title: Self-Reported Reasons for Smoking: Predicting Abstinence and Implications for Smoking Cessation Treatments Among Those With a Psychotic Disorder.
abstract: OBJECTIVE
  People living with a psychotic illness have higher rates of cigarette smoking and face unique barriers to quitting compared to the general population. We examined whether self-reported reasons for smoking are useful predictors of successful quit attempts among people with psychosis.
  
  
  METHODS
  As part of a randomized controlled trial addressing smoking and cardiovascular disease risk behaviors among people with psychosis, self-reported reasons for smoking were assessed at baseline (n = 235), 15 weeks (n = 151), and 12 months (n = 139). Three factors from the Reasons for Smoking Questionnaire (Coping, Physiological, and Stimulation/Activation) were entered into a model to predict short- and long-term abstinence. The relationship between these factors and mental health symptoms were also assessed.
  
  
  RESULTS
  Participants scoring higher on the Stimulation/Activation factor (control of weight, enjoyment, concentration, and "peps me up") at baseline were just less than half as likely to be abstinent at 15 weeks. Female participants were five times more likely to abstinent at 15 weeks, and those with a higher global functioning at baseline were 5% more likely to be abstinent. There was a positive correlation between changes over time in the Stimulation/Activation factor from baseline to 12-month follow-up and the Brief Psychiatric Rating Scale total score at 12-month follow-up. This indicates that increasingly higher endorsement of the factor was associated with more psychological symptoms. There was also a negative correlation between the change over time in the Stimulation/Activation factor and global functioning at 12 months, indicating that increasingly higher endorsement of the factor led to lower global assessment of functioning.
  
  
  CONCLUSIONS
  The Stimulation/Activation factor may be particularly important to assess and address among smokers with psychosis. It is recommended that further research use the Reasons for Smoking Questionnaire among smokers with psychosis as a clinical tool to identify specific quit barriers. Further research into why females have higher smoking cessation rates in the short term and relapse prevention interventions seem worthy of further investigation.
authors.affiliation: a School of Medicine and Public Health , University of Newcastle , New South Wales , Australia.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Clark
authors.affiliation: a School of Medicine and Public Health , University of Newcastle , New South Wales , Australia.|b NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre , University of Newcastle , New South Wales , Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Baker
authors.affiliation: c Priority Research Centre for Brain and Mental Health , University of Newcastle , New South Wales , Australia.
authors.forename: Terry
authors.initials: T
authors.lastname: Lewin
authors.affiliation: d School of Public Health and Community Medicine , University of New South Wales , Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Richmond
authors.affiliation: b NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre , University of Newcastle , New South Wales , Australia.|c Priority Research Centre for Brain and Mental Health , University of Newcastle , New South Wales , Australia.
authors.forename: Frances
authors.initials: F
authors.lastname: Kay-Lambkin
authors.affiliation: e Central Clinical School , Monash University , The Alfred Hospital, Victoria , Australia.
authors.forename: Sacha
authors.initials: S
authors.lastname: Filia
authors.affiliation: f St. Vincent's Hospital Melbourne , Victoria, Australia.|g The University of Melbourne , Victoria , Australia.|h Faculty of Health Sciences , Australian Catholic University , Victoria , Australia.
authors.forename: David
authors.initials: D
authors.lastname: Castle
authors.affiliation: i Division of Addiction Psychiatry , Rutgers-Robert Wood Johnson Medical School , New Brunswick , New Jersey , USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Williams
authors.affiliation: j School of Psychology , University of Newcastle , New South Wales , Australia.
authors.forename: Juanita
authors.initials: J
authors.lastname: Todd
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology*; D055502:Secondary Prevention; D057566:Self Report; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000150:complications / Q000523:psychology* / Q000628:therapy; D055815:Young Adult
keywords: Smoking; predicting abstinence; psychosis; self-reported reasons