The finding that better treatment adherence predicted better treatment outcomes was consistent across both the primary and the secondary measures of smoking cessation. Tests of Mediation Primary tests of mediation (i.e., tests of the ab effect) http://www.selleckchem.com/products/AZD2281(Olaparib).html suggested that the effects of both desire to quit and expected success in quitting were partially mediated by counselor-rated adherence to counseling. As shown in Table 2, this finding was robust across both the primary and the secondary measures of treatment outcome and was confirmed by the secondary test of mediation, the effect estimate for c �C c?. There was no evidence that nicotine patch adherence mediated the relationship between pretreatment thoughts about abstinence and smoking cessation outcomes.

Although the estimate of the primary mediation effect (test of the ab effect) suggested that session attendance mediated the relationship between expected success in quitting and prolonged abstinence, this effect was not confirmed in the alternative test of mediation, the effect estimate for c �C c?. Thus, the results of our mediation analyses provide strongest support for adherence to counseling, as rated by counselors, as a mediator of the effects of pretreatment desire to quit and expected success in quitting on smoking cessation outcome (see Figure 1 for a depiction of the primary findings). Figure 1. Summary of findings from the mediation analyses, demonstrating that counselor-rated adherence mediates the relationship between pre-treatment thoughts about abstinence (i.e., desire to quit and expected success in quitting) and outcome of a smoking cessation .

.. Discussion Our findings indicated that pretreatment motivation (i.e., desire to quit) and self-efficacy (i.e., expected success in quitting) were independently associated with smoking cessation outcomes in adults with ADHD, as were all three of the indicators of adherence to smoking cessation treatment that we examined: session attendance, adherence to counseling, and nicotine patch adherence. These findings are in agreement with previous studies documenting, with varying degrees of consistency, that increased self-efficacy (Gwaltney et al., 2010) and motivation (Schmueli et al., 2008) and better treatment adherence (Cooper et al., 2008; Shiffman et al., 2008) predict better smoking cessation outcomes.

The novel aspect of our findings is that, to our knowledge, this is the first study to demonstrate these relationships in treatment-seeking smokers with ADHD, who are typically excluded from smoking cessation studies and who have generally been under-represented in tobacco treatment research despite the high prevalence of smoking among individuals with the Brefeldin_A disorder (Lambert & Hartsough, 1998; McClave et al., 2010). In contrast to the findings of previously published studies in smokers without ADHD (Etter & Perneger, 2001; McCarthy et al.