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Cognitive and affective predictors of smoking after a sentinel health event
Emergency Medicine Publications and Presentations
  • Edwin D. Boudreaux, University of Massachusetts Medical School
  • Beau W. Abar, University of Massachusetts Medical School
  • Erin L. O'Hea, University of Massachusetts Medical School
  • Ashley F. Sullivan, Massachusetts General Hospital
  • Rita K. Cydulka, Case Western Reserve University School of Medicine
  • Steven L. Bernstein, Yale University
  • Carlos A. Camargo, Jr., Massachusetts General Hospital and Harvard Medical School
UMMS Affiliation
Department of Emergency Medicine
Publication Date
Document Type

Objective: This study examined how smoking-related causal attributions, perceived illness severity, and event-related emotions relate to both intentions to quit and subsequent smoking behavior after an acute medical problem (sentinel event).

Methods: Three hundred and seventy-five patients were enrolled from 10 emergency departments (EDs) across the USA and followed for six months. Two saturated, manifest structural equation models were performed: one predicting quit attempts and the other predicting seven-day point prevalence abstinence at 14 days, three months, and six months after the index ED visit. Stage of change was regressed onto each of the other predictor variables (causal attribution, perceived illness severity, event-related emotions) and covariates, and tobacco cessation outcomes were regressed on all of the predictor variables and covariates.

Results: Non-White race, baseline stage of change, and an interaction between causal attribution and event-related fear were the strongest predictors of quit attempt. In contrast, abstinence at six months was most strongly predicted by baseline stage of change and nicotine dependence.

Conclusion: Predictors of smoking behavior after an acute medical illness are complex and dynamic. The relations vary depending on the outcome examined (quit attempts vs. abstinence), differ based on the time that has progressed since the event, and include significant interactions.

  • Tobacco,
  • tobacco cessation,
  • motivation,
  • stage of change,
  • reliability,
  • validity
DOI of Published Version
Boudreaux ED, Abar B, O'Hea E, Sullivan AF, Cydulka R, Bernstein SL, Camargo CA Jr. Cognitive and affective predictors of smoking after a sentinel health event. Psychol Health Med. 2014 Aug;19(4):402-9. doi: 10.1080/13548506.2013.832781. Epub 2013 Sep 10. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
Citation Information
Edwin D. Boudreaux, Beau W. Abar, Erin L. O'Hea, Ashley F. Sullivan, et al.. "Cognitive and affective predictors of smoking after a sentinel health event" Vol. 19 Iss. 4 (2014) ISSN: 1354-8506 (Linking)
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