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Generalized Linear Mixed Modeling to Examine the Relationship Between Self Efficacy and Smoking Cessation

Parzynski, Craig S (2011) Generalized Linear Mixed Modeling to Examine the Relationship Between Self Efficacy and Smoking Cessation. Master's Thesis, University of Pittsburgh.

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    Abstract

    The relationship between self efficacy and smoking cessation is unclear. Self efficacy is often viewed as a causal antecedent for future abstinence from smoking, a primary outcome of cessation studies. However, recent research has questioned whether the participant's report of self efficacy is a reflection on previous abstinence success or failure rather than a precursor. To elucidate the dynamic relationship between self efficacy and abstinence status, two generalized linear mixed models were developed. The first examined the ability of self efficacy to predict next day's' abstinence, while the second examined the ability of abstinence to predict self efficacy ratings taken later that same day. All data came from a 2 x 2 crossover trial examining how interest to quit smoking and monetary reinforcement for abstinence affect the short term effects of medication on abstinence from smoking. Participants received both medication and placebo conditions in consecutive phases in a counter-balanced order, with an ad lib smoking washout period in between. Abstinence from smoking and self efficacy was recorded daily during both medication phases. Participants were 124 smokers, mean age 31.1(SE: 1.0), who smoked on average 16.3 (SE: 0.5) cigarettes per day and had a mean FTND score of 4.6 (SE: 0.1). The sample was comprised of 56.5% females. Results indicate that self efficacy is both a predictor of, and a reflection on abstinence status. Models were validated using bootstrapping procedures. These procedures revealed only a small amount of bias in the models. The effects observed in this study may be constrained by the timing of assessments as well as the duration of the cessation attempt. Public Health Importance: Tobacco use accounts for 443,000 deaths each year. Therefore, the development of successful clinical assessments to monitor smoking cessation efforts is of the utmost importance. Self efficacy is a measure of confidence to quit smoking. This study shows that the relationship between self efficacy and smoking cessation is bi-directional which may be influenced by the timing of assessments. Understanding this relationship may lead to more successful use of self efficacy as a clinical tool during smoking cessation attempts.


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    Item Type: University of Pittsburgh ETD
    ETD Committee:
    ETD Committee TypeCommittee MemberEmail
    Committee ChairRedmond, Carol K.ckr3@pitt.edu
    Committee MemberYouk, Ada O.ayouk@pitt.edu
    Committee MemberConklin, Cynthia A.conkca@upmc.edu
    Committee MemberPerkins, Kenneth A.perkinska@upmc.edu
    Title: Generalized Linear Mixed Modeling to Examine the Relationship Between Self Efficacy and Smoking Cessation
    Status: Unpublished
    Abstract: The relationship between self efficacy and smoking cessation is unclear. Self efficacy is often viewed as a causal antecedent for future abstinence from smoking, a primary outcome of cessation studies. However, recent research has questioned whether the participant's report of self efficacy is a reflection on previous abstinence success or failure rather than a precursor. To elucidate the dynamic relationship between self efficacy and abstinence status, two generalized linear mixed models were developed. The first examined the ability of self efficacy to predict next day's' abstinence, while the second examined the ability of abstinence to predict self efficacy ratings taken later that same day. All data came from a 2 x 2 crossover trial examining how interest to quit smoking and monetary reinforcement for abstinence affect the short term effects of medication on abstinence from smoking. Participants received both medication and placebo conditions in consecutive phases in a counter-balanced order, with an ad lib smoking washout period in between. Abstinence from smoking and self efficacy was recorded daily during both medication phases. Participants were 124 smokers, mean age 31.1(SE: 1.0), who smoked on average 16.3 (SE: 0.5) cigarettes per day and had a mean FTND score of 4.6 (SE: 0.1). The sample was comprised of 56.5% females. Results indicate that self efficacy is both a predictor of, and a reflection on abstinence status. Models were validated using bootstrapping procedures. These procedures revealed only a small amount of bias in the models. The effects observed in this study may be constrained by the timing of assessments as well as the duration of the cessation attempt. Public Health Importance: Tobacco use accounts for 443,000 deaths each year. Therefore, the development of successful clinical assessments to monitor smoking cessation efforts is of the utmost importance. Self efficacy is a measure of confidence to quit smoking. This study shows that the relationship between self efficacy and smoking cessation is bi-directional which may be influenced by the timing of assessments. Understanding this relationship may lead to more successful use of self efficacy as a clinical tool during smoking cessation attempts.
    Date: 23 September 2011
    Date Type: Completion
    Defense Date: 14 July 2011
    Approval Date: 23 September 2011
    Submission Date: 26 July 2011
    Access Restriction: No restriction; The work is available for access worldwide immediately.
    Patent pending: No
    Institution: University of Pittsburgh
    Thesis Type: Master's Thesis
    Refereed: Yes
    Degree: MS - Master of Science
    URN: etd-07262011-123110
    Uncontrolled Keywords: generalized linear mixed models; nicotine; self efficacy; smoking cessation
    Schools and Programs: Graduate School of Public Health > Biostatistics
    Date Deposited: 10 Nov 2011 14:54
    Last Modified: 20 Jan 2012 13:09
    Other ID: http://etd.library.pitt.edu/ETD/available/etd-07262011-123110/, etd-07262011-123110

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