Emotion regulation difficulties and social control correlates of smoking among pregnant women trying to quit

Abstract

Approximately 15% of US women currently smoke during pregnancy. An important step toward providing effective smoking cessation interventions during pregnancy is to identify individuals who are more likely to encounter difficulty quitting. Pregnant smokers frequently report smoking in response to intrapersonal factors (e.g., negative emotions), but successful cessation attempts can also be influenced by interpersonal factors (i.e., influence from close others). This study examined the association between emotion regulation difficulties, positive and negative social control (e.g., encouragement, criticism), and smoking cessation-related variables (i.e., smoking quantity, withdrawal symptoms) among pregnant smokers. Data were drawn from the pretreatment wave of a smoking cessation trial enrolling low-income pregnant women who self-reported smoking in response to negative affect (N = 73). Greater emotion regulation difficulties were related to greater smoking urges (b = 0.295, p = .042) and withdrawal symptoms (b = 0.085, p = .003). Additionally, more negative social control from close others was related to fewer smoking days (b = -0.614, p = .042) and higher smoking abstinence self-efficacy (b = 0.017, p = .002). More positive social control from close others interacted with negative affect smoking (b = -0.052, p = .043); the association between negative affect smoking and nicotine dependence (b = 0.812, p < .001) only occurred at low levels of positive social control. Findings suggest that emotion regulation difficulties may contribute to smoking during pregnancy by exacerbating women's negative experiences related to smoking cessation attempts. Negative social control was related to lower smoking frequency and greater confidence in quitting smoking, suggesting that it may assist pregnant smokers' cessation efforts. Positive social control buffered women from the effects of negative affect smoking on nicotine dependence. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01163864.

Keywords: Close relationships; Emotion regulation; Pregnancy; Smoking cessation; Social control.

Copyright © 2018 Elsevier Ltd. All rights reserved.

Figures

Figure 1.

Interaction between negative affect smoking and positive social control predicting nicotine dependence at pretreatment Note. FTND = Fägerstrom Test for Nicotine Dependence. Predicted values were calculated at +/− 1 standard deviation from the sample mean on negative affect smoking and positive social control. Because having negative affect smoking scores above 5.6 (mean established in prior research) was an eligibility criterion for the parent study, predicted values estimated at 1 standard deviation below the mean for negative affect smoking in the present sample are more appropriately characterized as “moderate” negative affect smoking.