Self-efficacy to resist smoking as a mediator between nicotine dependence and quit attempt among adolescent smokers in Alabama

Prevention and control of tobacco use is an important research focus in public health as it is the leading preventable cause of death in the United States. In Alabama, the percentage of high school smokers has increased to 27%. A goal of Healthy People 2010 is to reduce cigarette smoking among adolescents to 16% and to increase cessation attempts.

Addictive behaviors like smoking can be explained using Social Cognitive Theory (Bandura, 1977) and the Relapse Prevention Model (Marlatt and Gordon, 1985). Enhanced abstinence self-efficacy (ASE) is associated with decreased addictive behaviors, including nicotine dependence (ND). Based on the two theories, the researcher postulated that ASE at baseline mediates the relationship between nicotine dependence (ND) at baseline (T1) and the report of a quit attempt at 12-months post-intervention follow-up (T2).

This research was a secondary analysis of the data collected for an evaluation of the Not-On-Tobacco (N-O-T) adolescent smoking cessation program. Forty-four intervention schools were selected across Alabama, yielding a sample of 245 intervention and 224 control students. Smokers aged 16 to 19 years voluntarily participated in the smoking cessation program. The survey included measures of ASE, ND, and QA. Two measures of ND, the Fagerström Test for Nicotine Dependence and the Hooked On Nicotine Checklist were used to generate the hypotheses and the Baron and Kenny (1986) test for mediation was used for the data analyses. The two main hypotheses were not supported by the analyses. However, secondary findings that emerged are supported in the existing body of professional research.