title: The predictive utility of micro indicators of concern about smoking: findings from the International Tobacco Control Four Country study.
abstract: This study explored the association between six "micro indicators" of concern about smoking (1. stubbing out cigarettes before finishing; 2. forgoing cigarettes due to packet warning labels; thinking about... 3. the harms to oneself of smoking; 4. the harms to others of one's smoking; 5. the bad conduct of tobacco companies; and 6. money spent on cigarettes) and cessation outcomes (making quit attempts, and achieving at least six months of sustained abstinence) among adult smokers from Australia, Canada, the United Kingdom, and the United States of America. Participants were 12,049 individuals from five survey waves of the International Tobacco Control Four Country Survey (interviewed between 2002 and 2006, and followed-up approximately one year later). Generalized estimating equation logistic regression analysis was used, enabling us to control for within-participant correlations due to possible multiple responses by the same individual over different survey waves. The frequency of micro indicators predicted making quit attempts, with premature stubbing out, forgoing, and thinking about the harms to oneself of smoking being particularly strong predictors. An interaction effect with expressed intention to quit was observed, such that stubbing out and thinking about the harms on oneself predicted quit attempts more strongly among smokers with no expressed plans to quit. In contrast, there was a negative association between some micro indicators and sustained abstinence, with more frequent stubbing out, forgoing, and thinking about money spent on cigarettes associated with a reduced likelihood of subsequently achieving sustained abstinence. In countries with long-established tobacco control programs, micro indicators index both high motivation by smokers to do something about their smoking at least partly independent of espoused intention and, especially those indicators not part of a direct pathway to quitting, reduced capacity to quit successfully.
authors.affiliation: The Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia. Electronic address: Timea.Partos@cancervic.org.au.
authors.forename: Timea R
authors.initials: TR
authors.lastname: Partos
authors.affiliation: The Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia. Electronic address: Ron.Borland@cancervic.org.au.
authors.forename: Ron
authors.initials: R
authors.lastname: Borland
authors.affiliation: Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Health Sciences Building, 215, 800 Sumter Street, Columbia, SC 29208, USA. Electronic address: thrasher@mailbox.sc.edu.
authors.forename: James F
authors.initials: JF
authors.lastname: Thrasher
authors.affiliation: The Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia. Electronic address: Lin.Li@cancervic.org.au.
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.affiliation: The Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria 3004, Australia. Electronic address: Hua.Yong@cancervic.org.au.
authors.forename: Hua-Hie
authors.initials: HH
authors.lastname: Yong
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263, USA. Electronic address: Richard.O'Connor@RoswellPark.org.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Connor
authors.affiliation: Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198-4365, USA. Electronic address: msiahpush@unmc.edu.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Siahpush
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D002170:Canada; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D000074606:Smoking Prevention; D006113:United Kingdom; D014481:United States; D055815:Young Adult
keywords: Maintenance; Prospective study; Relapse; Smoking cessation; Tobacco