Laura J. Solomon

This study examined cognitive barriers that might prevent cigarette smokers who are interested in quitting from calling a smoking quitline. Using qualitative and quantitative methods, we developed a 53-item inventory of possible cognitive barriers to quitline access. A total of 641 daily smokers who reported high intentions to stop smoking in the next 30 days completed this inventory and were then prompted to call a toll-free smoking quitline (800-QUIT NOW) on 3 occasions. Two months later, they completed a follow-up phone interview to assess use of the quitline, quit attempts, and smoking status. Exploratory and confirmatory factor analysis of the barrier items revealed a 5-factor solution: stigma, low appraisal of the service, no need for assistance, poor fit with the service, and privacy concerns. Endorsements of barrier factors were generally low. Although several barrier factor scores predicted concurrent intentions to call a quitline in the near future, none prospectively predicted calling the quitline by 2-month follow-up. Cognitive barriers to use of quitlines remain elusive.

Theory-driven, mass media interventions prevent smoking among youth. This study examined effects of a media campaign on adolescent smoking cessation. Four matched pairs of media markets in four states were randomized to receive or not receive a 3-year television/radio campaign aimed at adolescent smoking cessation based on social cognitive theory. The authors enrolled 2,030 adolescent smokers into the cohort (n = 987 experimental; n = 1,043 comparison) and assessed them via annual telephone surveys for 3 years. Although the condition by time interaction was not significant, the proportion of adolescents smoking in the past month was significantly lower in the experimental than comparison condition at 3-year follow-up when adjusted for baseline smoking status. The media campaign did not impact targeted mediating variables. A media campaign based on social cognitive constructs produced a modest overall effect on smoking prevalence among adolescents, but the role of theory-based constructs is unclear.

This study examined the relationship between smoking status and psychological symptoms in pregnant women across pregnancy. Participants were 45 women who quit smoking early in pregnancy (early quitters), 22 who quit later in pregnancy (later quitters), and 84 who smoked throughout pregnancy (never quitters). Assessments of smoking status and psychological symptoms (Brief Symptom Inventory and Beck Depression Inventory) occurred near first prenatal visit, second visit, and end of pregnancy. Results indicated that scores on the Global Severity Index of the Brief Symptom Inventory, several Brief Symptom Inventory subscales, and on the Beck Depression Inventory were highest among never quitters, lowest among early quitters, and intermediate for later quitters. Scores decreased across pregnancy, especially between first and second assessments. We found no evidence that quitting smoking increased psychological symptoms either in the immediate post-withdrawal period or later in pregnancy. These findings should temper concerns that quitting smoking may have detrimental psychological consequences during pregnancy.