Background

Cigarette smoking disproportionately affects homeless individuals, who have a higher smoking prevalence, fewer resources, and increased stressors compared to domiciled smokers. Little is known about how to facilitate smoking cessation among this population although some findings support focusing efforts on affective variables as well as alternate outcomes in order to optimize interventions for this group.

Methods

Participants were homeless adults recruited from a Dallas, TX, shelter (N = 57, 61.4% male, M_age = 48.8 ± 9.0) to participate in tobacco cessation classes using an American Cancer Society-based therapy and support group with nicotine replacement therapy. Moment-to-moment changes in affect [e.g., negative affect (NA), positive affect (PA), and stress] were recorded via Ecological Momentary Assessments to assess whether they were associated with concurrent changes in cigarettes smoked per day (CPD) following a specific quit attempt. Separate generalized linear models (GLM) were evaluated for each predictor to examine the associations between affective variables and CPD in covariate-adjusted analyses.

Results

Significant interaction effects of time and affect were found for all variables (NA: p = 0.0011, PA: p = 0.0006, stress: p = 0.0259), whereby the association of affect and CPD were significant in the early part of the week but the effects faded as time progressed. With regard to main effects, only increases in PA during the post-quit week significantly predicted fewer CPD (adjusted incidence rate ratio = 0.924, SE = 0.027, p = 0.0032).

Conclusions

Homeless smokers may be more likely to decrease their cigarette consumption during periods of greater PA throughout the post-quit week. Relationship between positive affect and reduction in CPD suggest focus on affective variables with homeless smokers may be an effective avenue for change in smoking behaviors, particularly in the days immediately following a quit attempt. Time effects should be further investigated to determine when these interventions might best be implemented.

中文翻译：

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在无家可归的日常吸烟者尝试戒烟后检查吸烟率的影响因素

背景

与居住在当地的吸烟者相比，吸烟对无家可归者的影响尤为严重，他们的吸烟率更高，资源更少，压力源也更多。对于如何促进这一人群戒烟，人们知之甚少，尽管一些研究结果支持将工作重点放在情感变量和替代结果上，以优化该人群的干预措施。

方法

参与者是从德克萨斯州达拉斯的避难所招募的无家可归的成年人（N = 57，61.4% 男性，M_年龄 = 48.8 ± 9.0），使用美国癌症协会的治疗和尼古丁替代疗法支持小组参加戒烟课程。通过生态瞬间评估记录情感的瞬间变化[例如，负面情感 (NA)、正面情感 (PA) 和压力]，以评估它们是否与以下每日吸烟量 (CPD) 的同时变化有关特定的戒烟尝试。为每个预测变量评估单独的广义线性模型 (GLM)，以检查协变量调整分析中情感变量和 CPD 之间的关联。

结果

对于所有变量（NA：p = 0.0011，PA：p = 0.0006，压力：p = 0.0259）都发现了时间和情感的显着交互影响，其中情感和 CPD 的关联在一周的早期是显着的，但随着时间的推移，效果逐渐消失。关于主要影响，只有戒烟后一周 PA 的增加显着预测 CPD 的减少（调整后的发病率比 = 0.924，SE = 0.027，p = 0.0032）。

结论

无家可归的吸烟者可能更有可能在整个戒烟后一周的 PA 期间减少他们的卷烟消费量。积极影响与 CPD 降低之间的关系表明，关注无家可归吸烟者的情感变量可能是改变吸烟行为的有效途径，尤其是在尝试戒烟后的几天内。应进一步研究时间效应以确定何时可以最好地实施这些干预措施。