Influences of barriers to cessation and reasons for quitting on substance use among treatment-seeking smokers who report heavy drinking

Objectives: We examined behavioral and cognitively-based quit processes among concurrent alcohol and tobacco users and assessed whether smoking and drinking were differentially influenced.

Methods: Participants were 200 treatment-seeking smokers (37.50% female; M_age = 30.72; SD = 12.68) who reported smoking an average of 10 or more cigarettes daily for at least one year.

Results: Barriers to cessation (BCS) and reasons for quitting (RFQ) were generally correlated with substance use. BCS moderated the relationship between quit methods and cigarette use such that quit methods were negatively associated with smoking, particularly among those with more BCS. RFQ moderated the association between quit methods and cigarette use such that quit methods were negatively linked with smoking among those with fewer RFQ, but positively linked with smoking among those with more RFQ. Two 3-way interactions emerged. The first 3-way indicated that among individuals with fewer RFQ, quit methods was negatively associated with smoking, and this was strongest among those with more BCS. However, among those with more RFQ, smoking and quit methods were positively associated, particularly among those with more BCS. The second 3-way showed that among those with fewer RFQ, quit methods was negatively linked with drinking frequency, and this was strongest among those with more BCS. However, among those with fewer BCS, drinking and quit methods were positively linked.

Conclusions: The relationship between behavioral and cognitively-based quit processes and substance use is not straightforward. There may be concurrent substance-using individuals for whom these processes might be associated with increased substance use.