Tobacco Documents Online

I I I I NIti`ETY-EIGHTH .4.ti_NL;AI- CONVEN`TION OF THE APA DIVISION 28 PROGRAM orovtdine information relevant to the clinical effects of dtu¢s on btna~ ic r. V 1'OC'`G PSYCHOPHARMACOLOGIST AWARD AND PN- VITED ADDRESS Chair: Larn. B~rd. Yerkes Regional Primate Research Center. Emory Cniversity . Atlanta. GA Awardee to be announced) ~ . S~ `IPOSIt'Nt , Se/f Quuters: Smoking Cessation in the Real World - Chair: John R. Hughes. University of Vermont. Burlington. VT I I I I I I I I I I I I I I SMOKING CESSATION: A COMPARISON OF AIDED VS. UNAIDED Q[,'ITTERS/ATTEMPTERS. Gary A. Giovino. Cen- ter for Disease Control. Rockville. MD: John R. Hughes. Univer- sity of Vermont. Burlington. VT: John P. Pierce. University of California. San Diego. CA: and Stephen E. Marcus. Center for Disease Control. Rockville. MD. National survey data indicate that over 90% of the people who quit smoking between 1976 and 1985 did so without the help of formal cessation programs. If the smokers who get help differ from those who quit on their own, then the external validity of studies of program attenders may be challenged. Data from two national probability sample surveys, the 1986 Adult Use of Tobacco Survey (AC,'TS) and the 1987 National Health Interview Survey (NHIS ) Cancer Control Supplement. will be employed to generate a profile of smokers in the United States. Analyses of the AUTS indicate that. in 1986. of all current cigarette smokers 52.917c were male: 85.3% were White and 11.7% were Black: 6.3c-,c were Hispanic: 66.4% were married/cohabitating and 16.4% were never mamed: 28.1c7c had attended college: 19.9% of those employed were employed in administrative/technical occupations: 36.1 17c had never made a previous attempt to quit; and 6.8% smoked cigars and/or pipes. The mean age of these smokers was 40.5 ~ears i S.D. = l-t.9). They had smoked an average of 21.0 cigarettes (S.D. = 12.1) per day for an average of 21.7 years i S.D. = 14.=). This profile of all current smokers in the United States will be updated and expanded upon with data from the 1987 NHIS. In addition, descriptions will be provided of current smokers who have quit for at least one day in the previous year and of former smokers. The 1986 AUTS data will be used to compare current smokers who attempted to quit on their ovrn with current ;moken who attempted to quit using formal programs. Compari- sons of former smokers who quit with and without formal programs will also be made. Variables available for analysis include demographic characteristics, smoking characteristics, and several psychosocial variables (e.g.. intention to smoke in five ~ears. reasons for quitting, and presence of worksite smoking restnctions ). _ ~. . PREDICTORS OF EARLY RELAPSE. Arthur J. Garvey. Ryan E. Bliss and Kenneth D. Ward. VA Outpatient Clinic. Bos- j ton. MA l. Most studies of relapse have dealt with the 5% of smokers who attend special stop-smoking programs. despite evidence that this population is quite different from the large majority of smokers who make unaided quit attempts (self-quittets). The purpose of this study was to examine biological and behavioral factors related to relapse in a sample of self-quitters. Subjects (N=112) were recruited from newspaper advertisements. Each subject was inter- viewed orior to cessation. then reinterviewed at 1 day postcessa- tion. 3 days postcessation. 8. 15. 30. 45. 60 days postcessation. and then monthly thereafter for a total follow-up period of 1 year. Information collected included a complete smoking history. in- dices of social support. mottvation. confidence in the ability to succeed in the quit attempt. self-reported withdrawal symptoms. and objective indices of withdrawal such as heart rate, blood pressure. weight. and catecholamine excretion. Subjects ranged in age from 24-76 years ( mean = 45 years ). Sixty percent were males. approximately 50% were college graduates. and mean amount smoked was 28 cigarettes/day. Relapse was very rapid. with 23% relapsed by I day postcessation. 66% by 7 days. and 76% by 14 days postcessation. The very earliest relapsers tended to be of lower eduction. higher on amount smoked, and lower in confidence. Dramatic decreases in heart rate. blood pressure and catecholamine excretion were observed after cessation, but these changes were similar for relapsers and abstainers. Self-reported withdrawal (e.g., restlessness, inability to concentrate) likewise did not have major effects on relapse. though there was a slight trend for those who relapsed after day 3 to report more distress at day 3. Results reinforce earlier findings of extreme rapidity of relapse for self-quitters. Behavioral parameters (e.g., confidence. education) seem to predict relapse better than do biological variables. Surprisingly, severity of withdrawal was not signifi- cantly related to relapse. Findings suggest that seif-quitters nced to be especially vigilant in the early days after quitting. and that additional attention needs to be given to the smoker's preparation for quitting. SITUATIONAL DESCRIPTORS AND COPING IIv HIGH RISK AND RELAPSE SITUATIONS. Ellen R. Gritz. Clifford R. Carr and Alfred C. Marcus. University of California. Los Angeies. CA; Saul M. Shiffman. University of Pittsburgh, Pittsburgh. PA: and Donald R. Shopland. National Cancer Institute. Smokers who volunteered to stop smoking without formal assistance on either the Great American Smokeout or New Year's Day (N = 554) were followed for one year. At each follow-up those who had stopped smoking were asked to describe their highest risk or relapse situation and how they coped with that situation. Abstainers and Relapsers were compared on the charac- teristics of their high risk and relapse situations and their coping techniques. A total of 868 instances of high-risk/relapse situations were described by all subjects across all follow-ups. The highest percentage of the situations occurred at home (38%). from 5 to 9 p.m. (36%). while the subject was alone (35%). The most common affect identified was anxiotis/ttervous/tense (30%). 26% of the subjects were socializing at the time. and 46% were experiencing withdrawal symptoms. Forty-one percent of the subjects reported that how they were feeling was the most important tngger for the situation. The results of a disrrin+_ ina+±t analysis comparing Abstainers and Relapsers on the descriptors of the situation (place. time, affect, activity, withdrawal symptoms. trigger, presence of other petsons. whether the other persons were smoking) will be reported. Subjects were asked to repoa. in aa open-ended format. three thoughts or actions they used to cope with each high-risk/relapse situation. Three coping techniques were used in over ten percent of the situations, two cognitive and one behavioral: willpower (15%), "don't blow it now" thoughts (13%), and oral substitutes (14%). Abstainers and Relapsers were compared on the number of coping techniques employed; the number of cognitive and behavioral techniques employed; whether a cognitive, behavioral, or any"coping technique was etttployed; whether either cognitive or behavioral techniques were employed exclusively; and the technique employed. The results of a cluster