Changes in Motivation and Self-Efficacy to Quit Smoking Among People With Serious Mental Illness Who Smoke: A Latent Class Growth Analysis
Abstract
People with serious mental illness (SMI) smoke at exceedingly high rates, and have low rates of cessation success. Motivation and self-efficacy to quit smoking are important predictors of cessation success. While motivation and self-efficacy are dynamic constructs that change with time, little is known about the effects of the changes in motivation and self-efficacy to quit over time on smoking cessation among people with SMI. This study investigated: 1) latent classes of patterns of motivation and self-efficacy to quit smoking, 2) factors predicting latent class membership, 3) effects of latent class membership on smoking abstinence. Participants were 300 adults with SMI in inpatient psychiatric care who smoked at least 5 cigarettes/day pre-hospitalization who were randomized to receive either a tailored smoking cessation intervention for people with SMI (motivational counseling, post-discharge nicotine patches and telephone quitline counseling) or usual care (brief counseling). Participants completed baseline, 1, 3 and 6-month assessments. We conducted four separate latent class growth analysis (LCGA) based on: 1) desire to quit smoking, 2) willingness to work hard at quitting smoking, 3) perceived difficulty in quitting smoking, 4) perceived success in quitting smoking. We assessed whether treatment condition, nicotine dependence and mood symptoms predicted class membership as well as the effects of class membership on 6-month smoking abstinence. Across all four LCGA models, the two-class model showed the best model fit. For all four models, two classes were differentiated by overall levels (high vs. low). The rates of change over time in desire to quit, willingness to work hard, and perceived success did not differ across the two classes. For perceived difficulty, one class showed a reduction while the other class remained stable. Only desire to quit (both classes) showed an increase over time. Higher baseline anxiety and receiving treatment predicted higher desire to quit smoking. Higher baseline anxiety, depression, and nicotine dependence predicted lower perceived success and higher perceived difficulty in quitting. Class membership of all four constructs predicted 6-month abstinence. Individuals with SMI reported relatively stable motivation and self-efficacy to quit over 6 months after hospitalization while an increase in desire to quit and a decrease in perceived difficulty were also found. Higher sustained motivation and self-efficacy predicted cessation success. Identifying ways to elevate and sustain motivation and self-efficacy may facilitate cessation success for people with SMI.
Subject Area
Psychology|Medicine|Mental health|Clinical psychology
Recommended Citation
Selva Kumar, Danusha, "Changes in Motivation and Self-Efficacy to Quit Smoking Among People With Serious Mental Illness Who Smoke: A Latent Class Growth Analysis" (2024). ETD Collection for Fordham University. AAI30993357.
https://research.library.fordham.edu/dissertations/AAI30993357
