title: Predicting quit attempts among homeless smokers seeking cessation treatment: an ecological momentary assessment study.
abstract: BACKGROUND
  Homeless adults are more likely to smoke tobacco and are less likely to successfully quit smoking than smokers in the general population, despite comparable numbers of cessation attempts and desire to quit. To date, studies that have examined smoking cessation in homeless samples have used traditional lab/clinic-based assessment methodologies. Real-time assessment of key variables may provide new insights into the process of quitting among homeless smokers.
  
  
  METHODS
  The purpose of the current study was to identify predictors of a quit attempt using real-time assessment methodology during the 6 days prior to a scheduled quit attempt among homeless adults seeking care at a shelter-based smoking cessation clinic. Parameters for multiple variables (i.e., motivation for quitting, smoking expectancies, quit self-efficacy, smoking urges, negative affect, positive affect, restlessness, hostility, and stress) were calculated and were used as predictors of biochemically verified quit date abstinence (i.e., ≥13hr abstinent) using logistic regression analyses.
  
  
  RESULTS
  Participants (n = 57) were predominantly male (59.6%), non-White (68.4%), and smoked an average of 18 cigarettes per day. A total of 1,132 ecological momentary assessments (83% completion rate) were collected at random times (i.e., up to 4 assessments/day) during the 6 days prior to a scheduled quit attempt. Results indicated that declining (negative slope) negative affect, restlessness, and stress predicted quit date abstinence. Additionally, increasing positive coping expectancies across the prequit week predicted quit date abstinence.
  
  
  CONCLUSIONS
  Study findings highlight multiple variables that may be targeted during the precessation period to increase smoking cessation attempts in this difficult to treat population of smokers.
authors.affiliation: University of Texas Health Science Center School of Public Health, Dallas, TX; University of Texas Southwestern Medical Center, Dallas, TX; michael.businelle@utsouthwestern.edu.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Businelle
authors.affiliation: University of Texas Health Science Center School of Public Health, Dallas, TX; University of Texas Southwestern Medical Center, Dallas, TX;
authors.forename: Ping
authors.initials: P
authors.lastname: Ma
authors.affiliation: University of Texas Health Science Center School of Public Health, Dallas, TX; University of Texas Southwestern Medical Center, Dallas, TX;
authors.forename: Darla E
authors.initials: DE
authors.lastname: Kendzor
authors.affiliation: Department of Educational Psychology, University of Houston, Houston, TX;
authors.forename: Lorraine R
authors.initials: LR
authors.lastname: Reitzel
authors.affiliation: Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Minxing
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Cho Y
authors.initials: CY
authors.lastname: Lam
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, TX;
authors.forename: Ira
authors.initials: I
authors.lastname: Bernstein
authors.affiliation: Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: David W
authors.initials: DW
authors.lastname: Wetter
mesh_terms: D000328:Adult; D040421:Cell Phone / Q000706:statistics & numerical data; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011237:Predictive Value of Tests; D020377:Self Efficacy; D012907:Smoking / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*