Predicting successful 24-hr quit attempt in a smoking cessation intervention

Abstract

Introduction: The factors that influence the initial phase of quitting smoking have been understudied. Although maintenance of change is the ultimate test of the efficacy of treatment, maintenance is a nonissue for those who fail to manage even brief periods of abstinence. We examined factors associated with smokers' ability to achieve a targeted 24-hr quit during a smoking cessation program. As a comparison, we also examine whether predictors of an initial quit are different from factors that predict smoking abstinence at 52-week follow-up.

Methods: Using baseline data from a randomized clinical trial to examine the efficacy of selegiline for cigarette smoking cessation (n = 280), we conducted univariate analyses (analysis of variance or chi-square) to determine statistically significant predictors of a successful quit attempt (SQA) versus unsuccessful quit attempt. Multiple logistic regression was performed with significant predictors from the univariate analyses to determine main effects and interactions in a multivariate model. The same factors and analyses were used to examine predictors of 52-week point prevalence abstinence.

Results: Lower nicotine dependence (modified Fagerström Tolerance Questionnaire [mFTQ]), higher Behavioral Inhibition System score, and lower baseline heart rate were predictive of SQA in both the univariate and the multivariate models. Gender was the only predictor of 52-week smoking abstinence.

Conclusions: Predictors of initial induction of change were not predictors of abstinence at the 1-year follow-up, suggesting that different factors mediate the different subprocesses of behavior change. Knowledge of these pretreatment factors that moderate a SQA could help clinicians target smokers who need more intensive therapy during the initial induction of cessation.