title: Cognitive and affective predictors of smoking after a sentinel health event.
abstract: OBJECTIVE
  This study examined how smoking-related causal attributions, perceived illness severity, and event-related emotions relate to both intentions to quit and subsequent smoking behavior after an acute medical problem (sentinel event).
  
  
  METHODS
  Three hundred and seventy-five patients were enrolled from 10 emergency departments (EDs) across the USA and followed for six months. Two saturated, manifest structural equation models were performed: one predicting quit attempts and the other predicting seven-day point prevalence abstinence at 14 days, three months, and six months after the index ED visit. Stage of change was regressed onto each of the other predictor variables (causal attribution, perceived illness severity, event-related emotions) and covariates, and tobacco cessation outcomes were regressed on all of the predictor variables and covariates.
  
  
  RESULTS
  Non-White race, baseline stage of change, and an interaction between causal attribution and event-related fear were the strongest predictors of quit attempt. In contrast, abstinence at six months was most strongly predicted by baseline stage of change and nicotine dependence.
  
  
  CONCLUSIONS
  Predictors of smoking behavior after an acute medical illness are complex and dynamic. The relations vary depending on the outcome examined (quit attempts vs. abstinence), differ based on the time that has progressed since the event, and include significant interactions.
authors.affiliation: a Departments of Emergency Medicine, Psychiatry, and Quantitative Health Sciences , University of Massachusetts Medical School , Worcester , MA , USA ;
authors.forename: Edwin D
authors.initials: ED
authors.lastname: Boudreaux
authors.forename: Beau
authors.initials: B
authors.lastname: Abar
authors.forename: Erin
authors.initials: E
authors.lastname: O'Hea
authors.forename: Ashley F
authors.initials: AF
authors.lastname: Sullivan
authors.forename: Rita
authors.initials: R
authors.lastname: Cydulka
authors.forename: Steven L
authors.initials: SL
authors.lastname: Bernstein
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
mesh_terms: D003071:Cognition; D003657:Decision Making; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D009042:Motivation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: motivation; reliability; stage of change; tobacco; tobacco cessation; validity
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