Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116836

Kathleen S. Crittenden, PhD¹, Clara Manfredi, PhD², Young Ik Cho, MA, PhD³, Shasha Gao, MS², and Therese A. Dolecek, PhD⁴. (1) Sociology Department, University of Illinois at Chicago, 1007 W. Harrison St. (M/C 312), Chicago, IL 60607, 312-996-3009, kcritt@uic.edu, (2) Cancer Center, University of Illinois at Chicago, Health Research and Policy Centers, 850 W. Jackson Blvd. M/C 275, Chicago, IL 60607, (3) Survey Research Laboratory, University of Illinois at Chicago, 412 South Peoria Street, 6th Floor, Chicago, IL 60607-7069, (4) Program in Cancer Control and Population Science (MC 275), University of Illinois at Chicago Cancer Center, 1747 W. Roosevelt Road Suite 558, Chicago, IL 60608-1264

Smoking prevalence rates remain high among women of childbearing age and low SES, despite an overall decline in smoking nationally. We track smoking outcomes – quitting, stage of readiness, action, motivation, self-efficacy, and confidence – over time among a panel of 943 women smokers recruited into a clinic-based minimal smoking cessation intervention trial, assessing outcomes at 2, 6, 12, and 18 months after the initial clinic visit. As previously reported, demographic factors have little predictive power in this relatively homogeneous panel, but outcomes over time are diminished by a woman's level of habituation to smoking and enhanced by her initial level of readiness to quit and by participation in the intervention. Controlling for these factors, we use hierarchical linear modeling to assess how a woman's outcomes are affected by intervening events – pregnancy and exposure to additional smoking cessation interventions – in her life. We assess the direct effects of these events on smoking outcomes, as well as indirect effects through two mediating variables – perceived stress and health concerns. Intervening events and mediators are treated as time-varying covariates in the longitudinal models. Results and Implications. Intervening events in smokers' lives exert powerful influences on the long-term outcomes of smoking cessation interventions. All six smoking outcomes were negatively related to perceived stress and positively related to health concerns varying over time. Pregnancy and additional exposure to smoking cessation interventions had both direct and indirect effects on outcomes. Public health smoking interventions must acknowledge these everyday influences and provide tools for handling them.

Learning Objectives:

• Recognize the influence of levels of addiction and readiness to quit on a smoker's outcomes over time.
• Controlling for intervention exposure and a smoker's levels of addiction and readiness, articulate the additional imnpact of events in the smoker's life.
• Identify the pathways through which these events influence smoking outcomes.
• Consider how interventions might be designed to accommodate these everyday influences.

Keywords: Tobacco, Women

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.