title: Smoking cessation processes in low-SES women: the impact of time-varying pregnancy status, health care messages, stress, and health concerns.
abstract: We tracked smoking outcomes - quitting, stage of readiness, action, motivation, self-efficacy, and confidence - over time among 943 low-SES women smokers accrued in an earlier smoking cessation intervention trial conducted in public health clinics. We assessed outcomes at 2, 6, 12 and 18 months post-initial clinic visit. Controlling for baseline characteristics and earlier program participation, we used hierarchical linear modeling to assess how intervening life events - pregnancy and exposure to subsequent clinic smoking interventions - affected smoking outcomes directly and indirectly, through the mediators, perceived stress and health concerns.
  
  
  RESULTS
  All longitudinal smoking outcomes were positively related to health concerns and negatively related to perceived stress. Pregnancy favorably influenced all smoking outcomes but confidence, but exposure to additional interventions affected only motivation. Health concerns and stress partially mediated the positive impact of pregnancy.
  
  
  CONCLUSIONS
  Public health efforts targeted to low-SES women smokers should continue to emphasize the benefits of quitting smoking for health maintenance and incorporate more effective stress-coping mechanisms. Pregnancy increases abstinence, but preventing post-delivery relapse may require stress management and re-focusing of health concerns.
authors.affiliation: Sociology Department, University of Illinois at Chicago, 1007 W. Harrison St. (M/C 312), Chicago, IL 60607, USA. kcritt@uic.edu
authors.forename: Kathleen S
authors.initials: KS
authors.lastname: Crittenden
authors.forename: Clara
authors.initials: C
authors.lastname: Manfredi
authors.forename: Young I
authors.initials: YI
authors.lastname: Cho
authors.forename: Therese A
authors.initials: TA
authors.lastname: Dolecek
mesh_terms: D001294:Attitude to Health; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006801:Humans; D011247:Pregnancy; D020377:Self Efficacy; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D012933:Social Identification; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors