Readiness to quit smoking among smokers in substance use treatment: associations with stress, substance use severity, relapse concerns and gender

ABSTRACT

Smoking prevalence among individuals in substance use treatment remains higher than in the general population. Given that many smokers in substance use treatment are reluctant to quit smoking, it is important to understand the factors that impede smokers’ readiness to quit. The current study used baseline data from a randomized controlled trial involving 60 adult smokers receiving substance use treatment to investigate relations between the severity of substance use problems (SSUP), perceived stress (PS), concerns about relapse (i.e., concerns that quitting smoking would hurt one’s recovery process (CR)), and readiness to quit smoking. This study also investigated moderating roles of concerns about relapse and gender. Regression analyses showed a significant main effect of concerns about relapse on readiness to quit in the next 30 days, but no effect for either severity of substance use problems, perceived stress, or the SSUPxCR interaction. There were significant interaction effects between PS and both gender and CR. Among men and those with lower concerns about relapse, higher perceived stress was significantly associated with lower readiness to quit. Findings suggest that psychoeducation to alleviate concerns that quitting smoking could limit substance use recovery could be beneficial. Stress management interventions may be especially beneficial to men.

KEYWORDS:

• Readiness to quit
• perceived stress
• severity of substance use problems
• concerns about relapse

Acknowledgments

The authors thank the staff of the Addictions Research Group and the Alcohol and Drug Day Treatment Program at Butler Hospital who assisted with this research.

Disclosure statement

Dr. Richard A. Brown has equity ownership in Health Behavior Solutions, Inc., which is developing products for tobacco cessation that are not related to this study. The terms of this arrangement have been reviewed and approved by the University of Texas at Austin in accordance with its policy on objectivity in research.

Dr. Steven Ondersma is part owner of a company that licenses e-intervention authoring software to investigators, and which was used to develop the intervention in the parent trial from which these data were taken.

Dr. Lawrence H. Price has received royalties from OCDScales; received grant support from NIH; served as a consultant to Wiley, Springer, University of Texas (Austin), and Fordham University; and served as a data safety monitoring board member for Baylor University, Cleveland Clinic, Clexio Biosciences, and Worldwide Clinical Trials.

Ethical standards

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse, under Grant # R34DA034312 to Richard A. Brown.