Dyadic Patterns of Abstinence From Smoking in Dual-Smoking Couples Enrolled in a Pilot Randomized Clinical Trial

Despite the positive role of social relationships in behavior change, dyadic interventions for smoking have not been consistently successful. This owes, in part, to the fact that dual-smoking cohabiting couples share similar routines, environments, and relational dynamics that can undermine quitting efforts. We adopted an exploratory and descriptive approach to identify distinct profiles of smoking abstinence within dyads, how relationship dynamics relate to these patterns, and whether these patterns predict smoking status at follow-up.

We utilized pre-existing data from a pilot RCT examining the effects of partner-involved financial incentives (PIFs) on dyadic abstinence. Both members of 95 dual-smoking couples (52% female, 73% White, M_age=42.39, SD=10.57) recruited between 2021-2022 provided baseline information about their relational and motivational dynamics, followed by 10 weeks of daily reports of smoking behavior, and biochemically verified quit status at follow-up.

Latent growth mixture models suggested four patterns of dyadic abstinence: Concordant abstainers, Discordant abstainers, Discordant non-abstainers, and Concordant non-abstainers. Treatment arm and motivational and relational dynamics predicted the probability of following specific dyadic patterns of behavior change, and dyadic patterns of change predicted individual and couple quitting status at follow-up.

Our findings underscore the importance of considering that treatment will facilitate coordinated dyadic behavior change for some couples but not all and emphasize the need to better understand when and how mechanisms support long-term abstinence. More work is needed to investigate whether these patterns generalize across samples with more diverse sociodemographic and health characteristics.