Momentary predictors of tobacco lapse among African Americans during a quit attempt.

BACKGROUND AND AIMS

African American smokers are less likely to successfully quit and experience a greater burden of tobacco-related health outcomes than White individuals. There is a profound need to understand factors that impact tobacco cessation among African Americans who are undergoing a quit attempt. This study aimed to examine the within- and between-person associations of risk factors (motivation, self-efficacy, urge, positive affect, negative affect, smoking expectancies, and cigarette availability) with lapse.

DESIGN AND SETTING

Observational study in the Houston, TX area that used ecological momentary assessment (EMA) to collect data for 10 days following a smoking quit attempt. Multilevel modeling was used to test associations between risk factors and lapse.

PARTICIPANTS

N = 211 African American adults, 51 % female, and ages 18-74.

MEASUREMENTS

EMA was used to assess risk factors (motivation, self-efficacy, urge, positive affect, negative affect, smoking expectancies, and cigarette availability) and lapse.

FINDINGS

At the within-person level, moments characterized by greater urge, smoking expectancies, and cigarette availability were associated with greater risk of lapse in daily life. At the between-person level, those who had lower motivation and self-efficacy and greater urge, smoking expectancies, and cigarette availability were more likely to lapse in daily life.

CONCLUSIONS

The current study addresses important theoretical underpinnings regarding the dynamic nature of predictors of lapse. Although some predictors (urge, smoking expectancies, cigarette availability) did have a significant effect with lapse in expected directions, between person effects may be increasingly important in this population, and additional momentary predictors should be explored in future research.