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.     

College smoking-cessation using cell phone text messaging

Although rates of smoking among college-aged students continue to rise, few interventions that focus on college smokers' unique motivations and episodic smoking patterns exist. The authors developed and evaluated a prototype program targeting college students that integrates Web and cell phone technologies to deliver a smoking-cessation intervention. To guide the user through the creation and initialization of an individualized quitting program delivered by means of cell phone text messaging, the program uses assessment tools delivered with the program Web site. Forty-six regular smokers were recruited from local colleges and provided access to the program. At 6-week follow-up, 43% had made at least one 24-hour attempt to quit, and 22% were quit--based on a 7-day prevalence criterion. The findings provide support for using wireless text messages to deliver potentially effective smoking-cessation behavioral interventions to college students.     

Cigarette Smoking and Cessation Among Trade or Technical School Students in Texas

Although students enrolled in trade or technical colleges are at an elevated risk for tobacco use, virtually no information exists regarding their smoking behaviors. Objective and Participants: In the present study, the authors examined (1) the prevalence of smoking and quitting among 617 students in 2 trade or technical colleges in East Texas and (2) on-campus media exposure to antitobacco messages. Methods: Students voluntary completed the 42-item Texas Trade and Technical School Tobacco Survey during a required introductory-level class. Results: Of the participating students, 34% reported past-30-day smoking (current smoking). Of current smokers, 74% reported a previous quit attempt and 64% wanted to quit before graduation. Although most current smokers expressed a desire to quit smoking, the antitobacco message they were least likely to see on campus was that regarding how to quit. Current smokers cited their own health as the most likely reason to quit smoking, and most reported wanting to quit on their own, without the use of resources. However, of the 9 listed resources, students were most likely to report the possible use of medication. Conclusions: Given that most smoking students desire to quit smoking—and that they are enrolled in trade or technical schools for an extended period of time—additional research should examine how successful interventions can be delivered at the trade or technical school itself.     

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.     

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.     

A qualitative study of attitudes, beliefs, and practices among 40 undergraduate smokers

OBJECTIVE: Because little is known about college-age smokers, the authors conducted a qualitative study to better understand this population. PARTICIPANTS: Forty college student smokers from 12 Pacific Northwest colleges participated in the study. METHODS: The authors identified themes and built models to ascertain important factors related to smoking and smoking cessation. Four models emerged: smoking facilitators, smoking barriers, cessation facilitators, and cessation barriers. RESULTS: The authors observed physical, psychological, and social influences across models, and social influences were strongly associated with both smoking and cessation. Many smokers were unlikely to define themselves as regular smokers. Most smokers had made prior quit attempts. CONCLUSIONS: College students are a unique category of smoker and colleges can play a role in helping them achieve cessation.     

College students' use of technology to communicate with romantic partners about sexual health issues

Objective: To examine college students' technology-assisted sexual communication perceptions and practices alongside their beliefs about the effectiveness of face-to-face (F-t-F) sexual communication. Participants: 144 college students at a private university in the Northeast, U.S., completed a survey in October 2016. Method: A cross-sectional online survey examined how college students use text messaging and private social media messaging to communicate with romantic partners about sexual health issues. Results: Students who have communicated with romantic partners via technology reported being likely to do so again in the future, to perceive the effectiveness of technology-assisted sexual communication to be comparable to F-t-F sexual communication, and to be confident in their ability to initiate sexual communication with romantic partners via F-t-F communication. Conclusions: College students may see text messaging and social media messaging as useful for sexual communication, which has important implications for college health professionals who wish to promote frequent, effective sexual communication.     

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.     

Mobile MyPlate: A Pilot Study Using Text Messaging to Provide Nutrition Education and Promote Better Dietary Choices in College Students

Abstract

Objective: To evaluate the acceptance and effectiveness of repetitive nutrition-related text messages on college students’ nutrition knowledge and fruit and vegetable consumption. Participants: One hundred fifty undergraduate (18–24 years old) non–health major students with a texting mobile phone. Methods: The intervention group received biweekly text messages of the MyPlate icon and the United States Department of Agriculture's Dietary Guidelines (DGs) for 7 weeks. The control group received the same information in a mailed brochure. A pre and post online survey assessed the students’ knowledge and behavior. Results: The intervention resulted in greater MyPlate food group recognition (p <.05) compared with control and a trend toward improved knowledge of the DGs. In the intervention group, fruit consumption was elevated (p <.05) and a trend toward elevated vegetable consumption was determined. No gender differences in intervention effectiveness exist. Conclusion: Texting repeated messages appears to be an acceptable and effective way to increase nutrition knowledge and promote positive diet-related behaviors in college students.     

Attitudinal and behavioral differences between cigarette users who do and do not identify as “smokers”

Objective: The current research aimed to understand differences in smoking-related identity among college students and to illustrate the distinct characteristics of nonidentified smokers (NIS). Participants: Students from 2 colleges in Massachusetts (N = 538; April 2016). Methods: Respondents reported by online survey whether or not they had smoked a cigarette in the past 30 days and if they self-identified as smokers. Nonsmokers (NIS) and identified smokers (IS) were then compared on their smoking attitudes and behavior. Results: NIS made up 12.5% of the sample and 64% of all tobacco users. NIS perceived themselves as less addicted and were more confident in their ability to quit smoking. They also were less likely to smoke alone, buy their own cigarettes, or have friends who smoked. Conclusions: College health officials can best motivate NIS to quit smoking by focusing on peer norms and the potential of long-term addiction.     

Smoking cessation and relapse prevention among undergraduate students: a pilot demonstration project

The prevalence of college students' tobacco use is widely recognized, but successful cessation and relapse-prevention programs for these smokers have drawn little attention. The authors, who explored the feasibility of training peers to lead cessation and relapse-prevention programs for undergraduates, found a quit rate of 88.2%, suggesting that peers were effective facilitators. Relapse-prevention interventions, which began immediately after participants quit smoking, included 6 monthly group programs and individual meetings. Each session provided education and training in stress management, nutrition and exercise habits, managing environmental smoking triggers, and coping in social situations. After participating in the relapse-prevention programs, 63.3% of the initial quitters remained smoke free, another indication that peers were effective facilitators. The success of the program, combined with the dearth of population-specific cessation and relapse-prevention tools, suggests that college administrators and health educators should develop integrated tobacco management strategies on college campuses.     

Screening and Brief Intervention for Tobacco Use by Student Health Providers on College Campuses

Abstract

Objective: This study assessed college students’ reports of tobacco screening and brief intervention by student health center providers. Participants: Participants were 3,800 students from 8 universities in North Carolina. Methods: Web-based survey of a stratified random sample of undergraduates. Results: Fifty-three percent reported ever visiting their student health center. Of those, 62% reported being screened for tobacco use. Logistic regression revealed screening was higher among females and smokers, compared to nonsmokers. Among students who were screened and who reported tobacco use, 50% reported being advised to quit or reduce use. Brief intervention was more likely among current daily smokers compared to current nondaily smokers, as well as at schools with higher smoking rates. Screening and brief intervention were more likely at schools with lower clinic caseloads. Conclusions: Results highlight the need to encourage college health providers to screen every patient at every visit and to provide brief intervention for tobacco users.     

Cigarette smoking and cessation among trade or technical school students in Texas

Although students enrolled in trade or technical colleges are at an elevated risk for tobacco use, virtually no information exists regarding their smoking behaviors. OBJECTIVE AND PARTICIPANTS: In the present study, the authors examined (1) the prevalence of smoking and quitting among 617 students in 2 trade or technical colleges in East Texas and (2) on-campus media exposure to antitobacco messages. METHODS: Students voluntary completed the 42-item Texas Trade and Technical School Tobacco Survey during a required introductory-level class. RESULTS: Of the participating students, 34% reported past-30-day smoking (current smoking). Of current smokers, 74% reported a previous quit attempt and 64% wanted to quit before graduation. Although most current smokers expressed a desire to quit smoking, the antitobacco message they were least likely to see on campus was that regarding how to quit. Current smokers cited their own health as the most likely reason to quit smoking, and most reported wanting to quit on their own, without the use of resources. However, of the 9 listed resources, students were most likely to report the possible use of medication. CONCLUSIONS: Given that most smoking students desire to quit smoking--and that they are enrolled in trade or technical schools for an extended period of time--additional research should examine how successful interventions can be delivered at the trade or technical school itself.     

Socioeconomic Correlates of Current and Regular Smoking Among College Students in Rhode Island

Objective: The objective of this study was to determine how sociodemographic variables, in particular socioeconomic status, correlate with current and regular smoking among college students in Rhode Island. Participants and Methods: Over a 4-year period (academic year 2000-2001 to 2003-2004), the authors examined sociodemographic correlates of cigarette use among 3,984 students aged 17 to 24 years from 10 colleges and universities in Rhode Island. Results: One-third of participants (32.0%) had smoked a cigarette in the 30 days preceding the questionnaire. Findings from a pair of logistic regression models indicated that participants from upper-income families were more likely to be current smokers—although not regular smokers—suggesting that the effect of socioeconomic status on smoking is partly dependent on the level of addiction. In addition, freshmen were more likely to be current and regular smokers than were upperclassmen, and white students were most likely to be regular smokers. Conclusions: The frequency of college students who reported that they first tried smoking and first smoked regularly while in college increased from freshman to senior year, indicating that the college years are a vulnerable period for smoking initiation and habituation.     

Actual Versus Perceived Risk of Cervical Cancer Among College Women Smokers

Cervical cancer is a well-established smoking-related illness, but many at-risk women are unaware of this link. Objective: The authors designed this study to (1) investigate the relationship of smoking behavior with the history of abnormal Pap test results, sexual history, and perceived risk of cervical cancer and (2) determine whether self-classified smoking status (and hence perceived risk) corresponds with actual smoking behavior in a college student population. Participants and Method Summary: College women students (N = 135) completed a survey assessing smoking history, health history, sexual risk behavior, and risk awareness. Results: Relative to those who had not smoked in the past month, current smokers (n = 36, or 27% of the total sample) perceived themselves to be at higher risk for developing cervical cancer, but did not demonstrate increased awareness of specific cervical cancer risk factors, including smoking. Twenty-eight percent (10 of 36) of past-month smokers did not define themselves as current smokers. Conclusion: The authors conclude that antismoking and health-related messages targeting smokers may misfire for individuals who do not define themselves as smokers but are nonetheless at risk for smoking-related consequences and escalating use.     

Usability and Feasibility Study of a Remote Cognitive Behavioral Therapy System with Long-Term Unemployed Women

We present the results of the use of a cognitive behavioral therapeutic intervention tool to improve the mental, physical, and social health of a group of long-term unemployed women in Spain. Method: We sent automated text messages (SMS) to the mobile phones of long-term unemployed women selected at random from public social services. During a 28-day intervention period, women received four daily automated text messages on her mobile phone on a predetermined hourly schedule. We measured depression symptoms at the start and end of the intervention and we analyzed qualitative data to determine the acceptability of a remote SMS program. Results: Depression symptoms using the Personal Health Questionnaire-9 (PHQ-9), went from an average of 13.8 at baseline to 4.9 at the end of 28 days (p?=?0.89). One hundred percent of the women reported that they liked receiving the text messages and most found them helpful.     

Cigarette Use Among Young Adults: Comparisons Between 2-Year College Students, 4-Year College Students,and Those Not in College

Abstract

Objective: To examine cigarette smoking among young adults based on education status. Participants: Community-based sample of 2,694 young adults in the United States Methods: The authors compared 3 groups—those not in college with no college degree, 2-year college students/graduates, 4-year college students/graduates—on various smoking measures: ever smoked, smoked in past month, smoked in past week, consider self a smoker, began smoking before age 15, smoked over 100 cigarettes in lifetime, ever tried to quit, and plan to quit in next year. Results: The authors found that for nearly all the smoking measures, the 4-year college group was at lowest risk, the noncollege group was at highest risk, and the 2-year college group represented a midpoint. Differences between groups remain after adjusting for parents’ education and other potential confounding factors. Conclusions: Smoking behaviors clearly differ between the 2-year, 4-year, and no college groups. Interventions should be tailored for each group.     

Styles of Physician Advice About Smoking Cessation in College Students

Abstract

Objective: To examine whether young adult cigarette smokers who were in the precontemplation and contemplation stages of change for smoking cessation would differ in their evaluations of vignettes depicting 2 types of physician advice. Participants: Fifty-seven young adult cigarette smokers who were undergraduate students (49.1% female, mean age = 20.4 years) attending an urban university. Methods: Participants evaluated 2 written vignettes. Both vignettes depicted physicians using patient-centered communication styles. One vignette depicted a physician giving a patient direct advice to quit smoking and the other a physician using a motivational style of advice. Data were collected from September 2004 through May 2005. Results: Participants rated the motivational advice vignette as significantly more favorable compared to the direct advice vignette on all assessed dimensions (global satisfaction, general satisfaction, physician affective style, physician technical style, and physician communication style). Conclusion: Smokers preferred the motivational advice style to simple patent-centered advice.     

Using the Ecological Model to understand influences on college student vaping

ABSTRACT

Objective The Ecological Model was used to examine the social and environmental influences of the college environment on e-cigarette use (vaping) among college students. Participants: Undergraduate college student e-cigarette users (vapers) across three large college campuses in the southwest US from Jan 2015- Aug 2016. Methods: Thirty-three interviews were conducted. Transcribed interviews were coded then analyzed for themes. Results: College student vapers report multiple levels of influence on their vaping beyond personal beliefs and peer influences, including parents, explicit campus and community messaging, community member requests, and respect for others. College student vapers also describe constant associations with smokers in allowable public places to vape. Conclusions: Parents, community members, campus policy, and the physical environment all influence where and when college students vape. Health communication messages to prevent college student vaping should incorporate alternative messages that are important to college students, such as respect for others and social image.     

Evaluation of a Web-Phone Intervention System in Changing Smoking Behavior—A Randomized Controlled Trial

This study evaluates the effectiveness of a web-phone intervention in changing smoking behavior. One hundred and sixteen university student smokers were recruited to participate in a randomized controlled trial. Each participant used their own mobile phone to receive messages from an automated web-phone system. After 4 weeks the participants in both the experimental group and comparison group improved on self-efficacy (SE) and stage of change (SOC) toward smoking cessation. After another 5 weeks, their SE remained significantly improved, but SOC did not. Participants in the control group did not improve. The findings provide support for further research on and possible adoption of automated phone interventions as a tool in helping smokers move toward quitting, especially those who are at an earlier stage of change. Dosage in automated interventions was found to be an area requiring future research.