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

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cris.lastimport.scopus2025-04-07T03:12:32Z
dc.abstract.enAims 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.
dc.affiliationInstytut Psychologii
dc.contributor.authorPerski, Olga
dc.contributor.authorKwaśnicka, Dominika
dc.contributor.authorKale, Dimitra
dc.contributor.authorSchneider, Verena
dc.contributor.authorSzinay, Dorothy
dc.contributor.authorten Hoor, Gill
dc.contributor.authorYeboah‐Asiamah Asare, Bernard
dc.contributor.authorVerboon, Peter
dc.contributor.authorPowell, Daniel
dc.contributor.authorNaughton, Felix
dc.contributor.authorKeller, Jan
dc.date.access2023-10-19
dc.date.accessioned2023-10-19T08:39:43Z
dc.date.available2023-10-19T08:39:43Z
dc.date.created2023-02-06
dc.date.issued2023-05-12
dc.description.abstract<jats:title>Abstract</jats:title><jats:sec><jats:title>Aims</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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’ [<jats:italic>k</jats:italic> = 12, odds ratio (OR) = 4.53, 95% confidence interval (CI) = 2.02, 10.16, <jats:italic>P</jats:italic> = 0.001] and ‘cravings’ (<jats:italic>k</jats:italic> = 10, OR = 1.71, 95% CI = 1.34, 2.18, <jats:italic>P</jats:italic> &lt; 0.001). ‘Negative feeling states’ was not significantly associated with lapse incidence (<jats:italic>k</jats:italic> = 16, OR = 1.10, 95% CI = 0.98, 1.24, <jats:italic>P</jats:italic> = 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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>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.</jats:p></jats:sec>
dc.description.accesstimeat_publication
dc.description.issue7
dc.description.physical1195-1405
dc.description.versionfinal_published
dc.description.volume118
dc.identifier.doi10.1111/add.16173
dc.identifier.eissn1360-0443
dc.identifier.issn0965-2140
dc.identifier.urihttps://share.swps.edu.pl/handle/swps/83
dc.identifier.weblinkhttps://onlinelibrary.wiley.com/doi/full/10.1111/add.16173
dc.languageen
dc.pbn.affiliationpsychologia
dc.rightsCC-BY
dc.rights.questionYes_rights
dc.share.articleOTHER
dc.subject.enAmbulatory assessment
dc.subject.enecological momentary assessment
dc.subject.enmeta-analysis
dc.subject.ensmoking cessation
dc.subject.ensmoking lapse
dc.subject.ensystematic review
dc.swps.sciencecloudsend
dc.titleWithin‐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
dc.title.journalAddiction
dc.typeJournalArticle
dspace.entity.typeArticle