title: Delay discounting, locus of control, and cognitive impulsiveness independently predict tobacco dependence treatment outcomes in a highly dependent, lower socioeconomic group of smokers.
abstract: Tobacco use disproportionately affects lower socioeconomic status (SES) groups. Current explanations as to why lower SES groups respond less robustly to tobacco control efforts and tobacco dependence treatment do not fully account for this disparity. The identification of factors that predict relapse in this population might help to clarify these differences. Good candidates for novel prognostic factors include the constellation of behaviors associated with executive function including self-control/impulsiveness, the propensity to delay reward, and consideration and planning of future events. This study examined the ability of several measures of executive function and other key clinical, psychological, and cognitive factors to predict abstinence for highly dependent lower SES participants enrolled in intensive cognitive-behavioral treatment for tobacco dependence. Consistent with predictions, increased discounting and impulsiveness, an external locus of control as well as greater levels of nicotine dependence, stress, and smoking for negative affect reduction predicted relapse. These findings suggest that these novel factors are clinically relevant in predicting treatment outcomes and suggest new targets for therapeutic assessment and treatment approaches.
authors.affiliation: Department of Health Behavior and Health Education, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Sheffer
authors.forename: James
authors.initials: J
authors.lastname: Mackillop
authors.forename: John
authors.initials: J
authors.lastname: McGeary
authors.forename: Reid
authors.initials: R
authors.lastname: Landes
authors.forename: Lawrence
authors.initials: L
authors.lastname: Carter
authors.forename: Richard
authors.initials: R
authors.lastname: Yi
authors.forename: Bryan
authors.initials: B
authors.lastname: Jones
authors.forename: Darren
authors.initials: D
authors.lastname: Christensen
authors.forename: Maxine
authors.initials: M
authors.lastname: Stitzer
authors.forename: Lisa
authors.initials: L
authors.lastname: Jackson
authors.forename: Warren
authors.initials: W
authors.lastname: Bickel
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D056344:Executive Function; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000523:psychology*; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D012201:Reward; D016540:Smoking Cessation / Q000523:psychology*; D012923:Social Class; D014029:Tobacco Use Disorder / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome