title: Do environmental cues prompt attempts to stop smoking? A prospective natural history study.
abstract: BACKGROUND
  We prospectively tested whether environmental cues prompts attempts to stop smoking.
  
  
  METHODS
  We recruited 134 smokers who intended to quit in the next 3 months to complete nightly calls to report cues as well as smoking status, intentions to smoke or not on the next day, and quit attempts over 12 weeks. We provided no treatment.
  
  
  RESULTS
  Participants averaged 6.5 cues/week. The most common cues were embarrassment, cost of cigarettes and messages in the media. The number of cues over a 7-day period predicted the incidence of a quit attempt on the eighth day (e.g. from 1.5% when no cues occurred to 3% when 7 cues occurred during the 7 days). This effect was dose-dependent and was due to both between and within-subject predictors. Five cues predicted quit attempts. A cue that made smokers concerned about the cost of cigarettes appeared to be the strongest cue. Cues on the day prior were not more powerful predictors than more distal cues. Intention to not smoke the next day on the evening prior to the eighth day was a partial mediator of the effect of cues on quit attempts. Retrospective recall of cues was poor.
  
  
  CONCLUSIONS
  Our results suggest the occurrence of cues may be a cause of quit attempts and that programs to increase the frequency of cues may increase quit attempts. Further research should examine whether environmental cues and introspective states (e.g. self-efficacy) interact to prompt quit attempts.
authors.affiliation: Center on Behavior and Health, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT 05401, USA. Electronic address: john.hughes@med.uvm.edu.
authors.forename: John R
authors.initials: JR
authors.lastname: Hughes
authors.affiliation: Department of Medical Biostatistics, University of Vermont, Burlington, VT 05401, USA.
authors.forename: Shelly
authors.initials: S
authors.lastname: Naud
authors.affiliation: Center on Behavior and Health, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT 05401, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Fingar
authors.affiliation: Department of Medical Biostatistics, University of Vermont, Burlington, VT 05401, USA.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Callas
authors.affiliation: Department of Family Medicine, University of Vermont, Burlington, VT 05405, USA.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Solomon
mesh_terms: D003463:Cues; D004777:Environment; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020377:Self Efficacy; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: Natural history; Nicotine; Quit attempts; Smoking cessation; Tobacco