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Randomized Controlled Trial
. 2015 May;17(5):566-71.
doi: 10.1093/ntr/ntu192. Epub 2014 Sep 25.

A test of the stress-buffering model of social support in smoking cessation: is the relationship between social support and time to relapse mediated by reduced withdrawal symptoms?

Kasey G Creswell  1 , Yu Cheng  2 , Michele D Levine  3
Affiliations
Randomized Controlled Trial

A test of the stress-buffering model of social support in smoking cessation: is the relationship between social support and time to relapse mediated by reduced withdrawal symptoms?

Kasey G Creswell et al. Nicotine Tob Res. 2015 May.

Abstract

Introduction: Social support has been linked to quitting smoking, but the mechanisms by which social support affects cessation are poorly understood. The current study tested a stress-buffering model of social support, which posits that social support protects or "buffers" individuals from stress related to quitting smoking. We hypothesized that social support would be negatively associated with risk of relapse, and that this effect would be mediated by reduced withdrawal and depressive symptoms (i.e., cessation-related stress) over time. Further, we predicted that trait neuroticism would moderate this mediational effect, such that individuals high in negative affectivity would show the greatest stress-buffering effects of social support.

Methods: Participants were weight-concerned women (n = 349) ages 18-65 enrolled in a randomized, double-blind, placebo-controlled smoking cessation trial of bupropion and cognitive behavioral therapy. Social support was assessed at baseline, and biochemically-verified abstinence, withdrawal-related symptoms, and depressive symptoms were assessed at 1-, 3-, 6-, and 12-months follow-up.

Results: Social support was negatively related to risk of relapse in survival models and negatively related to withdrawal symptoms and depression in mixed effects models. These relationships held after controlling for the effects of pre-quit day negative affect and depression symptoms, assignment to treatment condition, and number of cigarettes smoked per day. A temporal mediation model showed that the effect of social support on risk of relapse was mediated by reductions in withdrawal symptoms over time but not by depression over time. Contrary to hypotheses, we did not find that neuroticism moderated this mediation effect.

Conclusions: Increased social support may buffer women from the harmful effects of cessation-related withdrawal symptoms, which in turn improve cessation outcomes.

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Figures

Figure 1.
Figure 1.
Reductions in withdrawal-related negative affect over time mediates the relationship between social support and risk of relapse.
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References

    1. Mermelstein R, Cohen S, Lichtenstein E, Baer JS, Kamarck T. Social support and smoking cessation and maintenance. J Consult Clin Psychol. 1986;54:447–453. - PubMed
    1. Cohen S, Lichtenstein E, Kingsolver K, Mermelstein R, Baer JS, Kamarck TW. Social support interventions for smoking cessation. In: Gottlieb BH, ed. Marshaling Social Support: Formats, Processes, and Effects. Thousand Oaks, CA: Sage Publications, Inc.; 1988:211–240.
    1. Coppotelli H, Orleans C. Partner support and other determinants of smoking cessation maintenance among women. J Consult Clin Psychol. 1985;53:455–460. - PubMed
    1. Gulliver SB, Hughes JR, Solomon LJ, Dey AN. An investigation of self-efficacy, partner support and daily stresses as predictors of relapse to smoking in self-quitters. Addiction. 1995;90:767–772. - PubMed
    1. Hanson BS, Isacsson SO, Janzon L, Lindell SE. Social support and quitting smoking for good. Is there an association? Results from the population study, “Men born in 1914,” Malmö, Sweden. Addict Behav. 1990;15:221–233. - PubMed

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