Within‐person associations between psychological and contextual factors and lapse incidence in smokers attempting to quit: A systematic review and meta‐analysis of ecological momentary assessment studies
Within‐person associations between psychological and contextual factors and lapse incidence in smokers attempting to quit: A systematic review and meta‐analysis of ecological momentary assessment studies
StatusVoR
Alternative title
Authors
Perski, Olga
Kwaśnicka, Dominika
Kale, Dimitra
Schneider, Verena
Szinay, Dorothy
ten Hoor, Gill
Yeboah‐Asiamah Asare, Bernard
Verboon, Peter
Powell, Daniel
Naughton, Felix
Monograph
Monograph (alternative title)
Date
2023-05-12
Publisher
Journal title
Addiction
Issue
7
Volume
118
Pages
Pages
1195-1405
ISSN
0965-2140
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Access date
2023-10-19
Abstract PL
Abstract EN
Aims
When attempting to stop smoking, discrete smoking events (‘lapses’) are strongly associated with a return to regular smoking (‘relapse’). No study has yet pooled the psychological and contextual antecedents of lapse incidence, captured in ecological momentary assessment (EMA) studies. This systematic review and meta-analysis aimed to synthesize within-person psychological and contextual predictor–lapse associations in smokers attempting to quit.
Methods
We searched Ovid MEDLINE, Embase, PsycINFO and Web of Science. A narrative synthesis and multi-level, random-effects meta-analyses were conducted, focusing on studies of adult, non-clinical populations attempting to stop smoking, with no restrictions on setting. Outcomes were the association between a psychological (e.g. stress, cravings) or contextual (e.g. cigarette availability) antecedent and smoking lapse incidence; definitions of ‘lapse’ and ‘relapse’; the theoretical underpinning of EMA study designs; and the proportion of studies with pre-registered study protocols/analysis plans and open data.
Results
We included 61 studies, with 19 studies contributing ≥ 1 effect size(s) to the meta-analyses. We found positive relationships between lapse incidence and ‘environmental and social cues’ [k = 12, odds ratio (OR) = 4.53, 95% confidence interval (CI) = 2.02, 10.16, P = 0.001] and ‘cravings’ (k = 10, OR = 1.71, 95% CI = 1.34, 2.18, P < 0.001). ‘Negative feeling states’ was not significantly associated with lapse incidence (k = 16, OR = 1.10, 95% CI = 0.98, 1.24, P = 0.12). In the narrative synthesis, negative relationships with lapse incidence were found for ‘behavioural regulation’, ‘motivation not to smoke’ and ‘beliefs about capabilities’; positive relationships with lapse incidence were found for ‘positive feeling states’ and ‘positive outcome expectancies’. Although lapse definitions were comparable, relapse definitions varied widely across studies. Few studies explicitly drew upon psychological theory to inform EMA study designs. One of the included studies drew upon Open Science principles.
Conclusions
In smokers attempting to stop, environmental and social cues and cravings appear to be key within-person antecedents of smoking lapse incidence. Due to low study quality, the confidence in these estimates is reduced.
Abstract other
Keywords PL
Keywords EN
Ambulatory assessment
ecological momentary assessment
meta-analysis
smoking cessation
smoking lapse
systematic review
ecological momentary assessment
meta-analysis
smoking cessation
smoking lapse
systematic review
Keywords other
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