title: Do ethnicity and gender moderate the influence of posttraumatic stress disorder on time to smoking lapse?
abstract: BACKGROUND
  Following a smoking cessation attempt, smokers with posttraumatic stress disorder (PTSD) experience smoking relapse at a higher and faster rate. Black ethnicity and female gender are also associated with lower success rates following smoking cessation. No study to date has prospectively examined how ethnicity and gender may moderate the effect of PTSD on smoking relapse. It was hypothesized that female gender and Black ethnicity would significantly predict early lapse after quitting; further, it was predicted that ethnicity and gender would moderate the effect of PTSD on relapse rate.
  
  
  METHODS
  Smokers with PTSD (n=48) and without PTSD (n=56) completed ecological momentary assessment (EMA) the week after a quit date, and self-initiated EMA entries after smoking lapse. Smoking abstinence was biologically verified. The sample included Black (62%) and White (38%) participants, and was 50% female. Study hypotheses were tested with Cox proportional hazards regression modeling time to first smoking lapse.
  
  
  RESULTS
  Study results confirmed the main hypothesis, with a significant PTSD × Ethnicity interaction emerging. The effect of PTSD on smoking relapse was significant for White participants but not for Black participants. No significant gender moderation was found.
  
  
  CONCLUSIONS
  Taken together, study results support previous research, and suggest that the relationship between smoking and PTSD is stronger for White smokers than for minorities. This study has significant implications for research in smoking and mental disease, as well as for smoking cessation treatments for Black smokers.
authors.affiliation: Department of Psychology & Neuroscience, Duke University, Durham, NC 27705, USA; Duke Global Health Institute, Duke University, Durham, NC 27705, USA. Electronic address: sarah.wilson@duke.edu.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Wilson
authors.affiliation: Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Dedert
authors.affiliation: Durham Veterans Affairs Medical Center, Durham, NC 27705, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Dennis
authors.affiliation: Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.
authors.forename: Michelle F
authors.initials: MF
authors.lastname: Dennis
authors.affiliation: Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Health Services Research and Development, Durham VA Medical Center, Durham, NC 27705, USA.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Calhoun
authors.affiliation: Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA.
authors.forename: Angela C
authors.initials: AC
authors.lastname: Kirby
authors.affiliation: Durham Veterans Affairs Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.
authors.forename: Jean C
authors.initials: JC
authors.lastname: Beckham
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012737:Sex Factors; D012907:Smoking / Q000208:ethnology* / Q000523:psychology; D016540:Smoking Cessation / Q000208:ethnology* / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: African Americans; Ethnic minorities; Health disparities; Posttraumatic stress disorder=PTSD; Smoking cessation; Tobacco control
references.citation: Nicotine Tob Res. 2012 Mar;14(3):372-6
references.pmid: 22025546
references.citation: Nicotine Tob Res. 2008 Aug;10(8):1415-27
references.pmid: 18686190
references.citation: Clin Pharmacol Ther. 2006 May;79(5):480-8
references.pmid: 16678549
references.citation: J Trauma Stress. 2007 Dec;20(6):989-98
references.pmid: 18157879
references.citation: Am J Public Health. 2004 Nov;94(11):1965-71
references.pmid: 15514238
references.citation: Nicotine Tob Res. 2011 Feb;13(2):113-9
references.pmid: 21159784
references.citation: J Nerv Ment Dis. 2005 Dec;193(12):843-6
references.pmid: 16319709
references.citation: Clin Pharmacol Ther. 2006 Sep;80(3):282-97
references.pmid: 16952495
references.citation: Nicotine Tob Res. 2010 Nov;12(11):1125-32
references.pmid: 20855413
references.citation: Am J Prev Med. 2011 Mar;40(3):286-94
references.pmid: 21335259
references.citation: Clin Psychol Rev. 2007 Jan;27(1):14-45
references.pmid: 17034916
references.citation: Nicotine Tob Res. 2013 Jun;15(6):1122-9
references.pmid: 23178322
references.citation: Cancer Epidemiol Biomarkers Prev. 2008 Dec;17(12):3526-35
references.pmid: 19029401
references.citation: Psychol Med. 2004 Feb;34(2):323-33
references.pmid: 14982138
references.citation: Pharmacol Rev. 2005 Mar;57(1):79-115
references.pmid: 15734728
references.citation: Public Health Rep. 1992 Mar-Apr;107(2):150-5
references.pmid: 1561295
references.citation: Addict Behav. 2007 Dec;32(12):2900-15
references.pmid: 17544226
references.citation: Biometrics. 1974 Mar;30(1):89-99
references.pmid: 4813387
references.citation: Arch Gen Psychiatry. 2005 Nov;62(11):1258-65
references.pmid: 16275813
references.citation: Psychol Med. 1997 Jan;27(1):153-60
references.pmid: 9122295
references.citation: Am J Public Health. 2007 Oct;97(10):1756-7
references.pmid: 17895405
references.citation: Br J Addict. 1991 Sep;86(9):1119-27
references.pmid: 1932883
references.citation: J Consult Clin Psychol. 2000 Oct;68(5):748-66
references.pmid: 11068961
references.citation: J Consult Clin Psychol. 2001 Jun;69(3):516-27
references.pmid: 11495181
references.citation: JAMA. 1998 Jul 8;280(2):152-6
references.pmid: 9669788
references.citation: Clin Pharmacol Ther. 2008 Apr;83(4):531-41
references.pmid: 18305452
references.citation: Nicotine Tob Res. 2010 Jun;12(6):647-57
references.pmid: 20439385
references.citation: J Trauma Stress. 1995 Jan;8(1):75-90
references.pmid: 7712061
references.citation: J Community Health. 2009 Dec;34(6):480-92
references.pmid: 19728056