3.1 Sample Description
The sample (N=60) had a mean age of 19.5 years (SD=2.9, Range: 13 to 25) and was 52% female. The sample was ethnically diverse with 41.6% Caucasian, 25.0% Hispanic/Latino, 15.0% multi-racial, 6.6% African American, 5.0% Asian, 6.4% other, and 1.6% American Indian/Alaska Native. All participants were receiving outpatient mental health treatment, with group or individual therapy visits comprising the greatest number of outpatient treatment encounters in the past month (median=3.0 group or individual visits). Mean (SD) scores on the BASC-2 internalizing and BASIS-24 depression scales for the older and younger subgroups were 53.71 (12.64) and 1.51 (0.76), respectively. Sixty-three percent of the sample was trauma-exposed, and trauma-exposure was associated with significantly greater depression/internalizing symptomatology (p=0.02). The prevalence of past month alcohol, marijuana and other illicit drug use was 58.3%, 50.0%, and 21.7%, respectively. Only 3 participants (5.1%) had an outpatient visit for alcohol or drug treatment in the past 30 days.
The sample smoked an average of 8.0 (SD=6.6) cigarettes per day and had a moderate level of nicotine dependence (M=4.8, SD=1.6). Most participants (63%) were daily smokers (i.e., smoked on at least 97% of the past 30 days). Over half the sample (52%) was in precontemplation, 37% was in contemplation, and 11% was in preparation. Participants had moderate levels of desire to quit (M=5.1, SD=2.6) and anticipated success with quitting (M=4.6, SD=2.6) and higher levels of expected difficulty with staying quit (M=6.7, SD=2.6). Paired-sample t-tests indicated that individuals’ ratings of perceived difficulty were significantly higher than their ratings of desire (t=-3.26, p=0.002) and perceived success with quitting (t=-3.86, p<0.001). Only 25.0% of the sample identified the goal of quitting smoking for good, 23.3% had no goal, and 51.7% had a goal to reduce consumption or quit for a limited period of time. Nearly half (46%) the sample had a parent who smoked; 50% described their home as smoke-free; only 27% described the place where they usually spend most of their time as smoke-free. On average, participants identified three of their five closest friends as current smokers (M=3.1, SD=1.7).
3.2 Correlates of Tobacco Dependence
Tobacco dependence, as measured by the mFTQ, was strongly correlated with cigarettes per day (r=0.64, p<0.001). Tobacco dependence (r=-0.32, p=0.01) but not cigarettes per day (r=-.21, p=0.11) was significantly inversely correlated with the number of lifetime quit attempts. The number of cigarettes smoked per day was significantly associated with abstinence goal (F=3.62, df=2, 57, p=0.03); participants with a goal for complete abstinence were the heaviest smokers (M=11.8, SD=7.17), those with a partial abstinence goal were the lightest (M=6.53, SD=5.99), and those with no goal smoked a M=7.11 (SD=6.24) cigarettes per day. Tobacco dependence was not associated with abstinence goal. Tobacco dependence and cigarettes per day also were unrelated to stage of change, the TAA measures of desire, perceived success, and difficulty, mental health severity, peer and parent smoking, secondhand smoke exposure, and other substance use (all p’s>0.09).
3.3 Correlates of Thoughts about Abstinence and Stage of Change
Desire to quit smoking and expected success with quitting were significantly positively correlated (r=.38, p=0.002). Perceived difficulty was inversely correlated with expected success (r=-.37, p=0.004), but not desire to quit (r=.-06, p=0.96). Abstinence goal and desire to quit were significantly associated (F=8.93, df=2, 57, p<0.001); participants with a goal to quit completely reported greater desire to quit than those with no goal to quit (M=7.20, SD=2.06 and M=3.64, SD=1.97, respectively). Participants in the precontemplation stage had significantly lower desire to quit and anticipated less success with quitting relative to participants in contemplation or preparation (desire to quit, F=16.4, df=2, 57, p<0.001; expected success with quitting, F=8.58, df=2, 57, p=0.001, ). Perceived difficulty with staying quit did not vary significantly by stage of change. Stage of change was significantly associated with abstinence goal (χ2=11.9, df=4, p=0.01), where participants in precontemplation were the most likely to have no abstinence goal, participants in preparation were the most likely to endorse a goal for complete abstinence, and those in contemplation favored a goal to partially quit or reduce ().
ANOVA of Thoughts about Abstinence Measures by Stage of Change (N=60)
Stage of Change and Abstinence Goal (N=60)
Neither the number of outpatient mental health visits, level of depressive symptoms, history of trauma, or substance abuse treatment was significantly associated with stage of change, abstinence goal, or ratings of desire, success, or difficulty (all p>0.20). Past 30 day use of marijuana was associated with greater perceived difficulty with staying quit from tobacco (t=-2.05, p=0.03), and other illicit drug use was associated with lower expected success with quitting smoking (t=2.45, p=0.02).
In terms of social/environmental variables, having more close friends who smoked was positively associated with participants’ perceived difficulty with staying quit (r=0.25, p<0.01), while parental smoking was unrelated (t=-1.73, p=.09). Participants’ secondhand smoke exposure in the home and in the place where they spend most of their time were unrelated to measures of motivation to quit.