Social Networks and Tobacco Cessation in High-Risk Populations

Cigarette smoking remains the leading cause of preventable disease and death in the United States. Emerging adulthood (ages 18–26) is a critical developmental period when lifelong patterns of tobacco use are often established. Despite population-level declines in smoking, these declines have not been equal, and significant differences persist in tobacco use across sociodemographic groups. This underscores the urgent need for innovative approaches to improve the reach and effectiveness of tobacco prevention and cessation efforts during this developmental period. We propose that to reduce tobacco use more effectively in this age group, it is necessary to understand and leverage the immediate social environment—specifically, the social relationships including peers, family, and close social ties that influence prevention and facilitate behavior change. However, the field lacks a clear understanding of how these micro-social dynamics interact with known psychosocial drivers of tobacco use. This project will use mixed methods to examine how psychosocial stress, social group identification, and the micro-social environment (i.e., network structure, social norms, and support) shape tobacco use trajectories and cessation outcomes in emerging adults. Our overarching goal is to identify modifiable drivers of persistent tobacco use that can serve as novel targets for future intervention development. In Aim 1, we use cross-sectional egocentric network interviews (N=600) to compare psychosocial stress and social network features across tobacco use statuses (never, current, former). In Aim 2, we follow a cohort of current smokers (N=350) over 12 months to evaluate how stress and network features predict cessation, including quit intention, attempts, and 7-day bioverified abstinence. For Aim 3, we will recruit a subset of this cohort for in-depth qualitative interviews with a purposive subsample of 12 ego networks from Aim 2 (N=36; 12 egos and up to 3 alters per ego) to examine how network structure and function influence quitting. The findings will be used to generate new insights for designing targeted, network-informed interventions to improve cessation outcomes across sociodemographic groups. Project Number: 1R01CA310767-01 | Fiscal Year: 2026 | NIH Institute/Center: National Cancer Institute (NCI) | Principal Investigator: Christopher Wheldon | Institution: TEMPLE UNIV OF THE COMMONWEALTH, PHILADELPHIA, PA | Award Amount: $522,235 | Activity Code: R01 | Study Section: Special Emphasis Panel[ZRG1 SCIL-J (90)] View on NIH RePORTER: https://reporter.nih.gov/project-details/11329008