Momentary Predictors of Tobacco Lapse Among African Americans During a Quit Attempt
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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.