AUTHOR=Voigt Elizabeth C. , Mutter Elizabeth R. , Oettingen Gabriele 

TITLE=Effectiveness of a Motivational Smoking Reduction Strategy Across Socioeconomic Status and Stress Levels

JOURNAL=Frontiers in Psychology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2022.801028

DOI=10.3389/fpsyg.2022.801028

ISSN=1664-1078

ABSTRACT=<p>Smoking consequences are seen disproportionately among low-SES smokers. We examine the self-regulatory strategy of mental contrasting with implementation intentions (MCII) as a smoking reduction tool and whether its effectiveness depends on subjective-SES. This pre-registered online experiment comprised a pre-screening, baseline survey, and follow-up. Participants reported past-week smoking, subjective-SES, perceived stress, and were randomized to an active control (<italic>n</italic> = 161) or MCII condition (<italic>n</italic> = 164). Data were collected via MTurk, during the U.S.’ initial wave of COVID-19. Participants were moderate-to-heavy smokers open to reducing or quitting. The primary outcome was self-reported smoking reduction, computed as the difference between recent smoking at baseline and follow-up. The secondary outcome was cessation, operationalized as self-reported 7-day point-prevalence abstinence at follow-up. Among those low—but not high—in subjective-SES, MCII (vs. control) improved smoking reduction by an average of 1.09 fewer cigarettes smoked per day, though this effect was not conclusive (<italic>p</italic> = 0.11). Similarly, quitting was descriptively more likely for those in the MCII than control condition, but the effect was non-significant (<italic>p</italic> = 0.11). Per an exploratory analysis, we observed that stress significantly moderated the condition effect (<italic>p</italic> = 0.01), such that MCII (vs. control) facilitated reduction among those experiencing high (<italic>p</italic> = 0.03), but not low stress (<italic>p</italic> = 0.15). Consistent with prior findings that MCII works best in vulnerable populations, MCII may be more effective for smoking reduction among high-stress than low-stress individuals. These findings contribute to growing research on income-related health disparities and smoking behavior change tools.</p>