivation to quit smoking is related to expectancies for quitting smoking and expectancies for continuing to smoke. While smoking expectancies have been frequently studied, less attention has been paid to abstinence expectancies. The present study sought to clarify the predictive utility of smoking and abstinence expectancies together for smoking motivation and behavior, versus measuring smoking expectancies alone. Expectancies were measured at baseline; outcomes were measured at baseline and one-month follow-up. Smoking expectancies were assessed via the Smoking Consequences Questionnaire-Adult (Copeland, Brandon, & Quinn, 1995), and abstinence expectancies were assessed via the Perceived Risks and Benefits of Quitting scale (McKee, O’Malley, Salovey, Krishnan-Sarin, & Mazure, 2005). Outcomes included motivation to quit (Contemplation Ladder, Biener & Abrams, 1991; Stage of Change, DiClemente et al., 1991), and average daily smoking rate. Data was analyzed for 183 smokers at baseline and 166 at follow-up. Baseline smoking expectancies and abstinence expectancies were each uniquely associated with concurrent motivation to quit, but not concurrent smoking rate. Abstinence expectancies uniquely predicted changes in smoking rate over time. Smoking and abstinence outcome expectancies may relate differently to smoking behavior, motivation to quit, and changes in these constructs over time.

Hospitalized smokers' expectancies for electronic cigarettes versus tobacco cigarettes

IntroductionThe objectives of the current study were to compare hospitalized smokers' expectancies for electronic cigarettes (e-cigarettes) against their expectancies for tobacco cigarettes and evaluate relationships between e-cigarette expectancies and intention to use e-cigarettes. MethodsAnalysis of baseline data from a one-year longitudinal observational study. The setting was a tertiary care academic center hospital in the Southeastern U.S. Participants were 958 hospitalized tobacco cigarette smokers. A questionnaire of e-cigarette expectancies based on the Brief Smoking Consequences Questionnaire—Adult (BSCQ-A) was developed and administered along with the original, tobacco-specific, BSCQ-A. Intention to use e-cigarettes was assessed with a single 10-point Likert scale item. ResultsParticipants reported significantly weaker expectancies for e-cigarettes relative to tobacco cigarettes on all 10 BSCQ-A scales. Participants held sizably weaker expectancies that e-cigarettes pose health risks (p<.001, Cohen's d=−2.07), relieve negative affect (p<.001, Cohen's d=−1.01), satisfy the desire for nicotine (p<.001, Cohen's d=−.83), and taste pleasant (p<.001, Cohen's d=−.73). Among the strongest predictors of intention to use e-cigarettes were greater expectancies that e-cigarettes taste pleasant (p<.001, adjusted β=.34), relieve negative affect (p<.001, adjusted β=.32), and satisfy the desire for nicotine (p<.001, adjusted β=.31). ConclusionsHospitalized tobacco smokers expect fewer negative and positive outcomes from e-cigarettes versus tobacco cigarettes. This suggests that e-cigarettes might be viable though imperfect substitutes for tobacco cigarettes.

Smoking Outcome Expectancies in Military Veteran Smokers With Posttraumatic Stress Disorder

Smoking outcome expectancies were investigated in treatment-seeking military Veteran smokers with posttraumatic stress disorder (PTSD). The investigation of smoking outcome expectancies may enhance our understanding of the relationship between PTSD and cigarette smoking. Participants were 943 military Veterans with a diagnosis of PTSD who were current smokers enrolled in a randomized multisite effectiveness trial to test whether the integration of smoking cessation treatment into mental health care (integrated care) improves prolonged abstinence rates compared with referral to specialized smoking cessation clinics (usual care). Using confirmatory factor analysis (CFA), we evaluated the conceptual model of smoking outcome expectancies measured on the Smoking Consequences Questionnaire-Adult (SCQ-A) version. The Kraemer method of mediation analysis was used to investigate the role of smoking outcome expectancies in mediating relationships between PTSD symptoms and smoking behavior, tobacco dependence, and abstinence self-efficacy. The CFA supported the 10-factor structure of the SCQ-A in smokers with PTSD. Relationships between measures of PTSD symptoms and tobacco dependence were mediated by the smoking outcome expectancy regarding negative affect reduction. This same smoking outcome expectancy mediated relationships between PTSD symptoms and smoking abstinence self-efficacy. The findings support the use of the SCQ-A as a valid measure of smoking outcome expectancies in military Veteran smokers with PTSD. Moreover, they suggest that smoking outcome expectancies may play an important role in explaining the relationship between PTSD and cigarette smoking.

Expectancy for negative affect relief due to smoking may not be predictive under acute mood situations.

Smoking behavior may be more persistent among those who expect that smoking will relieve negative affect (NA). Assessing smoking expectancies temporally close to mood situations could enhance the predictive value of that assessment. Dependent smokers (n = 71; 43 male, 28 female) participated in five laboratory sessions, each involving mood induction. The NA relief scale of the Smoking Consequences Questionnaire-Adult (SCQ-A), a very common measure of smoking expectancies during hypothetical situations, was assessed during initial screening. The SCQ-A was compared with a modified acute version administered each session, in which items asked about immediate expectancy for NA relief by smoking "right now" (termed Immediate Negative Affect Relief, or INAR). Actual NA relief due to smoking was measured each session by change on the NA scale of the Diener & Emmons Mood Form. The five sessions (counterbalanced) involved three different negative mood tasks, the negative mood condition of overnight smoking abstinence, and neutral mood (control). Generalized estimating equations showed that temporal proximity to the mood situation slightly enhanced the ability of expectancy to predict actual change in NA due to smoking, as the interaction with condition was significant for the INAR but marginal for the SCQ-A. However, the acute INAR predicted NA relief due to smoking only after overnight smoking abstinence and not during the other specific mood induction conditions, contrary to expectations, while the SCQ-A was not significant during any of the individual conditions. In sum, assessment of expectancy for NA relief may be of limited use in predicting actual NA relief from smoking during a current mood situation, aside from NA due to overnight abstinence.

The Smoking-Related Weight and Eating Episodes Test (SWEET): Development and Preliminary Validation

Many smokers believe that smoking helps them to control their weight, and concerns about weight gain can interfere with smoking cessation. As researchers typically assess general weight concerns, a measure specific to smoking-related weight concerns is needed. The Smoking-related Weight and Eating Episodes Test (SWEET) was created by generating items from 4 content domains: Hunger, Craving, Overeating, and Body Image. Female undergraduate smokers (N = 280) rated their postcessation weight gain concern and completed the SWEET, Fagerström Test for Nicotine Dependence, Brief Smoking Consequences Questionnaire-Adult, Eating Attitudes Test (EAT)-26, Bulimia Test-Revised (BULIT-R), and Body Shape Questionnaire. Factor analysis of the initial items suggested a 4-factor solution, suggesting 4 subscales: Smoking to suppress appetite, smoking to prevent overeating, smoking to cope with body dissatisfaction, and withdrawal-related appetite increases. Based on these results, the SWEET subscales were revised and shortened. The resulting 10-item SWEET showed excellent internal consistency (total α = .94; mean α = .86) and evidence of validity by predicting smoking frequency, eating pathology, and body image concerns (ps < .05). Smoking frequency, eating pathology, and body image concerns were significantly predicted by the SWEET while controlling for existing measures of postcessation weight gain concern. The SWEET appears to be a reliable and valid measure of tendencies to smoke in response to body image concern and nicotine withdrawal and as a way to control appetite and overeating.

The relationship between posttraumatic stress disorder and smoking outcome expectancies among U.S. military veterans who served since September 11, 2001

Posttraumatic stress disorder (PTSD) is associated with increased rates of smoking although little is known regarding the mechanisms underlying this relationship. The current study examined expectations about smoking outcomes among smokers with and without PTSD. The sample included 96 veterans (mean age of 34 years) and included 17% women and 50% racial minorities. Smoking expectancies were measured with the Smoking Consequences Questionnaire-Adult (Copeland, Brandon, & Quinn, 1995). Consistent with previous work suggesting that smokers with PTSD smoke in an effort to reduce negative affect, unadjusted analyses indicated that smokers with PTSD (n = 38) had higher expectations that smoking reduces negative affect than smokers without PTSD (d = 0.61). Smokers with PTSD also had increased expectancies associated with boredom reduction (d = 0.48), stimulation (d = 0.61), taste/sensorimotor manipulation aspects of smoking (d = 0.73), and social facilitation (d = 0.61). Results of hierarchical linear regression analyses indicated that PTSD symptom severity was uniquely associated with these expectancies beyond the effects of gender and nicotine dependence. More positive beliefs about the consequences of smoking may increase risk of continued smoking among those with PTSD who smoke. Further understanding of smoking expectancies in this group may help in developing interventions tailored for this vulnerable population.

Perception of Smoking Risks and Motivation to Quit Among Nontreatment-Seeking Smokers With and Without Schizophrenia

We examined perceived consequences/benefits of cigarette smoking and motivation for quitting in nontreatment-seeking smokers who had schizophrenia or schizoaffective disorder (N = 100) or had no Axis I psychiatric disorder (normals, N = 100). Participants completed questionnaires and provided a breath carbon monoxide (CO) sample 10-15 minutes after smoking 1 preferred-brand cigarette. Primary assessments included the Smoking Consequences Questionnaire-Adult, the Reasons for Quitting Scale, and the Stages of Change. There were no differences between the schizophrenia and control group in mean age of smoking onset (16.2 ± 5.4 vs 15.6 ± 5.5 y, P = .44), number of cigarettes daily (17.9 ± 11.6 vs 17.0 ± 7.9, P = 0.51), or in breath CO (28.0 ± 14.5 vs 22.9 ± 8.0 ppm, P = .61). Compared with normals, people with schizophrenia report greater stimulation/state enhancement (P < .0001) and social facilitation (P < .004) from smoking. People with schizophrenia had less appreciation of health risks associated with smoking than normal controls (P < .0001) and were less motivated to quit smoking than normal controls (P = .002), even though they were as likely to be in the preparation stage of change. Immediate reinforcement (P = .04) and health concerns (P = .002) were rated lower as motivators for considering quitting smoking in schizophrenia than normals. People with schizophrenia reported greater motivation to stop smoking due to social pressure/rewards than normals (P = .047). This study underscores the degree to which people with schizophrenia perceive the state-enhancing effects of smoking and their lower appreciation for health risks of smoking compared with normal controls.

The Brief Smoking Consequences Questionnaire-Adult (BSCQ-A): Development of a short form of the SCQ-A

A brief form of the Smoking Consequences Questionnaire-Adult (SCQ-A) was developed as an economical alternative to the 55-item SCQ-A in assessing smoking outcome expectancies in adult, heavy smokers. A total of 25 items (two to three items per each of the 10 SCQ-A scales) were administered to current smokers and ex-smokers. Confirmatory factor analysis was used to determine whether the brief form was better accounted for by a 4- or 10-factor model. Several variants of 9- and 8-factor models also were compared. The 10-factor model, representing the 10 subscales of the full-length SCQ-A, fit the data more adequately than the other models. The Brief SCQ-A (BSCQ-A) scales demonstrated good internal consistency (mean coefficient alpha = .79) and convergent validity. The BSCQ-A also showed promising validity in distinguishing among current smokers and ex-smokers. In a separate sample of smokers, strong and positive associations were present between corresponding pairs of the SCQ-A and BSCQ-A subscales.

Examination of a brief Smoking Consequences Questionnaire for college students

This study examined the factor structure of a brief version of the Smoking Consequences Questionnaire-Adult (SCQ-A) among 315 college freshman and sophomore smokers. A comparison of results from two confirmatory factor analyses demonstrated that a nine-factor model provided superior fit to a four-factor model. Furthermore, results revealed a lack of factorial invariance of factor loadings for daily and nondaily smokers, and of latent mean structures for smoking category and gender. In addition, concurrent validity tests demonstrated that positive expectancies increased with smoking rate and nicotine dependence. These results and their implications are discussed.

Smoke and mirrors: Magnified beliefs that cigarette smoking suppresses weight

Research suggests that for some smokers, weight concerns interfere with smoking cessation. Studies with individuals with eating disorders and weight concerns have indicated that weight-concerned individuals place undue faith in the effectiveness of certain weight control strategies; i.e., adopt a brand of magical thinking pertaining to food rules and dieting behaviors. The current study investigated whether weight-concerned smokers endorsed exaggerated beliefs in the ability of smoking to suppress body weight. Participants were 385 individuals undergoing treatment for smoking cessation. Prior to treatment, participants completed the Smoking Consequences Questionnaire-Adult (SCQ-A), the Dieting and Bingeing Severity Scale, and the Perceived Risks and Benefits Questionnaire (PBRQ). Results indicated that heightened beliefs in the effectiveness of smoking to control weight were related to eating and weight concerns; specifically, strong associations were observed between SCQ-A Weight Control scores and fear of weight gain, loss of control over eating, and body dissatisfaction. Although SCQ-A Weight Control scores were related to (self-reported) weight gain during a previous quit attempt, scores did not predict actual weight gain over the course of the cessation trial. Reported weight gain at previous attempts was also unrelated to actual weight gain over the current trial. These findings indicate that eating and weight-concerned smokers may benefit from psychoeducation concerning the relatively modest and temporary ability of nicotine to suppress weight.

A psychometric evaluation of the Smoking Consequences Questionnaire–Adult in smokers with psychiatric conditions

Rates of smoking among individuals with psychiatric conditions are much greater than those seen in the general population, yet little is known about the psychometric properties of commonly used instruments that assess smoking-related variables among smokers with psychiatric conditions. The present study examined the factor structure and psychometric characteristics of the Smoking Consequences Questionnaire-Adult (SCQ-A; Copeland, Brandon, & Quinn, 1995, Psychological Assessment, 7, 484-494) among smokers with psychiatric conditions. A confirmatory factor analysis of the instrument indicated that the factor structure derived by the instrument's authors provided an adequate fit to the data. In addition, many of the 10 subscales of the SCQ-A demonstrated adequate internal consistency as assessed by Cronbach's alpha as well as adequate test-retest reliability over the course of 1 week. Based on the data derived from this sample, the SCQ-A has adequate psychometric properties for applications involving smokers with psychiatric conditions.

Smokers' expectancies for nicotine replacement therapy vs. cigarettes.

Smokers (N=188) recruited from the local community completed a questionnaire that measured expected outcomes of using cigarettes, nicotine gum, nicotine patch, and nicotine nasal spray. Expectancy questions relating to negative affect, craving, weight, and health risks were derived from the Smoking Consequences Questionnaire-Adult. As predicted, smokers held much greater expectancies that cigarettes help control negative affect, craving, and weight relative to nicotine replacement therapy (NRT). All NRT products were expected to cause fewer health risks than cigarette smoking. As predicted, smokers held strong negative affect reduction expectancies for cigarette smoking. For NRT, although still relatively low, craving reduction was the strongest expectancy. Individuals who had experience using the nicotine patch had greater positive expectancies for NRT. Greater positive expectancies for NRT were correlated with more immediate plans to quit smoking. In summary, cigarette smokers' positive expectancies about cigarettes do not appear to generalize to NRT products, which may limit their use and effectiveness.

Use of a brief Smoking Consequences Questionnaire for Adults (SCQ-A) in African American smokers.

Purposes of the present study were to (a) examine psychometric properties of a brief Smoking Consequences Questionnaire-Adult (SCQ-A) among an African American sample and (b) explore differences in smoking expectancies across levels of smoking-nicotine dependence. Four hundred eighty-four smokers attending an urban health clinic completed the brief SCQ-A. Maximum likelihood factor extraction with a varimax rotation specifying 9 factors replicated 9 factors of the original SCQ-A. Evidence for the brief SCQ-A's reliability and validity was found. Heavier and/or more dependent smokers had significantly higher scores than lighter and/or less dependent smokers on positive expectancies SCQ-A subscales. Results suggest the brief SCQ-A may be a useful alternative to the full scale SCQ-A. Results also provide evidence for the SCQ-A's validity with African American smokers.

Do desirability ratings moderate the validity of probability ratings on the Smoking Consequences Questionnaire-Adult? A reanalysis using regression.

Smokers' responses to the Smoking Consequences Questionnaire-Adult (A. L. Copeland, T. H. Brandon, & E. P. Quinn, 1995) were used to determine whether smoking outcome expectancies are moderated by subjective evaluations (desirability ratings) in their effect on smoking-related variables. Hierarchical regression in a reanalysis of data from A. L. Copeland et al. indicated that the product of probability and desirability ratings accounted for a significant amount of variance in smoking rate, nicotine dependence, saliva cotinine, and posttreatment smoking status above that accounted for by probability and desirability ratings alone. Results indicate that desirability ratings serve as moderators to probability ratings in explaining current smoking, nicotine dependence, and continued smoking. Effects were modest in magnitude but suggest that it may be important to address subjective evaluations of outcomes in smoking cessation and relapse prevention efforts.