Associations between self-reported sleep quality, fatigue severity, factors associated with successful cessation, and cessation beliefs among regular smokers

Joe A Matthews; Hannah M Sallis; Maddy L Dyer; Ryan McConville; Hanna Isotalus; Angela S Attwood

doi:10.1093/ntr/ntad231

Associations between self-reported sleep quality, fatigue severity, factors associated with successful cessation, and cessation beliefs among regular smokers

Nicotine Tob Res. 2023 Nov 23:ntad231. doi: 10.1093/ntr/ntad231. Online ahead of print.

Authors

Joe A Matthews^{1

2

3

4}, Hannah M Sallis^{3

5}, Maddy L Dyer^{1

3}, Ryan McConville⁶, Hanna Isotalus², Angela S Attwood^{1

3

4

7}

Affiliations

¹ School of Psychological Science, University of Bristol, 12a Priory Rd, Bristol.
² Department of Electrical and Electronic Engineering, University of Bristol, 1 Cathedral Square, Bristol.
³ Medical Research Council Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol.
⁴ Integrative Cancer Epidemiology Programme at the University of Bristol.
⁵ CAMH (Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, BS8 2BN.
⁶ Department Engineering and Mathematics, Ada Lovelace Building, University of Bristol, University Walk, Bristol.
⁷ Bristol Biomedical Research Centre at the University of Bristol.

PMID: 37996095
DOI: 10.1093/ntr/ntad231

Abstract

Background: Smokers report poorer sleep than non-smokers and sleep quality deteriorates further during cessation, increasing risk of smoking relapse. Better understanding of the relationship between sleep and relapse-related outcomes could inform novel approaches to smoking cessation support. The aim of this study was to investigate same day associations of self-reported sleep quality and fatigue severity with factors associated with successful cessation and cessation beliefs, among regular smokers.

Methods: This cross-sectional observational study (n=412) collected self-reported sleep quality, fatigue severity, and factors associated with successful cessation and cessation beliefs among regular smokers via an online survey (60% male).

Results: There was evidence of an association between sleep quality (SQ) and reduced 24hr (β = -0.12, p = 0.05) and lifetime (β = -0.09, p = 0.04) abstinence self-efficacy. In addition, poorer SQ and higher fatigue severity (FS) were associated with increased smoking urges (SQ: β = 0.27, p < .001; FS: β = 0.32, p < .001), increased barriers to cessation (SQ: β = 0.19, p < .001; FS: β = 0.32, p < .001), and increased perceived risks to cessation (SQ: β = 0.18, p < .001; FS: β = 0.26, p < .001). Fatigue severity was weakly associated with increased perceived benefits to cessation (β = 0.12, p = .017).

Conclusions: Self-reported sleep quality and fatigue severity were associated with multiple factors associated with successful cessation and cessation beliefs. Further research is needed to extend these findings by using different methods to identify the temporal direction of associations and causality.

Implications: This study is the first to examine associations between sleep quality, fatigue severity, and factors associated with successful cessation and cessation beliefs. Findings show that both sleep quality and fatigue severity are associated with multiple factors associated with successful cessation and could be modifiable targets for future smoking cessation interventions. Furthermore, our data suggest that fatigue severity has an independent effect on multiple factors associated with successful cessation when accounting for sleep quality. This indicates that fatigue, independent of sleep quality, could be an important factor in a quit attempt.

Keywords: Barrier; Cessation beliefs; Fatigue; Sleep quality; Smoking; Smoking relapse.

Grants and funding

29019/CRUK_/Cancer Research UK/United Kingdom