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J Behav Med. 2012 Oct;35(5):484-91. doi: 10.1007/s10865-011-9376-y. Epub 2011 Aug 18.

Barriers to quitting smoking among medically ill smokers.

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VA Boston Healthcare System, Brockton, MA 02301, USA.


Few studies examine predictors of smoking cessation among medically ill smokers, despite their high smoking prevalence. We prospectively examined barriers to smoking cessation in medically ill smokers, with age as a hypothesized moderator. Participants were smokers (N = 237, M (age) = 56.1, 53.6% females) receiving home-based nursing care. Baseline self-report questionnaires assessed barriers to cessation (demographics, smoking history, psychosocial, and medical factors). Smoking status was biochemically verified at 2- and 6-months post-intervention. Compared with younger smokers, older smokers had significantly lower levels of nicotine dependence, stress, and depressed mood and a greater prevalence of smoking-related diseases. Older smokers were more likely to achieve biochemically verified abstinence at 6-month follow-up (7.8%) than younger smokers (3.1%) though this difference was not significant. Higher levels of depressed mood and lower levels of perceived stress were associated with a greater likelihood of cessation at both follow-up points, but only for younger smokers. For younger smokers, higher self-efficacy to quit and the presence of a smoking-related disease increased the odds of abstinence. These findings could help guide treatment development for this high-risk group of smokers.

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