Sex differences in smoking constructs and abstinence: The explanatory role of smoking outcome expectancies

Abstract

Scientific evidence suggests women experience more severe problems when attempting to quit smoking relative to men. Yet, little work has examined potential explanatory variables that maintain sex differences in clinically relevant smoking processes. Smoking outcome expectancies have demonstrated sex differences and associative relations with the smoking processes and behavior, including problems when attempting to quit, smoking-specific experiential avoidance, perceived barriers to quitting, and smoking abstinence. Thus, expectancies about the consequences of smoking may explain sex differences across these variables. Accordingly, the current study examined the explanatory role of smoking-outcome expectancies (e.g., long-term negative consequences, immediate negative consequences, sensory satisfaction, negative affect reduction, and appetite weight control) in models of sex differences across cessation-related problems, smoking-specific experiential avoidance, perceived barriers to quitting, and smoking abstinence. Participants included 450 (48.4% female; Mage = 37.45, SD = 13.50) treatment-seeking adult smokers. Results indicated that sex had an indirect effect on problems when attempting to quit smoking through immediate negative consequences and negative affect reduction expectancies; on smoking-specific experiential avoidance through long-term negative consequences, immediate negative consequences, and negative affect reduction expectancies; on barriers to quitting through negative affect reduction expectancies; and on abstinence through appetite weight control expectancies. The current findings suggest that sex differences in negative affect reduction expectancies and negative consequences expectancies may serve to maintain maladaptive smoking processes, whereas appetite weight control expectancies may promote short-term abstinence. These findings provide initial evidence for the conceptual role of smoking expectancies as potential "linking variables" for sex differences in smoking variables. (PsycINFO Database Record

Figure 1

Conceptual model of tested pathways. Note: a path = Effect of X on M; b paths = Effect of M on Y_i; c’ paths = Direct effect of X on Y_i controlling for M_i. Three separate paths were conducted (Y_1–4) with the predictor (M_1–5). Covariates included: Presence Axis 1 (First et al., 1994), Tobacco-Related Medical Illnesses (Buckner et al., 2015), Fagerström Test for Cigarette Dependence (Heatherton et al., 1991), and Positive and Negative Affect Schedule-Negative Affect Subscale (Watson et al., 1998). SCQ-LT = Smoking Consequence Questionnaire-Long Term Consequences; SCQ-IC = Smoking Consequence Questionnaire-Immediate Negative Consequences; SCQ-SS = Smoking Consequence Questionnaire-Sensory Satisfaction; SCQ-NR = Smoking Consequence Questionnaire-Negative Reinforcement; SCQ-AW = Smoking Consequence Questionnaire-Appetite-Weight Control (Garey et al., 2017); Quit problems = Smoking History Questionnaire (Brown et al., 2002), AIS = Smoking-specific Avoidance and Inflexibility Scale (Gifford & Lillis, 2009); BCS = Barriers to Cessation Scale (Macnee & Talsma, 1995); Abstinence = 1-week post-quit abstinence (0 = not abstinent; 1 = abstinent).