Tobacco control policies and smoking cessation treatment utilization: A moderated mediation analysis

Smoking cessation message testing to inform app-based interventions - an online experiment

Background: To improve the efficacy of digital smoking cessation interventions for young adults, intervention messages need to be acceptable and appropriate for this population. The current study compared ratings of smoking cessation and urge reduction messages based on Cognitive Behavioral Therapy (distraction themed) and Acceptance and Commitment Therapy (acceptance themed) in young adults who smoke. Methods: A total of 124 intervention messages were rated by an online Qualtrics panel of N=301 diverse young adults who currently smoked tobacco cigarettes (Age M=26.6 years; 54.8% male; 51.5% racial/ethnic minority; 16.9% sexual or gender minority (SGM); 62.5% daily smoking). Each participant rated 10 randomly selected messages (3,010 total message ratings; 24.3 ratings per message) on 5-point scales (higher scores representing more favorable ratings) evaluating quality of content, quality of design, perceived support for coping with smoking urges, and perceived support for quitting smoking. Mixed models examined associations between message category (distraction vs. acceptance), participant level predictors (sociodemographic variables, readiness and motivation to quit, daily smoking, psychological flexibility), and message ratings. Results: Overall ratings ranged from M=3.61 (SD=1.25) on support for coping with urges to M=3.90 (SD=1.03) on content, with no differences between distraction and acceptance messages. Male participants gave more favorable ratings on the dimensions of support for coping (p<0.01) and support for quitting (p<0.01). Participants identifying as SGM gave lower ratings for message design (p<0.05). Participants with a graduate degree gave higher ratings on support for coping with urges and support for quitting (both p<0.05). Higher motivation to quit was associated with more favorable scores across all dimensions (all p<0.01). Those smoking daily rated messages as less helpful for coping with urges (p<0.01) and quitting smoking (p<0.05) compared to those smoking non-daily. Few interactions were found between message category distraction vs. acceptance and participant characteristics. Conclusions: Distraction and acceptance messages received similar ratings among young adults who smoke cigarettes. Message revisions may be needed to increase appeal to women, SGM, those with lower education, and those less motivated to quit. Messages will be refined and used in an ongoing micro-randomized trial to investigate their real-time impact on smoking urges and behaviors.

Association of cigarette excise taxes and clean indoor air laws with change in smoking behavior in the United States: a Markov modeling analysis

The rates of cigarette smoking in the United States have declined over the past few decades in parallel with increases in cigarette taxes and introduction of more stringent clean indoor air laws. Few longitudinal studies have examined association of taxes and clean indoor air policies with change in smoking nationally. This study examined the association of state and local cigarette taxes and clean indoor laws with change in smoking status of 18,499 adult participants of the longitudinal 2010-2011 Tobacco Use Supplement of the Current Population Survey over a period of 1 year. Every $1 increase in cigarette excise taxes was associated with 36% higher likelihood of stopping smoking among regular smokers. We found no association between clean indoor air laws and smoking cessation nor between taxes and clean indoor air laws with lower risk of smoking initiation. Cigarette taxes appear to be effective anti-smoking policies. Some state and local governments do not take full advantage of this effective policy measure.

Tutorial on causal mediation analysis with binary variables: An application to health psychology research

Mediation analysis has been widely applied to explain why and assess the extent to which an exposure or treatment has an impact on the outcome in health psychology studies. Identifying a mediator or assessing the impact of a mediator has been the focus of many scientific investigations. This tutorial aims to introduce causal mediation analysis with binary exposure, mediator, and outcome variables, with a focus on the resampling and weighting methods, under the potential outcomes framework for estimating natural direct and indirect effects. We emphasize the importance of the temporal order of the study variables and the elimination of confounding. We define the causal effects in a hypothesized causal mediation chain in the context of one exposure, one mediator, and one outcome variable, all of which are binary variables. Two commonly used and actively maintained R packages, mediation and medflex, were used to analyze a motivating example. R code examples for implementing these methods are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Advancing health equity through implementation science: Identifying and examining measures of the outer setting

BACKGROUND

Implementation science (IS) could accelerate progress toward achieving health equity goals. However, the lack of attention to the outer setting where interventions are implemented limits applicability and generalizability of findings to different populations, settings, and time periods. We developed a data resource to assess outer setting across seven centers funded by the National Cancer Institute's IS Centers in Cancer Control (ISC3) Network Program.

OBJECTIVE

To describe the development of the Outer Setting Data Resource and characterize the county-level outer context across Centers.

METHODS

Our Data Resource captures seven key environments, including: (1) food; (2) physical; (3) economic; (4) social; (5) health care; (6) cancer behavioral and screening; and (7) cancer-related policy. Data were obtained from public sources including the US Census and American Community Survey. We present medians and interquartile ranges based on the distribution of all counties in the US, all ISC3 centers, and within each Center for twelve selected measures. Distributions of each factor are compared with the national estimate using single sample sign tests.

RESULTS

ISC3 centers' catchment areas include 458 counties and over 126 million people across 28 states. The median percentage of population living within ½ mile of a park is higher in ISC3 counties (38.0%, interquartile range (IQR): 16.0%-59.0%) compared to nationally (18.0%, IQR: 7.0%-38.0%; p < 0.0001). The median percentage of households with no broadband access is significantly lower in ISC3 counties (28.4%, IQR: 21.4%-35.6%) compared the nation overall (32.8%, IQR: 25.8%-41.2%; p < 0.0001). The median unemployment rate was significantly higher in ISC3 counties (5.2%, IQR: 4.1%-6.4%) compared to nationally (4.9%, 3.6%-6.3%, p = 0.0006).

CONCLUSIONS

Our results indicate that the outer setting varies across Centers and often differs from the national level. These findings demonstrate the importance of assessing the contextual environment in which interventions are implemented and suggest potential implications for intervention generalizability and scalability.

Tobacco Control Measures' Role in Improving Employees' Health Under the Impact of Health Education and Media Campaign

The overarching purpose of this study was to investigate the impact of health education, media campaigns, and peer counselor training on employees' health. This study also attempted to evaluate the function of tobacco control as a mediator in the relationship between employees' health and health education, media campaigns, and peer counselor training. Data were collected from 440 tobacco industry workers in China using a questionnaire technique. Smart-PLS software and a structural equation modeling (SEM) technique were used to evaluate the data. Employees' health was found to be significantly improved by health education, media campaigns, and peer counselor training. Furthermore, tobacco control was discovered to moderate the association between employee health and health education, media campaigns, and peer counselor training. By analyzing the impact of health education, media campaigns, and peer counselor training on employees' health, this research provided an important theoretical contribution. In terms of practical applications, this study would help employees consuming tobacco to maintain a healthy and safe atmosphere that encourages them to be engaged and perform well. Furthermore, this study could prove effective in resolving difficulties linked to controlling employee tobacco addiction and improving their performance. The tiny sample size of this study, which included solely employees working in the Chinese tobacco sector, was one of its limitations. In addition, future studies can incorporate other constructs to acquire a deeper knowledge of the factors that influence employees' health.

Extending Current Population Survey Linkages: Obstacles and Solutions for Linking Monthly Data from 1976 to 1988

The Current Population Survey (CPS) has been the nation's primary source of information about employment and unemployment for decades. The data are widely used by social scientists and policy makers to study labor force participation, poverty, and other high-priority topics. An underutilized feature of the CPS is its short-run panel component. This paper discusses the unique challenges encountered when linking basic monthly data as well as when linking the March basic monthly data to the Annual Social and Economic (ASEC) Supplement in the 1976-1988 period. We describe strategies to address linking obstacles and document linkage rates.