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. 2020 Apr 1:209:107840.
doi: 10.1016/j.drugalcdep.2020.107840. Epub 2020 Jan 30.

Socioeconomic status, mindfulness, and momentary associations between stress and smoking lapse during a quit attempt

Christopher Cambron  1 , Patricia Hopkins  2 , Cassidy Burningham  3 , Cho Lam  2 , Paul Cinciripini  4 , David W Wetter  2
Affiliations

Socioeconomic status, mindfulness, and momentary associations between stress and smoking lapse during a quit attempt

Christopher Cambron et al. Drug Alcohol Depend. .

Abstract

Background: Models of health disparities highlight stress among low socioeconomic status (SES) smokers as a barrier to cessation. Recent studies suggest that mindfulness may improve cessation outcomes by reducing stress during a quit attempt. The current study examined associations of SES and mindfulness with ecological momentary assessments (EMAs) of stress and smoking lapse during a quit attempt.

Methods: EMAs (N = 32,329) were gathered from 364 smokers engaged in a quit attempt. A multilevel structural equation model estimated within person paths from momentary stress to subsequent smoking lapse. Between person paths estimated paths from a latent variable for SES and mindfulness to stress and smoking lapse, the indirect effect of SES and mindfulness on lapse through stress, and moderation of within person stress-lapse associations by SES and mindfulness.

Results: Within person estimates found that momentary increases in stress predicted increased risk of subsequent smoking lapse. Between person estimates found that lower SES was indirectly associated with greater risk for smoking lapse through increased stress; and, higher mindfulness was indirectly associated with lower risk for smoking lapse through reduced stress. Additionally, higher SES participants, who reported lower stress during the quit attempt, showed a stronger relationship between momentary increases in stress and risk for subsequent smoking lapse.

Conclusions: Among low SES smokers engaged in a quit attempt, both SES and mindfulness uniquely influenced smoking lapse through their influence on stress. Findings support reports that mindfulness presents a promising intervention target to reduce stress and improve cessation outcomes among low SES smokers.

Keywords: Ecological momentary assessment; Mindfulness; SES-related smoking disparities; Stress.

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Conflict of interest statement

Declaration of Competing Interest The authors have no conflicts of interest to report.

Figures

Figure 1.
Figure 1.
Percentage of EMAs during which participants reported “yes” to experiencing an ongoing or new stressor since the previous EMA. SES was measured by a latent variable of income, education, health insurance, and employment and mindfulness was measured by the MAAS. Lo = 1 SD below mean; Mid = mean; Hi = 1 SD above mean.
Figure 2.
Figure 2.
Multilevel structural equation model of socioeconomic status (SES), mindfulness, and momentary measures of stressors and smoking lapse during a quit attempt. Black dots on the within level paths indicate a latent random slope. Subscript i indexes 364 participants and subscript j indexes 32,329 ecological momentary assessments. Within level paths control for the passage of time and width of intervals; between level paths control for race/ethnicity, age, sex, and cigarette availability.
See this image and copyright information in PMC

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