Beyond quitting: Predictors of teen smoking cessation, reduction and acceleration following a school-based intervention

Abstract

There remains a great need for effective, cost-efficient, and acceptable youth smoking cessation interventions. Unfortunately, only a few interventions have been demonstrated to increase quit rates among youth smokers, and little is known about how elements of cessation interventions and participants' psychosocial characteristics and smoking histories interact to influence program outcomes. Additionally, few studies have examined how these variables lead to complete smoking abstinence, reduction or acceleration over the course of a structured cessation intervention. Data for the present investigation were drawn from a sample of teen smokers (n = 5892) who voluntarily participated in either a controlled study or field study (i.e., no control group) of the American Lung Association's Not On Tobacco (N-O-T) program between 1998 and 2006 in five states. Results suggest that those who reduce smoking (but do not achieve full abstinence) are similar to those who quit on most measures except stage of change. Furthermore, it was found that those who increased smoking were heavier smokers at baseline, more addicted, were more likely to have parents, siblings, and significant others who smoked and reported less confidence in and less motivation for quitting than did those who quit or reduced smoking. Finally, a path model demonstrated how peers, siblings and romantic partners affected tobacco use and cessation outcomes differently for males and females. Implications for interventions are discussed.

Effects of Physical Activity on Teen Smoking Cessation

“…[10][11][12] In contrast to adult studies, these data provide further justification for enhancing physical activity as part of the N-O-T program for male participants. 18,19 the self-classified point prevalence rates were slightly higher than the 7-day rates. Point prevalence captures whether a participant is smoking at a particular point in time, and results can be validated biochemically, as in our study.…”

“…Table 3 provides a summary of the 18 key variables used to assess the participants' baseline similarity, selected on the basis of their potential relationships to our primary outcomes. 15,19,28,29 In addition to collecting data on daily cigarette use at the follow-up evaluations, we asked participants to classify themselves as "quit" or "not quit." Smoking abstinence was verified with exhaled carbon monoxide (CO) readings, which are valid for a few hours.…”

“…N-O-T was selected as the program of use because it has been demonstrated to be effective and cost-efficient. [17][18][19] The program has been adopted by the American Lung Association and has received several federal designations. 20 Enhancing the potential applicability of our findings, a study found N-O-T to be the most widely used teen smoking intervention in the nation.…”

Predictors of adolescent smoking cessation and smoking reduction

“…the number of cigarettes smoked [8,[11][12][13] as well as alcohol consumption [13,14] are important predictors of smoking abstinence. The result obtained from our final multivariate model that male gender predicted smoking abstinence could be explained by previous findings showing that gender differences in nicotine metabolism [26] as well as concerns about weight gain might deter more women from quitting than men [27].…”

“…Smokingrelated variables that relatively consistently predicted adolescent cessation were nicotine dependence, e.g. a smaller number of cigarettes smoked [8,[11][12][13] lower alcohol consumption [13,14] as well as smoking cessation self-efficacy [11,12,15]. Motivation for quitting or readiness to quit was found to be a significant predictor of smoking cessation in some studies [11,16], however, a recent study that tested readiness to quit and nicotine dependence within one model revealed that only nicotine dependence remained significant [8].…”