title: Dependence and motivation to stop smoking as predictors of success of a quit attempt among smokers seeking help to quit.
abstract: BACKGROUND
  It is not known how well motivation to stop smoking predicts abstinence in a clinical sample relative to the most widely used measure of cigarette dependence.
  
  
  METHODS
  A secondary analysis was conducted from a trial with 864 smokers making quit attempt. Fagerström Test of Cigarette Dependence (FTCD), Heaviness of Smoking Index (HSI), and motivation to stop smoking (composite of determination to quit and importance of quitting) were measured at baseline. Continuous smoking abstinence, validated by expired-air carbon monoxide, was assessed at 4weeks, 6months and 12months post-quit date. FTCD, HSI, non-HSI items in FTCD, and motivation were assessed as predictors of abstinence.
  
  
  RESULTS
  In multiple-logistic regressions, controlling for age, gender and medication use, lower scores for FTCD, HSI and non-HSI all significantly predicted abstinence at all follow-ups, while motivation did not predict abstinence at any time. Likelihood ratio tests showed that the FTCD contributed most to the model at 4weeks and 6months; at 12months FTCD and non-HSI equally contributed most to the model. At 4weeks and 6months, predictions were improved by combining HSI and non-HSI components, compared with using these components alone.
  
  
  CONCLUSIONS
  Cigarette dependence, measured by the FTCD, or by its HSI or non-HSI components, predicts both short-term and medium-term outcomes of attempts to stop smoking in treatment-seeking smokers involved in a clinical trial, whereas strength of motivation to stop predicts neither. Both the HSI and non-HSI components may be considered as briefer alternatives to the full FTCD.
authors.affiliation: Population Health Research Institute, St. George's University of London, Cranmer Terrace, London SW17 ORE, UK. Electronic address: mussher@sgul.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Ussher
authors.affiliation: Population Health Research Institute, St. George's University of London, Cranmer Terrace, London SW17 ORE, UK.
authors.forename: Geetanjali
authors.initials: G
authors.lastname: Kakar
authors.affiliation: Academic Tobacco Dependence Research Unit, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, 55 Philpot Street, Whitechapel, London E1 2HJ, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Hajek
authors.affiliation: Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1 6BT, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: West
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012720:Severity of Illness Index; D012907:Smoking / Q000523:psychology* / Q000628:therapy; D016540:Smoking Cessation / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Cigarette dependence; Motivation; Predictors; Smoking cessation; Trial