Everyday discrimination indirectly influences smoking cessation through post-quit self-efficacy

Drug Alcohol Depend. 2019 May 1:198:63-69. doi: 10.1016/j.drugalcdep.2019.01.033. Epub 2019 Feb 28.


Background: Although studies have shown an association between discrimination and current smoking, the influence of discrimination on smoking cessation is an understudied area in tobacco research. The current study evaluated the influence of everyday discrimination on smoking cessation and examined self-efficacy as a potential mediator of this association.

Methods: Participants (N = 146), who were recruited from a safety-net hospital in Dallas County, Texas, from 2011 to 2013, completed a self-report measure of perceived discrimination one week before the scheduled quit attempt and self-efficacy for quitting was assessed one day after the scheduled quit date. Biochemically-verified 7-day point prevalence abstinence was assessed weekly, through the fourth week after the scheduled quit date. Structural equation modeling was used to evaluate the indirect effect of perceived discrimination on smoking cessation via self-efficacy for quitting.

Results: Analyses indicated significant indirect effect of discrimination on smoking cessation through self-efficacy at Weeks 1 (B = .09, SE = .04, p = .02) and 4 (B = .07, SE = .03, p = .03). A higher frequency of discrimination was associated with lower self-efficacy one day after the scheduled quit date, and lower self-efficacy increased the likelihood of smoking one and four weeks after the scheduled quit attempt.

Conclusions: Findings suggest that perceptions of discrimination reduce the likelihood of smoking cessation via diminished self-efficacy. Future research is needed to identify intervention strategies to reduce the frequency of discrimination experiences and attenuate the negative impact of discrimination and low self-efficacy on smoking cessation.

Keywords: Discrimination; Mediation; Self-efficacy; Smoking cessation; Socioeconomic status.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Discrimination, Psychological*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Safety-net Providers
  • Self Efficacy*
  • Smoking / psychology*
  • Smoking / therapy
  • Smoking Cessation / psychology*
  • Texas