Short-term fluctuations in motivation to quit smoking in a sample of smokers in Hawaii

Acute exercise-induced changes in motivation and behavioral expectation for quitting smoking as predictors of smoking behavior in women

OBJECTIVE

Temporally static self-reports of motivation and behavioral expectation are established predictors of addictive behavior. However, previous research has not tested intervention effects on within-day changes in motivation/behavioral expectation for smoking cessation as mediators of smoking abstinence. The goals of this study were to test whether aerobic exercise exerts acute pre-postexercise effects on motivation and behavioral expectation and to test the main and interactive effects of change in motivation/behavioral expectation for cessation on subsequent smoking abstinence.

METHOD

We conducted secondary analyses of ecological momentary assessment data collected among N = 105 women who participated in a 12-week randomized controlled trial (RCT) examining thrice weekly aerobic exercise (vs. contact control) as an adjunct to cessation treatment. A multilevel, longitudinal mixed-effects model was used to test all pathways simultaneously.

RESULTS

Exercise (vs. control) was associated with greater increases in motivation (p = .04), but not behavioral expectation (p > .05), pre-to-postexercise session. Increases in motivation and behavioral expectation were associated with higher odds of abstinence at next session (ps < .05), and for those with larger changes in behavioral expectation, larger changes in motivation were associated with greater odds of abstinence (p = .02). There was also an indirect effect of exercise on abstinence via acute changes in motivation (p < .05).

CONCLUSIONS

A single bout of exercise can increase motivation for quitting smoking, which may improve quit success. Moreover, increasing behavioral expectation may enhance the effect of increased motivation on cessation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The dynamics of smoking quit motivation in daily life: Associations with momentary self-regulation and nightly quit intentions

Due to prior work suggesting dynamic fluctuations in quit motivation over time, the current study used ecological momentary assessment (EMA) to examine contextual predictors of momentary quit motivation, most notably perceived self-regulation. The sample (n = 84) intentionally excluded smokers actively trying to quit and those who plan to never quit, focusing on the group of smokers who are interested in but not yet committed to quitting. Participants completed one week of EMA, where they responded to random prompts 7x/day and logged each cigarette. At each prompt, they completed measures assessing cigarette craving, affect (positive and negative), quit motivation, and perceived momentary self-regulation (i.e., willpower self-efficacy, distress intolerance, craving uncontrollability). Participants also completed a nightly prompt where they reported their quit intentions. Results revealed that the newly developed 4-item index of quit motivation had strong psychometric properties, and demonstrated fluctuations over time and across situations. Quit motivation was higher when craving was ideographically lower than usual, and when willpower was higher than usual. People with higher distress intolerance reported higher quit motivation. In addition, stronger quit motivation and less variability in quit motivation was associated with higher quit intentions. The current study suggests that quit motivation does shift dynamically and speaks to the potential importance of targeting craving and willpower self-efficacy to enhance people's motivation to quit.

Interactive associations between abstinence plans and romantic partner conflict and support with cigarette smoking

BACKGROUND

While most individuals who smoke cigarettes desire to quit, quit motivation can change daily and sustained abstinence is rarely achieved in quit attempts. Assessment of psychosocial factors that moderate associations between daily abstinence intentions and smoking behavior is necessary to inform effective cessation efforts.

METHODS

A secondary analysis was conducted using data from a 28-day ecological momentary assessment study among individuals who smoke and who were not actively planning a long-term quit attempt (N = 81 individuals; N = 1585 days). We examined main effect and interaction associations between primary predictors (daily abstinence plans and within- and between-person estimates of perceived romantic relationship conflict and support) and daily number of cigarettes smoked, as well as baseline emotion regulation difficulties as a moderator of these associations.

RESULTS

Smoking was reduced on days with an abstinence plan (β=-0.57,p<.001), especially among individuals with lower average levels of conflict (plan × between-person conflict interaction: β=0.98, p < .001), and higher average levels of support (plan × between-person support interaction: β=0.26, p < .001). Additionally, smoking was increased on days when participants had higher levels of conflict than usual (β=0.07, p < .01), but only on days when participants did not have a plan (plan × within-person conflict interaction:β=-0.10, p < .05). Emotion regulation difficulties did not moderate any associations.

CONCLUSION

This study adds to the literature on the influence of negative aspects of social experience on smoking behavior. Further, the present study underlines the importance of assessing the influence of both positive and negative aspects of - and within- and between-person differences in - social experiences.

Predictors of Re-Engagement after Relapse in a Tobacco Quit Line Intervention: Secondary Analysis from a Randomized Clinical Trial

People who smoke often make several quit attempts before successfully maintaining abstinence. Therefore, incorporating re-engagement for people who fail to initially quit could increase quit attempts and ultimately increase cessation rates. Within the context of quit line-based interventions, it remains unknown what characteristics are associated with re-engagement. The purpose of this study was to assess associations between demographic and motivational characteristics, tobacco use, and initial intervention engagement with re-engagement in a tobacco quit line intervention. Among 372 adults who reported smoking three months after initiating a quit line-facilitated quit attempt as part of a larger randomized clinical trial, associations between personal characteristics (e.g., age, gender, nicotine dependence, and confidence in their ability to quit smoking) and initial intervention engagement (number of completed counseling sessions and use of nicotine replacement therapy (NRT)) with re-engagement (accepting an offer to re-initiate the quit line intervention) were determined using multivariable logistic regression modeling. Compared to non-White participants, White participants had lower odds of re-engaging (OR: 0.42, 95% CI: 0.23, 0.75). Number of initial counseling sessions completed was associated with re-engaging. NRT use during the initial intervention was not associated with re-engaging. Initial intervention engagement is important in the process of re-engagement, specifically attending counseling sessions. Exploration of associations between initial intervention engagement and potentially modifiable motivational factors is needed to be potentially leveraged in future interventions to maintain continued engagement in cessation among adults who smoke.

Shifts in momentary motivation to quit smoking based on experimental context and perceptions of motivational instability

BACKGROUND

Smoking quit intentions (i.e., plans or commitments to reduce smoking) are distinct from quit motivation (i.e., desire to quit). Motivation to quit is a dynamic avoidance motivational state, likely subject to frequent fluctuations and shifts based on environmental context, similar to craving (an approach motivational state). Moreover, people's perceptions of motivational instability may influence their momentary quit motivation and beliefs surrounding their abilities to manage the quit process successfully.

METHODS

In the current study, smokers were recruited online. Baseline motivation to quit was examined along with perceptions of motivational instability. Participants who reported some interest in eventually quitting (n = 174; M_age = 45.29, SD = 14.81, 74.1% women) were randomly assigned to negative affect, cigarette or neutral cue conditions and then momentary motivation to quit was assessed, followed by a validated index of quit intentions.

RESULTS

Participants in the negative affect and cigarette cue conditions reported greater momentary motivation to quit than participants in the neutral condition (F = 3.73, p = .03), particularly for people who reported upfront that their motivation did not change from day-to-day (F = 3.97, p = .02). In addition, greater momentary quit motivation predicted stronger quit intentions (B = 0.66, p < .001).

CONCLUSION

Findings from this study suggest that motivation to quit is likely dynamic and influenced by context as well as by self-perceptions. Implications suggest that further efforts to separate motivation from intention may be useful in understanding smokers' desires and plans to quit smoking.

Association between smoking and alcohol-related behaviours: a time-series analysis of population trends in England

AIMS

This paper estimates how far monthly changes in prevalence of cigarette smoking, motivation to quit and attempts to stop smoking have been associated with changes in prevalence of high-risk drinking, and motivation and attempts to reduce alcohol consumption in England.

DESIGN

Data were used from the Alcohol and Smoking Toolkit Studies between April 2014 and June 2016. These involve monthly household face-to-face surveys of representative samples of ~1700 adults in England.

MEASUREMENTS

Autoregressive Integrated Moving Average with Exogeneous Input (ARIMAX) modelling was used to assess the association over time between monthly prevalence of (a) smoking and high-risk drinking; (b) high motivation to quit smoking and high motivation to reduce alcohol consumption; and (c) attempts to quit smoking and attempts to reduce alcohol consumption.

FINDINGS

Mean smoking prevalence over the study period was 18.6% and high-risk drinking prevalence was 13.0%. A decrease of 1% of the series mean smoking prevalence was associated with a reduction of 0.185% of the mean prevalence of high-risk drinking 2 months later [95% confidence interval (CI) = 0.033 to 0.337, P = 0.017]. A statistically significant association was not found between prevalence of high motivation to quit smoking and high motivation to reduce alcohol consumption (β = 0.324, 95% CI = -0.371 to 1.019, P = 0.360) or prevalence of attempts to quit smoking and attempts to reduce alcohol consumption (β = -0.026, 95% CI = -1.348 to 1.296, P = 0.969).

CONCLUSION

Between 2014 and 2016, monthly changes in prevalence of smoking in England were associated positively with prevalence of high-risk drinking. There was no significant association between motivation to stop and motivation to reduce alcohol consumption, or attempts to quit smoking and attempts to reduce alcohol consumption.