title: Effects of readiness to change, quit history, and health perceptions on depressive symptoms among young adult smokers.
abstract: BACKGROUND
  The current study sought to evaluate the main and interactive effect of health perceptions, smoking quit attempt history, and readiness to change with respect to depressive symptoms among college student smokers.
  
  
  METHODS
  The present data came from baseline data from a randomized trial and included 495 undergraduate students (Mage= 23.84,SD= 4.92, 47.47% female) who reported smoking at least 1 cigarette per day.
  
  
  RESULTS
  A three-way interaction emerged between smoking quit attempt history, health perceptions, and readiness to change with respect to depressive symptoms. Quit attempt history was positively associated with depressive symptoms, particularly among individuals high in readiness to change if they perceived their health as poorer relative to peers; however, quit attempt history was negatively associated with depressive symptoms, particularly among individuals high in readiness to change if they perceived their health as comparable or better than that of their peers.
  
  
  CONCLUSIONS
  These findings support the assertion that readiness to change, quit history and perceived health interact in a dynamic way to confer greater risk for poor outcomes including smoking- (e.g., cessation failure) and psychological-related outcomes (e.g., increased depressive symptoms). As such, development of informed interventions and programs targeting readiness to change to improve quit history and perceptions of health may provide unique benefit.
authors.affiliation: Yale School of Medicine, New Haven, Connecticut.
authors.forename: Dawn W
authors.initials: DW
authors.lastname: Foster
authors.affiliation: University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Georges E
authors.initials: GE
authors.lastname: Khalil
authors.affiliation: University of Houston, Houston, Texas.
authors.forename: Samantha G
authors.initials: SG
authors.lastname: Farris
authors.affiliation: Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Till W
authors.initials: TW
authors.lastname: Bärnighausen
authors.affiliation: Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, South Africa.
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Prokhorov
keywords: decisional balance; depression; motivation; smoking; tobacco