Smoking Cessation in a University Setting: The Efficacy of an Experiential, Theory-Based Intervention for College Students

The college setting represents an untapped window of opportunity to target the growing number of college student smokers. To address this need the current study tested an intervention drawing upon research from social psychology and previously effective health-related interventions. The primary purpose of this study was to examine the efficacy of an experiential, dissonance-enhancing smoking intervention for increasing motivation to quit smoking and reducing smoking by comparing it to two control groups, in a three-arm randomized study. Participants were 215 college student smokers randomized to an experiential smoking intervention, a traditional educational smoking intervention, or an experiential intervention on nutrition. A secondary purpose of the present study was to explore the influence of possible mediating variables (e.g. risk perceptions, smoking knowledge) and to investigate whether demographic or smoking history variables would moderate the effects of the intervention. As predicted, the experiential smoking intervention was more effective in increasing motivation to quit as compared to both groups. However, moderator analyses revealed that the effect was found only for females. Increased motivation to quit was also demonstrated on an immediate behavioral measure of impact. Additional analyses indicated that a greater reduction in smoking and higher quit rates at follow-up were found for participants in both smoking conditions as compared to participants in the Nutrition control condition. Potential mechanisms of change were not supported; however, participants who received the experiential smoking intervention exhibited greater smoking knowledge and were more likely to report greater negative consequences of smoking. Findings support the efficacy of a standard didactic intervention, and the added efficacy of a more intensive experiential intervention. Implications for intervention are discussed

College-student smoking: An initial test of an experiential dissonance-enhancing intervention

This study was designed as an initial test of whether an experiential learning intervention, based on cognitive dissonance theory, would increase college-student smokers' intentions to quit smoking. One hundred forty-four college smokers were asked to prepare educational videos about (1) the risks of smoking or (2) the feasibility of quitting (in a 2×2 factorial design). Main effects for the experimental manipulations were not found. However, an interaction suggested that intentions to quit smoking were increased by either manipulation, but that the effects were not additive. In addition, risk perceptions were increased by the health-risk manipulation alone, but not when quitting feasibility was also targeted. As predicted, smoking history and smoking-related expectancies were both correlated with magnitude of dissonance. Moreover, dissonance magnitude was associated with the reported use of dissonance-reducing strategies, including intending to quit smoking and believing that tobacco use was out of their control due to nicotine addiction. The findings from this initial analogue study suggest that attitudes and intentions to quit smoking can be influenced by a brief experiential intervention

Tailored interventions for motivating smoking cessation: using placebo tailoring to examine the influence of expectancies and personalization

The present study examined mechanisms underlying the effectiveness of tailored interventions for motivating smoking cessation. The study used a placebo-tailoring design to test whether the efficacy of tailoring was due, in part, to personalized features in addition to the theoretically based content. Two hundred forty adult smokers were randomized to 1 of 3 conditions: standard booklet, minimally personalized booklet, or extensively personalized booklet. The interventions varied in their degree of ostensible tailoring, yet the actual smoking-related content of the booklets was identical. A dose-response relationship was hypothesized, with the greatest apparent tailoring producing the most positive outcomes. This pattern was found for evaluation of the booklets, with trends for readiness to change and self-efficacy increases. Moreover, as hypothesized, the effect of the interventions on readiness was moderated by participants' expectancies about tailoring

Tobacco-Related Health Disparities across the Cancer Care Continuum

Background Use of tobacco is the leading preventable cause of death in the United States. Racial/ethnic minorities and individuals of low socioeconomic status disproportionately experience tobacco-related disease and illness. Unique challenges and circumstances exist at each point in the cancer care continuum that may contribute to the greater cancer burden experienced by these groups. Methods We reviewed tobacco-related disparities from cancer prevention to cancer survivorship. We also describe research that seeks to reduce tobacco-related disparities. Results Racial/ethnic minorities and low-income individuals experience unique social and environmental contextual challenges such as greater environmental cues to smoke and greater levels of perceived stress and social discrimination. Clinical practice guidelines support the effectiveness of pharmacotherapy and behavioral counseling for racial and ethnic minorities, yet smoking cessation rates are lower in this group when compared with non-Hispanic whites. Superior efficacy for culturally adapted interventions has not yet been established. Conclusions To reduce health disparities in this population, a comprehensive strategy is needed with efforts directed at each point along the cancer care continuum. Strategies are needed to reduce the impact of contextual factors such as targeted tobacco marketing and social discrimination on smoking initiation and maintenance. Future efforts should focus on increasing the use of evidence-based cessation treatment methods and studying its effectiveness in these populations. Attention must also be focused on improving treatment outcomes by reducing smoking in diverse racial and ethnic patient populations. </jats:sec

Post-operative Smoking Status in Lung and Head and Neck Cancer Patients: Association with Depressive Symptomatology, Pain, and Fatigue

Objective: An estimated 35–50% of lung and head and neck cancer patients are smoking at diagnosis; most try to quit; however, a substantial proportion resumes smoking. As cancer treatments improve, attention to the effects of continued smoking on quality of life in the survivorship period is increasing. The current study examines if smoking abstinence following surgical treatment is associated with better quality of life. Methods: Participants were 134 patients with head and neck or lung cancer who received surgical treatment. Smoking status and indices of quality of life (depressive symptoms, fatigue, and pain) were assessed at the time of surgery (baseline) and at 2, 4, 6, and 12 months post-surgery. Analyses were performed using a generalized estimating equations approach. A series of models examined the correlation between smoking status and post-surgery quality of life while adjusting for demographics, clinical variables, and baseline smoking status and quality of life. Results: Continuous post-surgery abstinence was associated with lower levels of depressive symptoms and fatigue; however, the relationship with fatigue became nonsignificant after adjusting for baseline fatigue and income. There was no significant relationship observed between smoking status and pain. Conclusions: Findings add to a growing literature showing that smoking cessation is not associated with detrimental effects on quality of life and may have beneficial effects, particularly with regard to depressive symptoms. Such information can be used to motivate smoking cessation and continued abstinence among cancer patients and increase provider comfort in recommending cessation. Copyright © 2014 John Wiley & Sons, Ltd

Cognitive behavioral therapy versus general health education for smoking cessation: A randomized controlled trial among diverse treatment seekers

Racial and ethnic disparities in smoking cessation persist. This randomized controlled trial compared the efficacy of group cognitive behavioral therapy (CBT) for cessation among African American/Black, Latino/Hispanic, and White adults. African American/Black (39%), Latino/Hispanic (29%), and White (32%) adults ( = 347) were randomly assigned to eight group sessions of CBT or general health education (GHE), both including nicotine patch therapy. Biochemically confirmed 7-day point prevalence abstinence (7-day ppa) was measured at the end-of-therapy, and at 3-, 6-, and 12-month follow-ups. Generalized linear mixed models and logistic regressions tested abstinence rates by condition, stratified by race and ethnicity, and interaction effects. CBT led to greater abstinence than GHE across 12-months of follow-up (AOR = 1.84, 95% CI [1.59, 2.13]) overall [12-month follow-up: CBT = 54% vs. GHE = 38%] and within racial and ethnic groups [12-months: African American/Black (CBT = 52%, GHE = 29%), Latino/Hispanic (CBT = 57%, GHE = 47%), and White (CBT = 54%, GHE = 41%)]. African American participants were less likely than White participants to quit irrespective of condition, as were persons with lower education and income. Socioeconomic status indicators positively predicted abstinence among racial and ethnic minority participants, but not White participants. Group CBT was efficacious compared with GHE. However, cessation patterns suggested that intensive group interventions were less beneficial over the longer term among lower socioeconomic African American and Latino individuals, compared with White participants. Tobacco interventions should target racial and ethnic and socioeconomic differences, via culturally specific approaches and other means. (PsycInfo Database Record (c) 2023 APA, all rights reserved)