Self-monitored smoking motives

Ineffectiveness of the Tobacco Hazards Prevention Act in patients with severe and persistent mental illness

OBJECTIVES

The effect of the Tobacco Hazards Prevention Act (THPA) on the reduction of tobacco use in the general population in Taiwan is understood. However, there has been little research on how these policies affect people with severe and persistent mental illness (SPMI). Hence, the influence of the THPA on daily cigarette use by patients with SPMI was investigated in a 3-year follow-up. The risk and protective factors in smoking behavior and cessation were investigated.

STUDY DESIGN

This is an observational study.

METHODS

A total of 144 participants (78 of whom had smoked >100 cigarettes throughout their lifetime) were randomly selected from a healthcare network. Then, 100 of 144 patients with SPMI, included 50 smokers and 50 non-smokers, have agreed with 1st year follow-up. Eighty-two patients with SPMI, consisted of 44 smokers and 38 non-smokers, have agreed with 2nd year follow-up.

RESULTS

Although women were less likely to smoke than men, those who did smoke reduced the number of cigarettes less than men over the 3-year period. Less-educated patients were more likely to smoke than those who were more educated but reduced the number of daily cigarettes more after implementation of the THPA. Maternal overprotection was a risk factor and paternal care a protective factor for smoking. Addiction, a perception of pleasure, interpersonal relationships, and self-destructive behavior increased cigarette smoking. Patients perceived that smoking alleviated their depressive symptoms.

CONCLUSIONS

The THPA was ineffective for patients with SPMI. Some factors had different effects on the development of smoking behavior and the cessation process. Understanding the etiology of smoking can help policymakers establish more effective programs for smoking prevention and cessation.

Reasons for smoking among tri-ethnic daily and nondaily smokers

INTRODUCTION

Nondaily smokers experience adverse effects from tobacco use, yet they have been understudied compared to daily smokers. Understanding how reasons for smoking (RS) differ by smoking level, gender, and race/ethnicity could inform tailored interventions.

METHODS

A cross-sectional survey was administered through an online panel survey service to 2,376 current smokers who were at least 25 years of age. The sample was stratified to obtain equal numbers of 3 racial/ethnic groups (African American [AA], Latino, and White) across smoking level (native nondaily, converted nondaily, daily light, and daily moderate/heavy).

RESULTS

A 7-factor structure of a 20-item Modified Reasons for Smoking Scale (MRSS) was confirmed (each subscale alpha > 0.80). Each factor of the MRSS varied by smoking level, with nondaily smokers endorsing all RS less frequently than daily smokers (p < .0001). The 4 smoker subgroups incrementally differed from one another (p < .05) with several exceptions between converted nondaily and daily light smokers. Males reported stronger RS on 5 out of 7 reasons (p < .05). Females had higher scores on tension reduction/relaxation (p < .0001). Latinos reported stronger RS than Whites and AAs on all reasons (p < .05) except for tension reduction/relaxation (p > .05). AAs and Whites were comparable on all RS (p > .05).

CONCLUSIONS

The present study highlights considerable variability across smoking level, gender, and race/ethnicity in strength of RS. Addressing subgroup differences in RS may contribute to more sensitive and effective prevention and treatment efforts.

WISDM primary and secondary dependence motives: associations with self-monitored motives for smoking in two college samples

The Wisconsin Inventory of Smoking Dependence Motives (WISDM) assesses 13 domains of smoking motivation emphasized by diverse theoretical perspectives. Emerging findings support a distinction between four primary dependence motives (PDM) indexing core features of tobacco dependence and nine secondary dependence motives (SDM) indexing accessory features. The current study explored the validity of this distinction using data from two samples (Ns=50 and 88) of college smokers who self-monitored their reasons for smoking with electronic diaries. PDM scores were associated with diary endorsement of habitual or automatic motives for smoking individual cigarettes, which are conceptually consistent with the content of the PDM subscales. SDM did not clearly predict conceptually related self-monitored motives when tested alone. However, when these two correlated scale composites were co-entered, PDM predicted being a daily vs. nondaily smoker, being higher in nicotine dependence, and smoking individual cigarettes because of habit or automaticity. Conversely, after PDM-SDM co-entry, the unique variance in the SDM composite predicted the tendency to report smoking individual cigarettes for situational or instrumental motives (e.g., to control negative affect). The results suggest that the PDM composite may reflect core motivational features of nicotine dependence in these young smokers. The relative prominence of primary motives in advanced or dependent use may be even clearer when motives for smoking are assessed in real time rather than reported via questionnaire.

Construct validity and reliability of college students' responses to the reasons for smoking scale

When utilizing self-assessments to determine motives for health behaviors, it is essential that the resulting data demonstrate sound psychometric properties. The purpose of this research was to assess the reliability and construct validity of college students' responses to the Reasons for Smoking Scale (RFS). Confirmatory factor analyses and internal consistency reliability coefficients were completed. The data of 110 college students who smoke fell short of providing a good fit, chi2(130) = 343.856, root mean square error of approximation (RMSEA) = 0.123, comparative fit index (CFI) = 0.793, Tucker-Lewis index (TLI) = 0.756. Reliability coefficients ranged from .615 to .912. Three subscales improved reliability by removing an item. Although the fit indices showed improvement with these modifications, good model fit was still not achieved, chi2(50) = 148.059, RMSEA = 0.134, CFI = 0.872, TLI = 0.831. Although other populations' responses to the RFS have demonstrated validity and reliability, this college population's did not. Health educators should use caution when interpreting the results of college students' responses to the RFS because they may be incomplete and/or inaccurate.

Smoking motives in the prediction of affective vulnerability among young adult daily smokers

The primary aim of this study was to examine whether smoking to reduce negative affect was uniquely related to a range of affective vulnerability factors (e.g., anxiety sensitivity, anxious arousal, and negative affectivity) among daily smokers. Participants were 276 young adult daily smokers (124 females; M(age)=25.12, SD=10.37). Partially consistent with prediction, the motivation to smoke to reduce negative affect was significantly related to anxiety sensitivity and negative affectivity, but not anxious arousal; the observed significant effects were above and beyond other theoretically relevant factors (e.g., smoking rate, years smoked, age, gender). In contrast to prediction, habitual smoking motives demonstrated significant incremental associations with anxiety sensitivity and anxious arousal symptoms. These results suggest that there are important associations between certain smoking motives and negative affective states and that such relations are not attributable to other smoking factors (e.g., smoking rate).