Valued life activities and readiness to quit smoking among mobility-impaired smokers.

Busch AM, Borrelli B.  Centers for Behavioral and Preventive Medicine, Program in Nicotine and Tobacco, Alpert Medical School of Brown University, Providence, RI 02903, USA.  Health Psychol. 2012 Jan;31(1):122-5. doi: 10.1037/a0025218. Epub 2011 Aug 29.

OBJECTIVE: People with physical disabilities smoke at a higher rate than their nondisabled peers, with rates as high as 28-40% among nonelderly adults. One possible explanation for these findings is that restriction of valued life activities (social, professional, pleasurable or otherwise meaningful) due to mobility impairment interferes with smoking cessation.

METHODS: Forty-seven smokers (48.9% female; Mage = 48.91) with chronic mobility impairments (i.e., regularly use equipment to ambulate) were interviewed over the telephone. We assessed demographics, self-efficacy to quit smoking, stage of change, current engagement in valued activities, current restriction of valued activities due to physical limitations, and efforts to replace restricted valued activities in a cross sectional design.

RESULTS: Bivariate results indicate that 74% of those in the preparation stage had satisfactory replacements for their most valued restricted activity, whereas only 27% in the contemplation stage and 17% in the precontemplation stage had such satisfactory replacements. Multinomial ordinal regression analyses revealed that (a) having satisfactory replacements for activities restricted due to physical disability was significantly associated with higher stage of change and (b) more current valued activities and, to a lesser extent, fewer restricted activities were significantly associated with higher levels of self-efficacy to quit smoking.

CONCLUSIONS: These results support the need for the development of treatments for smoking cessation that aim to increase engagement in valued activities, such as behavioral activation.