title: Subjective social status affects smoking abstinence during acute withdrawal through affective mediators.
abstract: OBJECTIVE
  Direct and mediated associations between subjective social status (SSS), a subjective measure of socio-economic status, and smoking abstinence were examined during the period of acute withdrawal among a diverse sample of 421 smokers (33% Caucasian, 34% African American, 33% Latino) undergoing a quit attempt.
  
  
  METHODS
  Logistic regressions examined relations between SSS and abstinence, controlling for socio-demographic variables. Depression, stress, positive affect and negative affect on the quit day were examined as potential affective mediators of the SSS-abstinence association, with and without adjusting for pre-quit mediator scores.
  
  
  RESULTS
  SSS predicted abstinence to 2 weeks post-quit. Abstinence rates were 2.6 (postquit week 1) and 2.4 (postquit week 2) times higher in the highest versus the lowest SSS quartile. Depression and positive affect mediated the SSS-abstinence relationships, but only depression maintained significance when adjusting for the baseline mediator score.
  
  
  CONCLUSIONS
  Among a diverse sample of quitting smokers, low SSS predicted relapse during acute withdrawal after controlling for numerous covariates, an effect accounted for partially by quit day affective symptomatology. Smokers endorsing lower SSS face significant hurdles in achieving cessation, highlighting the need for targeted interventions encompassing attention to quit day mood reactivity.
authors.affiliation: Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA. lrreitze@mdanderson.org
authors.forename: Lorraine R
authors.initials: LR
authors.lastname: Reitzel
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Mazas
authors.forename: Ludmila
authors.initials: L
authors.lastname: Cofta-Woerpel
authors.forename: Yisheng
authors.initials: Y
authors.lastname: Li
authors.forename: Yumei
authors.initials: Y
authors.lastname: Cao
authors.forename: Michael S
authors.initials: MS
authors.lastname: Businelle
authors.forename: Paul M
authors.initials: PM
authors.lastname: Cinciripini
authors.forename: David W
authors.initials: DW
authors.lastname: Wetter
mesh_terms: D000208:Acute Disease; D000328:Adult; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D016540:Smoking Cessation / Q000191:economics / Q000523:psychology*; D012931:Social Environment; D012959:Socioeconomic Factors; D013375:Substance Withdrawal Syndrome / Q000191:economics / Q000523:psychology*