Psychosocial stress and cigarette smoking persistence, cessation, and relapse over 9–10 years: a prospective study of middle-aged adults in the United States

• Published in: Cancer causes & control 2013-10, Vol.24 (10), p.1849-1863
• Main Authors: Slopen, Natalie, Kontos, Emily Z., Ryff, Carol D., Ayanian, John Z., Albert, Michelle A., Williams, David R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biomedical and Life Sciences; Biomedicine; Cancer Research; Children; Cigarette smoking; Cigarettes; Epidemiology; Female; Health behavior; Health care policy; Hematology; Humans; Inequality; Job stress; Longitudinal Studies; Male; Married status; Middle age; Middle Aged; Occupational stress; Oncology; Original Paper; Prospective Studies; Psychological stress; Public Health; Relapse; Smoking - epidemiology; Smoking - psychology; Smoking cessation; Smoking Cessation - psychology; Smoking Cessation - statistics & numerical data; Stress; Stress, Psychological - epidemiology; Stress, Psychological - psychology; Tobacco; Trajectories; United States - epidemiology; Vigilance; Young Adult
• ISSN: 0957-5243; 1573-7225
• DOI: 10.1007/s10552-013-0262-5

Purpose: Year-to-year decreases in smoking in the US have been observed only sporadically in recent years, which suggest a need for intensified efforts to identify those at risk for persistent smoking. To address this need, we examined the association between a variety of psychosocial stressors and smoking persistence, cessation, and relapse over 9–10 years among adults in the United States (n = 4,938, ages 25–74). Methods: Using information provided at baseline and follow-up, participants were categorized as non-smokers, persistent smokers, ex-smokers, and relapsed smokers. Stressors related to relationships, finances, work—family conflict, perceived inequality, neighborhood, discrimination, and past-year family problems were assessed at baseline and follow-up. Results: High stress at both assessments was associated with greater odds of persistent smoking for stressors related to relationships, finances, work, perceived inequality, past-year family problems, and a summary score. Among respondents who were smokers at baseline, high stress at both time points for relationship stress, perceived inequality, and past-year family problems was associated with nearly double the odds of failure to quit. Conclusions: Interventions to address psychosocial stress may be important components within smoking cessation efforts.