Changes in smoking expectancies in abstinent, reducing, and non-abstinent participants during a pharmacological trial for smoking cessation

Abstract

Introduction: Smoking expectancies are related to smoking consumption and predict smoking cessation. Little is known about whether expectancies change during smoking treatments, consistent with changes in smoking behavior. This study examined reported changes in smoking beliefs during an 8-week smoking cessation trial, which evaluated the safety and efficacy of the monoamine oxidase B inhibitor selegiline hydrochloride versus placebo.

Methods: Participants were classified as "Quit" (n = 18), "Reduced" (n = 34), or "Not Quit" (n = 49) by 7-day point prevalence abstinence at the end of treatment. Expectancies were assessed at randomization, 1 week after the target quit date, and at the end of treatment.

Results: Beliefs about smoking assessed prior to the quit attempt were not associated with cessation outcomes. Participants who quit smoking reported a reduction in expectations that smoking would reduce negative affect, boredom, and cravings, and facilitate social interactions, while participants who did not quit smoking reported an increase in Negative Social Impression beliefs. There were gender differences in beliefs related to Negative Affect Reduction, Negative Physical Feelings, Social Facilitation, and Cravings and significant Gender X Smoking Status interactions for Health Risk and Weight Control beliefs. There were no significant effects of medication on expectancies.

Discussion: Baseline expectancies were not associated with abstinence outcomes; however, expectancies changed over time with changes in smoking, and the greatest changes were seen with smoking abstinence. Information about the relationship between smoking beliefs and behaviors may be used to enhance or tailor smoking cessation treatments.

Figure 1.

Changes in (A) Negative Affect Reduction, (B) Negative Boredom Reduction, and (C) Craving/Addiction expectancies for Quit (n = 18), Reduced (n = 34), and Not Quit (n = 49) participants at the beginning of the trial (Week 1), 1 week after the target quit date (Week 4), and at the study endpoint (Week 9). *p < .05, Quit compared with Not Quit; **p < .01, Quit compared with Not Quit; +p < .05, Quit compared with Reduced.