The experience of smoking in recovery settings: an ecological momentary assessment pilot study

ABSTRACT

Smoking continues to be the leading cause of preventable death in the United States, and people with substance use disorders (SUD) smoke at higher rates compared to their non-using counterparts. Individuals with SUDs may have different emotional experiences and expectancies than those without. The current study explored the relationship between smoking and emotional experiences among residents in recovery homes, a population that little is known about regarding their tobacco addiction. Using ecological momentary assessment (EMA), significant emotional differences were found between nicotine users and nonusers. Implications of these findings could help in the development of interventions directed toward reducing smoking cessation.     

Is more better? The relationship between outcomes achieved by problem gamblers and the number of counselling sessions attended

Abstract

This paper addresses the question of how much intervention is necessary for the effective treatment of problem gambling by exploring the relationship between the number of counselling sessions attended and the degree of problem resolution achieved for 613 individuals who attended problem gambling counselling services in Victoria. While those who achieved partial or full resolution of presenting problems attended more sessions than those who finished counselling with their problems still unresolved, problems were typically reported as being resolved in fewer than five sessions. It is concluded that for some problem gamblers a relatively brief intervention may be sufficient.     

A systematic approach to smoking cessation activities in Danish shelters

Introduction: Shelter users have an alarmingly high smoking prevalence; our aim was to develop systematic smoking cessation activities in the shelters. Method: All available (n?=?13) shelters in Copenhagen were included. This Participatory Action Research had a development/test period and an implementation period for the revised intervention. Shelter-staff completed a questionnaire at baseline. Municipal smoking cessation counselors were trained to work with shelter users. Three types of on-site smoking cessation activities were developed and offered. Results: The estimated mean smoking prevalence in shelter users was 79%. Only two shelters ran smoking cessation activities prior to study start. All but one of the shelters implemented group-based intervention activities and approximately 13% of smokers signed-up; 26.6% of those who attended the first session were abstinent after approximately 12 weeks, as confirmed by staff. Conclusion: Smoking cessation activities in shelters are wanted by staff and shelter users, they are feasible and even very vulnerable persons are able to quit. Based on our experiences in Copenhagen shelters, we propose a systematic approach for future smoking cessation initiatives: smoking activities should be driven by the municipality, be pro-active, on-site, tailored and flexible, in addition, free nicotine therapy should be offered and trained smoking cessation counselors should be available.     

Do “Clicker” Educational Sessions Enhance the Effectiveness of a Social Norms Marketing Campaign?

Abstract

Objective: Social norms campaigns are a cost-effective way to reduce high-risk drinking on college campuses. This study compares effectiveness of a “standard” social norms media (SNM) campaign for those with and without exposure to additional educational sessions using audience response technology (“clickers”). Methods: American College Health Association's National College Health Assessment questions are used to evaluate actual and perceived use. Additional survey questions assess individual exposure to the interventions. Results: The authors find “clicker” technology to be more effective than social norms poster media alone in reducing misperceptions of normative alcohol use for those students who attended clicker sessions. Conclusion: Poster SNM campaigns may be most effective when supported by group “clicker” heath-related sessions.     

Efficacy of a Web-Based,Tailored, Alcohol Prevention/Intervention Program for College Students: Initial Findings

Abstract

Objective: Reduce college student at-risk drinking (ARD) using a Web-based brief motivational alcohol prevention/intervention called Michigan Prevention and Alcohol Safety for Students (M-PASS). Participants: Participants included 1,137 randomly sampled first-year college students, including 59% female, 80% white, and averaged age 18.1 years. Methods: Intervention group participants (n = 616) attended 4 online M-PASS sessions, receiving feedback tailored to individual drinking patterns and concepts from 4 behavior change theories. Control group participants (n = 521) completed a mid-phase survey, and both groups were surveyed at baseline and posttest. Results: Evidence of M-PASS's efficacy was found. The intervention was associated with advanced stage of change, lower tolerance of drinking and drink/driving, fewer reasons to drink, and use of more strategies to avoid ARD. Preliminary evidence of behavioral change was also found. Efficacy was greater for women than men. Conclusions: Web-based programs may be useful in reducing alcohol-related risk among college students. Further evaluation is needed.     

DSM-5 substance use disorders among college-age young adults in the United States: Prevalence,remission and treatment

Abstract

Objective: To determine the prevalence, remission, and treatment associated with DSM-5 substance use disorders (SUDs) among young adults based on college attendance. Participants: The population-based sample included 2,057 young adults aged 19–23 in college/school and 1,213 not currently attending college/school who participated from April 2012 through June 2013. Methods: Face-to-face interviews were conducted as part of a cross-sectional national survey. Results: The prevalence of any past-year DSM-5 SUD was 39.6% among young adults in college and 44.5% among those not attending college. Past-year tobacco use disorder and multiple DSM-5 SUDs were more prevalent among those not attending college. Among those with prior-to-past-year SUDs, abstinent remission was low among college (1.0%) and noncollege (1.9%) young adults. Conclusions: Approximately two in five U.S. college students had at least one past-year DSM-5 SUD. Sustained abstinent remission from SUDs is extremely rare (1–2%) and the majority of those with SUDs do not receive treatment.     

Use of and Interest in Smoking Cessation Strategies Among Daily and Nondaily College Student Smokers

Abstract

Objective: To examine use of and interest in cessation strategies among nondaily and daily college student smokers. Participants: 800 undergraduate student smokers aged 18 to 25. Methods: The authors examined nondaily versus daily smoking in relation to use of and interest in cessation strategies using an online survey. Results: Nondaily (65.8%) versus daily smokers (34.3%) were more likely to have made a quit attempt (p = .01) but less likely to have used any assistance (p < .001). Nondaily smokers were less interested in pharmacotherapy and traditional behavioral interventions; however, there was no difference in interest in technology-based interventions among nondaily versus daily smokers. Controlling for covariates, there were no significant differences in interest in traditional or technology-based behavioral interventions. Higher motivation, lower confidence, and depressive symptomatology were related to interest in each intervention. Smoking for social reasons was related to interest in technology-based interventions. Conclusions: Different intervention strategies may be appropriate for nondaily and daily smokers.     

College Smoking Policies and Smoking Cessation Programs: Results of a Survey of College Health Center Directors

Abstract

College students' cigarette smoking rose dramatically during the 1990s. Little is known about what colleges do to address the problem. Health center directors at 393 4-year US colleges provided information (response rate: 65.1%) about college policies addressing smoking and the availability of smoking cessation programs. Of the health center directors surveyed, 85% considered students' smoking a problem; yet only 81% of colleges prohibit smoking in all public areas and only 27% ban smoking in all indoor areas, including students' rooms in dormitories and in private offices. More than 40% of the respondents reported that their schools did not offer smoking cessation programs and that the demand for existing program was low. Colleges need to do more to discourage student tobacco use. Recommended actions include campus-wide no-smoking policies that apply to student residences and identification of new ways of providing smoking prevention and cessation services.     

Assessing College Students' Autonomy Over Smoking With the Hooked on Nicotine Checklist

Objective, Participants, and Methods: In this study, the authors explored the psychometric properties of the Hooked on Nicotine Checklist (HONC) among 300 college students who were current smokers. The HONC is a 10-item survey instrument designed to measure diminished autonomy over smoking, a key aspect of dependence. Autonomy is diminished when symptoms present a barrier to cessation. Results: Internal consistency was high (α = .89), as was concurrent validity. Students who began smoking earlier and heavier smokers reported more symptoms than did those who started later and smoked less. After controlling for smoking frequency, the HONC was predictive of the likelihood of a failed cessation attempt, with each additional symptom doubling that likelihood. Conclusions: College health professionals could use the HONC to help new smokers recognize their symptoms of diminished autonomy. The HONC may serve as a recruiting tool for cessation programs, which could benefit such early-phase smokers.     

Evaluation of targeted human papillomavirus vaccination education among undergraduate college students

Abstract

Objective: To design and evaluate pharmacy student-led educational sessions to improve health beliefs about the HPV vaccine in college-aged students. Participants: Students aged 18–26 attending a large, urban university, including 545 respondents to a December 2014 needs assessment survey about HPV-related health beliefs, 131 students participating in educational sessions during 2015–2016 (intervention group), and 369 undergraduate respondents completing the needs assessment survey (control group). Methods: A needs assessment survey was conducted to inform design and implementation of pharmacy student-led educational sessions. A similar survey was administered to students after attending educational sessions. Health beliefs were compared for the intervention versus control group. Results: The intervention group was less likely to report high perceived barriers to HPV vaccination and more likely to report high perceived benefits and intention to vaccinate (if previously unvaccinated). Conclusions: Pharmacy student-led, health belief-based educational sessions were associated with improved health beliefs about HPV vaccination.     

Internet and Mobile Phone Text Messaging Intervention for College Smokers

Objective: The authors developed a smoking cessation program using mobile phone text messaging to provide tailored and stage-specific messages to college smokers. Participants and Methods: The authors recruited 31 daily smokers who desired to quit from a college campus and asked them to use an Internet and mobile phone text messaging program to quit smoking. Results: Six weeks after program initiation, 45% reported abstinence with 42% abstinent based on cotinine verification. Continued smokers reported significantly reduced smoking rates and dependence. Overall, participants accepted the text messages. Conclusions: These results replicate findings from an earlier study and indicate that mobile phone text messaging is a potentially efficacious and easily disseminated method for providing cessation interventions to young adult smokers.     

Comparing the effectiveness of behavioral interventions in adults with co-occurring tobacco and substance use disorders: a systematic review of literature

ABSTRACT

This systematic literature review compares the e?ectiveness of various behavioral interventions delivered to persons with co-occurring tobacco and substance use disorders. It examines ?ndings of six randomized trials and three secondary analyses from randomized trials. Based on the ?ndings of this literature review, support is given to the following: (1) The consequences of tobacco use and smoking are deadly, costly, and can have an inhibitory e?ect on the progress of people in substance abuse treatment, (2) tobacco cessation options are a preventive intervention that can be easily incorporated into a treatment facility’s standard of practice and should be made available within the context of all substance abuse treatment facilities, and (3) concurrently treating tobacco use disorder and substance use disorder(s) is an e?ort that will help meet the social work profession’s Grand Challenge to ‘Close the Health Gap.’     

Preliminary evaluation of contingent meals and telephone use to improve evidence-supported family therapy session attendance in mothers referred by Child Protective Services for substance abuse

Persons referred by Child Protective Services (CPS) for substance abuse evidence high rates of nonattendance to therapy sessions, taxing systems of care and exacerbating outcomes. This study examined the influence of two telephone-based incentive programs on therapy session attendance in mothers who were referred by CPS for substance abuse. After baseline therapy session attendance was established in an evidence-based clinic that incorporated a telephone engagement intervention (Phase I), participants were provided free cellular telephones with limited minutes and permitted to order free meals delivered by the therapist during upcoming sessions (Phase II). The third phase was similar to Phase II, but participants were provided unlimited minutes. Results indicated that participants’ attendance was significantly improved when meals and cellular telephone minutes were contingent on attendance. Although the percentage of sessions attended by participants during Phase III was higher than Phase II, unlimited minutes and meals did not significantly enhance attendance relative to limited minutes and meals. Session attendance for significant others of these participants was significantly higher during Phase III as compared with Phase I. Session attendance of significant others was statistically similar between Phase I and II and between Phase II and Phase III. Study implications and recommendations for future research and practice are discussed in light of the findings.     

Coping and Regulating Emotions: A Pilot Study of a Modified Dialectical Behavior Therapy Group Delivered in a College Counseling Service

Abstract

Objective: To analyze the efficacy of a pilot program, aimed at treating college students with borderline personality disorder (BPD) using short-term, modified group dialectical behavior therapy at an Australian college counseling service (CCS). Participants: Seventeen enrolled college students aged between 18 and 28 (76.5% female), with a diagnosis of BPD completed the program between November 2009 and November 2010. Methods: Participants attended 8 2-hour group therapy sessions, held at the CCS during semester. Participants were assessed for levels of depression, anxiety, BPD traits, and coping strategies, at commencement and completion of the program. Results: There was a reduction in symptoms of depression and BPD traits, and an increase in adaptive coping skills, including problem solving, and constructive self-talk. There was no reduction in anxiety. Conclusions: The findings indicate promise for short-term treatment of college students with BPD. Implications and limitations are discussed, with emphasis on replication with a control group.     

Depressive Symptoms and Cigarette Smoking in a College Sample

Objective and Participants: The authors examined (1) the relationship between depressive symptoms and cigarette smoking in a college sample and (2) the role of smoking self-efficacy (one's perceived ability to abstain from smoking) in explaining the relationship between depressive symptoms and cigarette smoking. Methods: Predominantly first-year college students at a large public university completed a self-report inventory indexing depressive symptoms, cigarette smoking, and smoking self-efficacy. Results: Findings indicated that students high in depressive symptoms smoked significantly more cigarettes per day than did those with low depressive symptoms. Further, among current smokers, smoking self-efficacy explained the relationship between depressive symptoms and cigarette smoking. Conclusions: These findings add to accumulating evidence that depressive symptoms are a risk factor for increased cigarette smoking in college students. The authors discuss implications for university-based smoking cessation and prevention programs.     

Preliminary Results of a Longitudinal Study of Collegiate Alcohol Abuse

Abstract

Objective: Hookah smoking is a popular form of tobacco use on university campuses. This study documented use, attitudes, and knowledge of hookah smoking among college students. Participants: The sample included 943 university students recruited between February 2009 and January 2010. Respondents (M age = 20.02) included 376 males, 533 females, and 34 who did not report sex. Methods: An anonymous online questionnaire was completed by respondents. Results: In this sample, 42.9% of college students had tried hookah, and 40% of those individuals had used it in the past 30 days. Students perceived fewer negative consequences of hookah smoking compared with cigarette smoking. Age, sex, racial background, marijuana/cigarette use, and perceptions of side effects were significantly associated with hookah use. Conclusions: University students are misinformed regarding the health consequences of hookah smoking. Programs aimed at education, prevention, and intervention for hookah use are needed to address this growing public health concern.     

The impact of a health education intervention on health behaviors and mental health among Chinese college students

Abstract

Objective: This study aimed to assess the impact of a health education intervention on health behaviors, self-efficacy, and well-being among college students. Participants: Between March and October 2016, a total of 532 undergraduates participated. Methods: A theory-based intervention was conducted at Wuhan University, China. Participants were assigned to a control or intervention group (IG). The IG attended a 7-week health education class on knowledge, attitude, and practice of health behaviors. Results: Participants in the IG, compared with those in the control group (CG), reported significantly increased prevalence of high physical activity and regular breakfast, as well as lower screen time, sugar beverage intake, and Internet addiction tendency. Furthermore, intervention students improved in health behavior scores (p?=?0.040), compared with the CG, while the changes in subjective well-being and self-efficacy remained similar between the two groups. Conclusions: Health education may promote health behaviors among Chinese college students.     

A Smoking and Health Fair: Implementation and Evaluation

Abstract

A two-day health fair that focused entirely on the tobacco smoking habit was organized. Participating agencies offered information on smoking effects, cessation programs, and health screening to fair visitors. A visitor questionnaire indicated that the fair was successful in attracting both smokers and nonsmokers and that each group found information that was perceived as helpful. Issues involved in coordinating the project are discussed and suggestions for future smoking and health fairs are offered.     

Examination of the relationship between social support and treatment outcomes in mothers referred by Child Protective Services utilizing the Significant Other Support Scale

ABSTRACT

Supportive social networks may play an important role in recovery for mothers within the umbrella of Child Protective Services (CPS). However, investigators have yet to develop methods of measuring how significant others contribute to the treatment and recovery process. In this study, the influence of significant others was examined in the family-based treatment of 38 mothers who were referred for Family Behavior Therapy by CPS. The Significant Other Support Scale (SOSS) was empirically developed and subsequently utilized to assess the extent to which participants’ significant others were perceived by treatment providers to support the participants’ goals during treatment sessions. Results indicated that SOSS scores (but not participant and significant other session attendance) were associated with lower participant child abuse potential and drug use frequency at the conclusion of treatment. There was no relationship found between SOSS scores and participant session attendance. However, there was a positive correlation between SOSS scores and significant other session attendance (r = .489, p < .01). The results of this study suggest the quality of significant other support during treatment sessions in this population of mothers may be more important to improving treatment outcomes than session attendance per se. Future directions are discussed in light of the results, including methods of using SOSS scores to assist family-based treatments.     

Evaluation of a Resilience Intervention to Enhance Coping Strategies and Protective Factors and Decrease Symptomatology

Objective: In this pilot study, the authors examined the effectiveness of a 4-week resilience intervention to enhance resilience, coping strategies, and protective factors, as well as decrease symptomatology during a period of increased academic stress. Participants and Methods: College students were randomly assigned to experimental (n = 30) and wait-list control (n = 27) groups. The experimental group received a psychoeducational intervention in 4 two-hour weekly sessions. Measures of resilience, coping strategies, protective factors, and symptomatology were administered pre- and postintervention to both groups. Results: Analyses indicated that the experimental group had significantly higher resilience scores, more effective coping strategies (ie, higher problem solving, lower avoidant), higher scores on protective factors (ie, positive affect, self-esteem, self-leadership), and lower scores on symptomatology (ie, depressive symptoms, negative affect, perceived stress) postintervention than did the wait-list control group. Conclusions: These findings indicate that this resilience program may be useful as a stress-management and stress-prevention intervention for college students.