Social Network Determinants of Cigarette Forgoing and Quit-Related Conversations in a 15-Day Ecological Momentary Assessment Study in Mexico and the US.

Introduction: It is unclear why people of Mexican ancestry who smoke report relatively high rates of discussing quitting-related topics, which predicts cessation attempts. Methods: Using Ecological Momentary Assessment (EMA), adults from Mexico (n=40) and with Mexican heritage living in the US (n=52) who smoked daily were sent texts/emails each morning with cessation tips and cessation benefits over 15 days. At baseline, participants reported their personal network characteristics across up to eight different alters. Each evening of the 15 days, participants reported forgoing any cigarettes they normally would smoke (yes/no) and having had any quitting-related conversations (yes/no). Multilevel logistic models were estimated to regress these day-level outcomes of forgoing and, separately, quitting-related conversation on the number of EMA surveys participants had completed prior to that day, network characteristics, and baseline sociodemographic and smoking-related covariates. Results: Participants were more likely to forgo cigarettes if they reported a higher proportion of female alters (AOR = 2.20, 95% CI 1.16-4.18), had more quitter alters whose opinions they respected (AOR = 6.14, 95% CI 1.41-26.75), and as the number of prior EMA surveys completed increased (AOR = 1.19, 95% CI 1.14-1.25). Mexican Americans who preferred English were significantly less likely to forgo smoking (AOR = 0.20, 95% CI 0.04-0.99) compared to participants residing in Mexico. Greater social bonding (i.e., tightly knit networks) was positively associated with having quitting-related conversations (AOR = 1.45, 95% CI 1.05-1.99). Conclusions: Combining targeted messages with activation of quit-support within networks may influence intermediary behaviors that facilitate smoking cessation among Latino/a populations, including individuals not intending to quit soon.