Social cognitive mediators of adolescent smoking cessation: results from a large randomized intervention trial

Abstract

Only one prior study has examined why adolescent smoking cessation interventions are effective. To address this understudied and important issue, we examined whether a large adolescent smoking cessation intervention trial's outcomes were mediated by social cognitive theory processes. In a randomized trial (N = 2,151), counselors proactively delivered a telephone intervention to senior year high school smokers. Mediators and smoking status were self-reported at 12-months postintervention eligibility (88.8% retention). At least 6-months abstinence was the outcome. Among all enrolled smokers, increased self-efficacy to resist smoking in (a) social and (b) stressful situations together statistically mediated 55.6% of the intervention's effect on smoking cessation (p < .001). Among baseline daily smokers, increased self-efficacy to resist smoking in stressful situations statistically mediated 56.9% of the intervention's effect (p < .001). Self-efficacy to resist smoking is a possible mediator of the intervention's effect on smoking cessation.

Figure 1

HS Study experimental design. Note. ^aOf the 901 (6.9%) who did not complete baseline survey: 524 (4.0%) absent/no reply, 377 (2.9%) declined. ^bTwenty-four smokers who declined further contact were excluded. ^cTrial participants who declined study participation post randomization.