Smoking abstinence-related expectancies among American Indians, African Americans, and women: Potential mechanisms of disparities in cigarette use

Research has documented tobacco-related health disparities by race and gender. Prior research, however, has not examined expectancies about the smoking cessation process (i.e., abstinence-related expectancies) as potential contributors to tobacco-related disparities in special populations. This cross-sectional study compared abstinence-related expectancies between American Indian (n = 87), African American (n = 151), and White (n = 185) smokers, and between women (n = 231) and men (n = 270) smokers. Abstinence-related expectancies also were examined as mediators of race and gender relationships with motivation to quit and abstinence self efficacy. Results indicated that American Indians and African Americans were less likely than Whites to expect withdrawal effects, and more likely to expect that quitting would be unproblematic. African Americans also were less likely than Whites to expect smoking cessation interventions to be effective. Compared with men, women were more likely to expect withdrawal effects and weight gain. These expectancy differences mediated race and gender relationships with motivation to quit and abstinence self-efficacy. Findings emphasize potential mechanisms underlying tobacco-related health disparities among American Indians, African Americans, and women and suggest a number of specific approaches for targeting tobacco dependence interventions to these populations

Physicians are a key to encouraging cessation of smoking among people living with HIV/AIDS: a cross-sectional study in the Kathmandu Valley, Nepal

BackgroundHIV care providers may be optimally positioned to promote smoking behaviour change in their patients, among whom smoking is both highly prevalent and uniquely harmful. Yet research on this front is scant, particularly in the developing country context. Hence, this study describes smoking behaviour among people living with HIV/AIDS (PLWHA) in the Kathmandu Valley of Nepal, and assesses the association between experience of physician-delivered smoking status assessment and readiness to quit among HIV-positive smokers.MethodsWe conducted a cross-sectional survey of PLWHA residing in the Kathmandu Valley, Nepal. Data from 321 adult PLWHA were analyzed using multiple logistic regression for correlates of current smoking and, among current smokers, of motivational readiness to quit based on the transtheoretical model (TTM) of behaviour change.ResultsOverall, 47% of participants were current smokers, with significantly higher rates among men (72%), ever- injecting drug users (IDUs), recent (30-day) alcohol consumers, those without any formal education, and those with higher HIV symptom burdens. Of 151 current smokers, 34% were thinking seriously of quitting within the next 6 months (contemplation or preparation stage of behaviour change). Adjusting for potential confounders, experience of physician-delivered smoking status assessment during any visit to a hospital or clinic in the past 12 months was associated with greater readiness to quit smoking (AOR = 3.34; 95% CI = 1.05,10.61).ConclusionsRoughly one-third of HIV-positive smokers residing in the Kathmandu Valley, Nepal, are at the contemplation or preparation stage of smoking behaviour change, with rates significantly higher among those whose physicians have asked about their smoking status during any clinical interaction over the past year. Systematic screening for smoking by physicians during routine HIV care may help to reduce the heavy burden of smoking and smoking-related morbidity and mortality within HIV-positive populations in Nepal and similar settings

The role of perceived similarity in supportive responses to victims of negative life events

The authors examined whether participants' perceived similarity to an ostensible victim of a negative life event influenced their supportiveness during a live interaction. Two competing models were considered: (a) increased similarity would be associated with increased supportiveness through attraction to the target and (b) increased similarity would be associated with decreased supportiveness through anxiety (due to heightened vulnerability). Participants (N = 241) met individually with a confederate posing as a cancer patient. Reactions were assessed, including verbal and nonverbal behaviors, both before and after the interaction, by participants themselves and by observers of the interaction. Results supported a model based on the classic similarity/attraction paradigm: Perceived similarity indirectly predicted participant-reported supportiveness/warmth and smiling through its relationship to attraction. Results extend the literature on similarity and attraction to the stress and coping arena and suggest that emphasizing perceived similarities to victims would be beneficial

Peer mentoring and automated text messages for smoking cessation: a randomized pilot trial

Introduction Text-messaging programs for smoking cessation, while efficacious, have high dropout rates. To address this problem, we developed and tested the feasibility and early efficacy of a peer-mentoring intervention for smoking cessation provided by former smokers. Methods Adult US smokers were recruited nationally into a randomized pilot trial (N = 200), comparing 6–8 weeks of automated text-messaging support (SmokefreeTXT) and automated text support plus personalized texts from a peer mentor who formerly smoked. The primary outcome was biochemically verified 7-day point-prevalence abstinence at 3 months post-quit date, assessed on an intention-to-treat basis (missing = smoking). Self-reported abstinence, program acceptability, user engagement, and user perceptions were also assessed. Results Biochemically verified abstinence at 3 months was 7.9% (8/101) in the intervention group and 3.0% (3/99) in the control group (adjusted difference 6.5, 95% CI = 0.7% to 12.3%; p = .03). Self-reported abstinence at 3 months was 23.8% (24/101) in the intervention group versus 13.1% (13/99) in the control group (adjusted difference 12.7, 95% CI = 1.2% to 24.1%; p = .03). The intervention had a positive but insignificant effect on overall satisfaction (78.3% vs. 72.9% control group, p = .55). Having a mentor did not significantly alter duration of interaction with the program nor the proportion unsubscribing, although the intervention group reset their quit date with greater frequency (p Conclusions Peer mentoring combined with automated text messages was feasible and acceptable and increased smoking abstinence compared with automated messages alone. The results highlight the promise of this intervention approach and the need for a full-scale evaluation. Implications Providing quitting assistance by automated text messaging has been shown to increase smoking abstinence. Yet, dropout rates in text-messaging programs are high. No studies have tested the effectiveness of peer mentors who are former smokers as part of a text-messaging intervention, although they represent a promising way to retain, engage, and support smokers. This randomized pilot trial suggests that peer mentors can complement automated text-messaging programs to promote smoking abstinence.</p

Peer mentoring and automated text messages for smoking cessation: a randomized pilot trial

Introduction Text-messaging programs for smoking cessation, while efficacious, have high dropout rates. To address this problem, we developed and tested the feasibility and early efficacy of a peer-mentoring intervention for smoking cessation provided by former smokers. Methods Adult US smokers were recruited nationally into a randomized pilot trial (N = 200), comparing 6–8 weeks of automated text-messaging support (SmokefreeTXT) and automated text support plus personalized texts from a peer mentor who formerly smoked. The primary outcome was biochemically verified 7-day point-prevalence abstinence at 3 months post-quit date, assessed on an intention-to-treat basis (missing = smoking). Self-reported abstinence, program acceptability, user engagement, and user perceptions were also assessed. Results Biochemically verified abstinence at 3 months was 7.9% (8/101) in the intervention group and 3.0% (3/99) in the control group (adjusted difference 6.5, 95% CI = 0.7% to 12.3%; p = .03). Self-reported abstinence at 3 months was 23.8% (24/101) in the intervention group versus 13.1% (13/99) in the control group (adjusted difference 12.7, 95% CI = 1.2% to 24.1%; p = .03). The intervention had a positive but insignificant effect on overall satisfaction (78.3% vs. 72.9% control group, p = .55). Having a mentor did not significantly alter duration of interaction with the program nor the proportion unsubscribing, although the intervention group reset their quit date with greater frequency (p Conclusions Peer mentoring combined with automated text messages was feasible and acceptable and increased smoking abstinence compared with automated messages alone. The results highlight the promise of this intervention approach and the need for a full-scale evaluation. Implications Providing quitting assistance by automated text messaging has been shown to increase smoking abstinence. Yet, dropout rates in text-messaging programs are high. No studies have tested the effectiveness of peer mentors who are former smokers as part of a text-messaging intervention, although they represent a promising way to retain, engage, and support smokers. This randomized pilot trial suggests that peer mentors can complement automated text-messaging programs to promote smoking abstinence.</p

Afraid and tired: A longitudinal study of the relationship between cancer‐related fatigue and fear of cancer recurrence in long‐term cancer survivors

Abstract Objective Cancer‐related fatigue (CRF) and fear of cancer recurrence (FCR) are two common concerns experienced by cancer survivors. However, the relationship between these two concerns is poorly understood, and whether CRF and FCR influence each other over time is unclear. Methods Data were from a national, prospective, longitudinal study, the American Cancer Society's Study of Cancer Survivors‐I (SCS‐I). Surveys were completed by 1395 survivors of 10 different cancer types at three time‐points, including assessment 1.3 years (T1), 2.2 years (T2) and 8.8 years (T3) following their cancer diagnosis. CRF was assessed using the fatigue‐inertia subscale of the Profile of Mood States, and FCR by the FCR subscale of the Cancer Problems in Living Scale. Multiple group random intercepts cross‐lagged panel models investigated prospective associations between CRF and FCR. Results For younger participants (at or below median age of 55 years, n = 697), CRF at T1 and T2 marginally and significantly predicted FCR at T2 and T3, respectively, but no lagged effects of FCR on subsequent CRF were observed. Cross‐lagged effects were not observed for survivors over 55 years of age. Conclusion Both CRF and FCR are debilitating side effects of cancer and its treatments. Given that CRF may be predictive of FCR, it possible that early detection and intervention for CRF could contribute to lowering FCR severity