Persuasive communications can be developed to promote shifts in belief parameters sellckchem that will favor smoking cessation. We did not find, as others have, that perceived behavioral control was the strongest correlate of intention (Hu & Lanese, 1998; Norman et al., 1999), but there is substantial variability in studies regarding which, and how many, of the TPB constructs emerge as significant for intention to quit smoking (Armitage, 2007; Rise, Kovac, Kraft, & Moan, 2008). Methodological differences may account for dissimilar findings, but it is expected that the importance of each TPB construct will vary by population and behavior under study (Ajzen, 1991). Researchers have examined the contribution of non-TPB constructs in explaining the variation in intention to quit smoking.
In this study, number of prior quit attempts was the only non-TPB variable to meet multivariate model criteria, and it trended toward being positively related to intention to quit smoking. This suggests that LGBT smokers who try to quit and fail are not necessarily discouraged from future attempts to quit. Ongoing opportunities and support for cessation are important for building cessation experience and in sustaining motivation to quit. Despite our inclusion of LGBT-relevant measures in the study, none were associated with intention to quit smoking. The TPB assumes that the antecedents of intention and behavior, when adequately assessed, capture individual and cultural differences in a sample (Ajzen, 1988), so-called ��background variables,�� eliminating the need to measure these constructs separately from the TPB constructs.
Notably, we found that our sample’s mean CES-D score exceeded the cutoff score for clinically significant distress (Comstock & Helsing, 1976; Weissman et al., 1977). Depressive symptoms are more prevalent among smokers than nonsmokers (Anda et al., 1990). Further, the level of perceived stress in our sample was significantly elevated compared with the mean level observed in a large sample of working adults (n=10,189, M = 4.90, SD = 2.96; Ng & Jeffery, 2003; N. Mitchell, personal communication, 13 November 2007). Perceived stress is often higher among smokers (Jorm et al., 1999; Vollrath, 1998). It has been proposed that LGBT persons are burdened with minority stress (Meyer, 2003), which leads to greater prevalence of depression and other mental health problems (Cochran, Mays, & Sullivan, 2003). Perhaps LGBT persons who smoke would benefit from culturally tailored stress management integrated into smoking cessation treatment. Among the study’s limitations was the Carfilzomib low response to our anonymous survey, raising concerns about possible sampling bias.