Attachment style moderates the relationship between social media use and user mental health and wellbeing

Background: Past research has correlated social media use with a variety of mental health outcomes – both positive and negative. The current study aims to explore two possible moderators of the link between social media use and mental health outcomes; specifically, the effects of having an anxious and/or avoidant attachment style. Method; A cross-sectional correlational design was implemented. Participants (n = 124). aged ≥18 years completed scales measuring experiences in close relationships, general problematic Internet use, psychological wellbeing and satisfaction with life. Results: Negative relationships between problematic social media use and both psychological wellbeing and life satisfaction were observed. For psychological wellbeing, the relationship was strongest amongst individuals who were low in avoidant attachment and high in anxious attachment. Discussion: These results suggest that attachment style impacts the extent that social media affects user mental health and wellbeing; partly explaining paradoxical results in previous research. Conclusion: We suggest that individuals who are high in anxious attachment and low in attachment avoidance may be more susceptible to negative outcomes arising from problematic SNS use

New converts and seasoned campaigners: the role of social identity at different stages in the addiction recovery journey

Social identities associated with recovery are protective of relapse from addiction. How such identities develop and differentially link to outcomes at different points of the recovery journey and across multiple recovery attempts is relatively unknown. The current study utilised a pre-existing cross-sectional dataset (n=237 Alcoholics Anonymous (AA) members, 50% male, 49.4% female and 0.6% female-to-male, aged between 19 and 71 years) to explore these issues. Relationships between AA identity, quit efficacy (a proxy for recovery maintenance) and AA meeting attendance (over the last month) were tested. The moderating effects of length of AA attendance during the current recovery episode and first vs subsequent quit attempts on the identity-efficacy link was also tested. Levels of social identity were stable amongst those in the early in their current recovery through to those who have more experience, but the relationships between identity and efficacy differed. While those early on in their current AA attendance showed a positive relationship between identities and frequency of attending meetings, those with more long-standing attendance reported social identification unrelated to involvement. Our results suggest that social identities may be particularly protective for those who are on their first quit, suggesting recovery formation and transition may be a priority

When ingroup identities “clash”: The influence of beliefs about incompatibilities between being a Christian and a drinker affect motivation to change drinking behaviour.

Whilst research has demonstrated the influence of individual and social identities on drinking-related beliefs and behaviours, none evaluates how identities’ incompatibilities are associated with mental health, current drinking status nor intentions and motivations to change drinking behaviour. The current study explored how variability in incompatibilities between the social identities of being a drinker and a Christian related to mental health, alcohol use behaviour and intentions to change drinking behaviour. A cross-sectional online survey (via a recruitment platform, Prolific) recruited n = 180 US resident Christians who drank alcohol (56.4% male, 46.6% female, mean age = 37 years). Increased incompatibility between identities moderated the effect of current Christian identity on drinking change motivations – with the strongest links amongst those with the highest levels of incompatibility. A similar effect was also shown for increasing incompatibility between perceptions of the self as an individual and drinking behaviour (self/drinker incompatibility). The relationship between Christian identity on current drinking behaviour was also shown to be moderated by decreased Christian/drinker identity incompatibility but not self/drinker incompatibility. No effects were shown for general mental well-being. The study highlights that differences in the protective role of religious identities likely depend on how they relate to others, and the key role of identity incompatibility

Comparison of Allen Carr's Easyway programme with a specialist behavioural and pharmacological smoking cessation support service: a randomized controlled trial.

BACKGROUND AND AIMS: A combination of behavioural and pharmacological support is judged to be the optimal approach for assisting smoking cessation. Allen Carr's Easyway (ACE) is a single-session pharmacotherapy-free programme that has been in operation internationally for 38 years. We compared the effectiveness of ACE with specialist behavioural and pharmacological support delivered to the national standard in England. DESIGN: A two-arm, parallel-group, single-blind, randomized controlled trial. SETTING: London, UK, between February 2017 and May 2018. PARTICIPANTS: A total of 620 participants (310 in ACE and 310 in the combined behavioural and pharmacological support condition) were included in the analysis. Adult (≥ 18 years) smokers wanting to quit were randomized in a 1 : 1 ratio. Mean age for the total sample was 40.8 years, with 53.4% being male. Participant baseline characteristics (ethnicity, educational level, number of previous quit attempts, nicotine dependence) were evenly balanced between treatment groups. INTERVENTION AND COMPARATOR: The intervention was the ACE method of stopping smoking. This centres on a 4.5-6-hour session of group-based support, alongside subsequent text messages and top-up sessions if needed. It aims to make it easy to stop smoking by convincing smokers that smoking provides no benefits for them. The comparator was a specialist stop smoking service (SSS) providing behavioural and pharmacological support in accordance with national standards. MEASUREMENTS: The primary outcome was self-reported continuous abstinence for 26 weeks from the quit/quit re-set date verified by exhaled breath carbon monoxide measurement < 10 parts per million (p.p.m.). Primary analysis was by intention to treat. Secondary outcomes were: use of pharmacotherapy, adverse events and continuous abstinence up to 4 and 12 weeks. FINDINGS: A total of 468 participants attended treatment (255 ACE versus 213 SSS, P < 0.05). Of those who did attend treatment, 100 completed 6-month measures (23.7% ACE versus 20.7% SSS). Continuous abstinence to 26 weeks was 19.4% (60 of 310) in the ACE intervention and 14.8% (46 of 310) in the SSS intervention [risk difference for ACE versus SSS 4.5% (95% confidence interval (CI) = -1.4 to 10.4%, odds ratio (OR) = 1.38)]. The Bayes factor for superiority of the ACE condition was 1.24. CONCLUSION: There was no clear evidence of a difference in the efficacies of the Allen Carr's Easyway (ACE) and specialist smoking cessation support involving behavioural support and pharmacotherapy

What moderates the attainment gap? The effects of social identity incompatibility and practical incompatibility on the performance of students who are or are not Black, Asian or Minority Ethnic

A successful journey through higher education is, for many, a once in a lifetime opportunity for social mobility. Unfortunately, one notable feature of higher education systems is that students from some backgrounds do not achieve the same academic attainments as do others. The current study tests the role of one particular set of processes: social identity (in)compatibility on academic performance. Participants were recruited at two time points from a pool of first year undergraduates at a modern London University (N=215) of which 40.1% were classed as Black, Asian or Minority Ethnic (BAME), 57.1% as non-BAME and 2.8% did not provide this information. A prospective design was employed: Alongside demographic data, measures at the start of the academic year consisted of measures of student and ethnic identity, and both practical and identity incompatibility. At the end of the academic year, average marks achieved were gained for each student from the university’s registry system. Results indicate that BAME students had equal levels of student identity to non-BAME students, but higher levels of ethnic identity. They also typically experienced higher levels of both practical and identity incompatibility. Finally, BAME students had lower attainment than did non-BAME students. Both practical and identity incompatibility appeared to moderate this effect. However, contrary to predictions, it was only under conditions of low and medium levels of incompatibility that BAME students attained lower marks than their non-BAME peers. The theoretical and practical implications of these findings are discussed

Do alcohol product labels stating lower strength verbal description, percentage alcohol‐by‐volume, or their combination affect wine consumption? A bar laboratory adaptive randomised controlled trial

A previous research study concluded that wine and beer labelled as lower in strength increase consumption compared with the same drinks labelled as regular strength. The label included both a verbal and numerical descriptor of strength. The present study aimed to estimate the effect of each of these label components. Adaptive, parallel group randomised controlled trial, comprising an internal pilot sample (N = 90) and a confirmatory sample (N = 57). University bar laboratory in London UK. One-hundred and forty-seven weekly wine drinkers were sampled from a nationally representative English panel. Participants were randomised to one of three groups to taste test wine in a bar-laboratory, varying only in the label displayed: (i) verbal descriptor only (Super Low); (ii) numerical descriptor only (4%ABV); and (iii) verbal descriptor and numerical descriptor combined (Super Low 4%ABV) [each group n = 49]. The primary outcome was total volume (ml) of wine consumed. Participants randomised to the numerical descriptor label group (4%ABV: M = 155.12ml, B = 20.30, 95% CI = 3.92, 36.69, p-value = 0.016) and combined verbal and numerical descriptor label group (Super Low 4%ABV: M = 154.59ml, B = 20.68, 95%CI = 4.32, 37.04, p-value = 0.014) drank significantly greater amounts than those randomised to the verbal descriptor label group (Super Low: M = 125.65ml). This bar laboratory study estimated that a greater quantity of 'lower' strength wine was consumed when the label included a numerical strength descriptor compared with a verbal only strength descriptor. [Abstract copyright: This article is protected by copyright. All rights reserved.

Discrimination and social identity processes predict impairment and dysfunction among heavy drinkers

Background: Previous research has linked discrimination to poorer health. Yet health risk behaviours such as heavy alcohol consumption are often targeted with stigmatising public health campaigns. The current study sought to establish the link between experiencing discrimination and health outcomes among heavy drinkers, with a focus on exploring the multiple social identity processes that might underpin this relationship. Method: A survey was conducted with 282 people who self-reported consuming alcohol above recommended guidelines. We measured discrimination experienced as a drinker, components of social identification as a drinker (centrality, satisfaction, solidarity, homogeneity, and self-stereotyping), and two health outcomes: psychological distress and severity of alcohol use disorder symptomatology. Results: Discrimination was a moderate-large predictor of psychological distress and alcohol use disorder symptoms. Three social identity constructs were implicated in the link between discrimination and ill-health: identity centrality and homogeneity positively mediated this relationship, while identity satisfaction was a negative mediator. The model explained a large proportion of the variance (39-47%) in health outcomes. Discussion: Results are interpreted with an emphasis on the need to avoid stigmatising messaging and to prioritise social identity processes to prevent and treat substance use disorders. We further highlight the need for social identity researchers to consider the multidimensional nature of social identities, especially in the context of stigmatised groups

Study protocol for a randomised controlled trial of Allen Carr's Easyway programme versus Lambeth and Southwark NHS for smoking cessation.

INTRODUCTION: Smoking is a major cause of ill health and is associated with several diseases including cancer, coronary heart disease and stroke. Many psychological and pharmacological smoking cessation treatments are available and although they are undoubtedly the most cost-effective health interventions available, many people still fail to maintain cessation in the longer term. Recently, National Institute for Health and Care Excellence called for comparative studies to determine the short-term and long-term effectiveness of Allen Carr's Easyway (ACE) method of stopping smoking. This study will compare the efficacy of the ACE programme and a 1-1 counselling service available via the National Health Service. METHODS AND ANALYSIS: A two-arm, parallel-group, blinded, randomised controlled trial will be conducted with people who smoke tobacco cigarettes, are aged ≥18 years and are motivated to quit. Exclusion criteria comprise self-reported mental health condition, pregnancy or respiratory disease such as chronic obstructive pulmonary disease or emphysema. The primary treatment outcome is smoking cessation 26 weeks after treatment. Participants will be analysed on an intention to treat basis at the point of randomisation. Before being randomised, the research team will not inform participants which two treatments are being compared. Once randomised researchers will be blinded to participant condition, and participants will be blinded to the condition they are not assigned to. Logistic regression will be used to estimate the effectiveness of the treatment condition on smoking cessation at 26 weeks. The following covariates will be included: baseline quit efficacy (at inclusion), age (at inclusion), gender and baseline nicotine dependency. ETHICS AND DISSEMINATION: Approval was granted by London-Fulham Research Ethics Committee (ref: 16/LO/1657). The study's findings will be published in peer-reviewed journals and disseminated at national and international conferences. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier number: NCT02855255. ISRCTN registration number: ISRCTN23584477; Pre-results

Development and Testing of Relative Risk-based Health Messages for Electronic Cigarette Products

Background: Health messages on e-cigarette packs emphasise nicotine addiction or harms using similar wording to warnings on cigarette packs. These may not be appropriate for e-cigarettes which constitute a reduced risk alternative for smokers. This research aimed to i) develop and test a selection of relative risk messages for e-cigarette products; ii) compare these to the two current EU Tobacco Products Directive (TPD) nicotine addiction messages; and iii) explore differences between smokers, non-smokers and dual users. Method: Twenty-six messages focusing on either harm-reduction or cessation were developed and rated by multidisciplinary experts for accuracy, persuasiveness and clarity. The eight highest ranking messages were compared alongside the TPD messages in a sample of 983 European residents (316 smokers, 327 non-smokers, 340 dual users) on understandability, believability and convincingness. Results: On all three constructs combined, the two TPD messages rated the highest, closely followed by four relative risk messages “Completely switching to e-cigarettes lowers your risk of smoking related diseases”, “Use of this product is much less harmful than smoking”, “Completely switching to e-cigarettes is a healthier alternative to smoking”, and “This product presents substantially lower risks to health than cigarettes” which did not differ statistically from the TPD messages. Non-smokers rated TPD1 significantly higher overall than dual users. Dual users rated “This product is a safer alternative to smoking” significantly higher than non-smokers. Messages did not differ on understandability. Conclusions: These alternative messages provide a useful resource for future research and for policy makers considering updating e-cigarette product labelling

Do alcohol product labels stating lower strength verbal description, percentage alcohol‐by‐volume, or their combination affect wine consumption? A bar laboratory adaptive randomised controlled trial

Background and Aims A previous research study concluded that wine and beer labelled as lower in strength increase consumption compared with the same drinks labelled as regular strength. The label included both a verbal and numerical descriptor of strength. The present study aimed to estimate the effect of each of these label components. Design Adaptive, parallel group randomised controlled trial, comprising an internal pilot sample (n1 = 90) and a confirmatory sample (n2 = 57). Setting University bar laboratory in London, United Kingdom (UK). Participants A total of 147 weekly wine drinkers were sampled from a nationally representative English panel. Intervention Participants were randomised to one of three groups to taste test wine in a bar‐laboratory, varying only in the label displayed: (i) verbal descriptor only (Super Low); (ii) numerical descriptor only (4% alcohol by volume (ABV)); and (iii) verbal descriptor and numerical descriptor combined (Super Low 4%ABV) (each group n = 49). Measurements The primary outcome was total volume (ml) of wine consumed. Findings Participants randomised to the numerical descriptor label group (4%ABV: M = 155.12 ml, B = 20.30; 95% CI = 3.92, 36.69; P value = 0.016) and combined verbal and numerical descriptor label group (Super Low 4%ABV: M = 154.59 ml, B = 20.68; 95% CI = 4.32, 37.04; P value = 0.014) drank significantly greater amounts than those randomised to the verbal descriptor label group (Super Low: M = 125.65 ml). Conclusions This bar laboratory study estimated that a greater quantity of ‘lower’ strength wine was consumed when the label included a numerical strength descriptor compared with a verbal only strength descriptor