Erika Ashley Pinsker1, Deborah Jane Hennrikus2, Darin J Erickson3, Kathleen Thiede Call4, Jean Lois Forster5, Kolawole Stephen Okuyemi6. 1. Minneapolis VA Health Care System, Center for Chronic Disease Outcomes Research, One Veterans Drive, Minneapolis, MN 55417, USA; University of Minnesota, Department of Medicine, 401 East River Parkway Suite 131, Minneapolis, MN 55455, USA. Electronic address: Erika.Pinsker@va.gov. 2. University of Minnesota, Division of Epidemiology and Community Health, 1300 S 2nd St., Minneapolis, MN 55455, USA. Electronic address: hennr001@umn.edu. 3. University of Minnesota, Division of Epidemiology and Community Health, 1300 S 2nd St., Minneapolis, MN 55455, USA. Electronic address: erick232@umn.edu. 4. University of Minnesota, Division of Health Policy & Management, 516 Delaware St. SE Suite 15-223, Minneapolis, MN 55455, USA. Electronic address: callx001@umn.edu. 5. University of Minnesota, Division of Epidemiology and Community Health, 1300 S 2nd St., Minneapolis, MN 55455, USA. Electronic address: forst001@umn.edu. 6. University of Utah, Department of Family and Preventive Medicine, 375 Chipeta Way Suite A, Salt Lake City, UT 84108, USA. Electronic address: kola.okuyemi@hsc.utah.edu.
Abstract
INTRODUCTION: In the U.S., approximately 73% of homeless adults smoke cigarettes and they experience difficulty quitting. Homeless smokers report low self-efficacy to quit and that smoking urges are a barrier to quitting. Self-efficacy to quit and smoking urges are dynamic and change throughout smoking cessation treatment. This study examines changes in self-efficacy to quit and smoking urges throughout a smoking cessation intervention among the homeless and identifies predictors of change in these characteristics. METHODS:Homeless smokers (n=430) participating in a smoking cessation randomized controlled trial in the U.S. completed surveys at baseline, and weeks 1, 2, 4, 6, 8, and 26 on demographic and smoking characteristics (i.e., confidence to quit, self-efficacy to refrain from smoking, and smoking urges). A growth curve analysis was conducted by modeling change in the smoking characteristics over time and examining the variability in the change in smoking characteristics by demographic characteristics and treatment group. RESULTS: Among the full sample, self-efficacy to refrain from smoking increased linearly over time, confidence to quit increased until the midpoint of treatment but subsequently decreased, and smoking urges decreased until the midpoint of treatment but subsequently increased. There were race differences in these trajectories. Racial minorities experienced significantly greater increases in self-efficacy to refrain from smoking than Whites and Blacks had higher confidence to quit than Whites. CONCLUSIONS: White participants experienced less increase in self-efficacy to refrain from smoking and lower confidence to quit and therefore may be a good target for efforts to increase self-efficacy to quit as part of homeless-targeted smoking cessation interventions. Sustaining high confidence to quit and low smoking urges throughout treatment could be key to promoting higher cessation rates among the homeless. Published by Elsevier Ltd.
RCT Entities:
INTRODUCTION: In the U.S., approximately 73% of homeless adults smoke cigarettes and they experience difficulty quitting. Homeless smokers report low self-efficacy to quit and that smoking urges are a barrier to quitting. Self-efficacy to quit and smoking urges are dynamic and change throughout smoking cessation treatment. This study examines changes in self-efficacy to quit and smoking urges throughout a smoking cessation intervention among the homeless and identifies predictors of change in these characteristics. METHODS: Homeless smokers (n=430) participating in a smoking cessation randomized controlled trial in the U.S. completed surveys at baseline, and weeks 1, 2, 4, 6, 8, and 26 on demographic and smoking characteristics (i.e., confidence to quit, self-efficacy to refrain from smoking, and smoking urges). A growth curve analysis was conducted by modeling change in the smoking characteristics over time and examining the variability in the change in smoking characteristics by demographic characteristics and treatment group. RESULTS: Among the full sample, self-efficacy to refrain from smoking increased linearly over time, confidence to quit increased until the midpoint of treatment but subsequently decreased, and smoking urges decreased until the midpoint of treatment but subsequently increased. There were race differences in these trajectories. Racial minorities experienced significantly greater increases in self-efficacy to refrain from smoking than Whites and Blacks had higher confidence to quit than Whites. CONCLUSIONS: White participants experienced less increase in self-efficacy to refrain from smoking and lower confidence to quit and therefore may be a good target for efforts to increase self-efficacy to quit as part of homeless-targeted smoking cessation interventions. Sustaining high confidence to quit and low smoking urges throughout treatment could be key to promoting higher cessation rates among the homeless. Published by Elsevier Ltd.
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