title: Post-quit stress mediates the relation between social support and smoking cessation among socioeconomically disadvantaged adults.
abstract: Social support interventions have demonstrated limited effectiveness for preventing smoking relapse. The stress-buffering hypothesis may be a useful framework by which to understand social support in smoking cessation interventions. The current study evaluated the interrelations among social support, stress, and smoking cessation in both moderation and mediation models.
  
  
  
  Participants (N=139) were enrolled in a smoking cessation study at the safety-net hospital in Dallas, Texas. During the week prior to a scheduled quit attempt, general social support was measured using the Interpersonal Support Evaluation List (ISEL) questionnaire and smoking-specific social support was measured via repeated smartphone-based ecological momentary assessments (EMA). Post-quit stress was repeatedly assessed via smartphone. Logistic regression analyses evaluated potential interaction effects of pre-quit social support and post-quit stress on the likelihood of achieving biochemically-verified 7-day point prevalence abstinence at 4 weeks post-quit. Mediation models were evaluated to determine if post-quit stress mediated the association between pre-quit social support and smoking cessation.
  
  
  
  Participants were predominantly Black (63.3%) and female (57.6%); and 55% reported an annual household income of <$12,000. Analyses indicated that pre-quit social support did not significantly interact with post-quit stress to influence smoking cessation. However, post-quit stress did mediate associations between social support variables and smoking cessation.
  
  
  
  Findings indicated that social support impacts smoking cessation through its influence on post-quit stress among socioeconomically disadvantaged adults participating in cessation treatment. Increasing social support for the specific purpose of reducing stress during a quit attempt may improve smoking cessation rates in disadvantaged populations.
authors.affiliation: University of Texas, School of Public Health, Dallas Regional Campus, United States; The University of Texas, Southwestern Medical Center, Harold C. Simmons Comprehensive Cancer Center, United States. Electronic address: Frank.Bandiera@UTSouthwestern.edu.
authors.forename: Frank C
authors.initials: FC
authors.lastname: Bandiera
authors.affiliation: University of Texas, School of Public Health, Dallas Regional Campus, United States.
authors.forename: Folefac
authors.initials: F
authors.lastname: Atem
authors.affiliation: The University of Texas, Southwestern Medical Center, United States.
authors.forename: Ping
authors.initials: P
authors.lastname: Ma
authors.affiliation: University of Oklahoma, Health Sciences Center, United States; Stephenson Cancer Center, United States.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Businelle
authors.affiliation: University of Oklahoma, Health Sciences Center, United States; Stephenson Cancer Center, United States.
authors.forename: Darla E
authors.initials: DE
authors.lastname: Kendzor
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000191:economics / Q000379:methods; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D064876:Safety-net Providers / Q000191:economics / Q000379:methods; D012907:Smoking / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D016540:Smoking Cessation / Q000191:economics* / Q000523:psychology*; D012944:Social Support; D013315:Stress, Psychological / Q000191:economics* / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations / Q000523:psychology*
keywords: Smoking cessation; Social support; Socioeconomically disadvantaged adults; Stress