title: Patient's lung cancer diagnosis as a cue for relatives' smoking cessation: evaluating the constructs of the teachable moment.
abstract: To understand whether patient-reported experiences with lung cancer may create teachable moments (TM) for their relatives as evidenced by shifts in their risk perceptions, affective response, and self-image and in turn, motivation to quit smoking.
  
  
  
  Patients at a comprehensive cancer center (n = 152) completed a survey within 6 months of lung cancer diagnosis to assess their cancer-related symptoms and openness and enumerated relatives who were smokers. Relative smokers (n = 218) then completed a survey assessing their risk perceptions, affective response, and self-image as a smoker related to the patient's diagnosis (TM mechanisms), and their motivation to quit smoking. Cross-sectional mediation and moderation analyses were conducted to explore the links between patient-reported experiences, and relatives' TM mechanisms, and motivation to quit smoking.
  
  
  
  Relative-reported affect was a significant mediator of the association between patient-reported symptoms and relative smoker's desire to quit. Relatives' self-image was a significant moderator of the association between patient-reported symptoms and relative smoker's desire to quit, such that patients' reported symptoms were associated with relatives' desire to quit only when the relative smoker reported a generally positive self-image as a smoker. No evidence was found for moderated mediation. However, the link between symptoms and negative affect was moderated by perceptions of risk.
  
  
  
  Whether smokers experience a family member's lung cancer as a TM is influenced by multiple interrelated cognitive and affective factors that warrant further exploration. Clearer understanding of these factors could inform how to re-invigorate and sustain this motivation to promote concrete actions toward smoking cessation. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory Rollins School of Public Health, Atlanta, GA, USA.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: McBride
authors.affiliation: Abt Associates, Boston, MA, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Blocklin
authors.affiliation: Duke University, Durham, NC, USA.
authors.forename: Isaac M
authors.initials: IM
authors.lastname: Lipkus
authors.affiliation: National Cancer Institute, Rockville, MD, USA.|National Institutes of Health, Bethesda, MD, USA.
authors.forename: William M P
authors.initials: WM
authors.lastname: Klein
authors.affiliation: Tobacco Research and Intervention Program, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Brandon
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005190:Family; D005192:Family Health; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires