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Wang L, Siau CS, Baharom N, Hairol MI, Huang L, Wee LH. Media Search Frequency, Source Credibility About e-Cigarette Health Information, and Motivation to Quit EC Among University Students in Chengdu, China. Int J Gen Med 2024; 17:895-907. [PMID: 38476623 PMCID: PMC10929557 DOI: 10.2147/ijgm.s430997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024] Open
Abstract
Purpose E-cigarettes (ECs) are gaining popularity among young people. This study aimed to assess university student vapers' search frequency and source credibility of commonly used media in China, and their association with daily EC users' motivation to quit EC use. Participants and Methods This was a cross-sectional study involving an online quantitative survey in six universities in Chengdu, China. Participants answered questions on their EC use patterns, motivation to quit EC, use frequency and source credibility of media use. Hierarchical linear regression analyses were performed to determine the association between media search frequency and source credibility concerning EC health information with the motivation to quit EC. Results There were a total of 325 participants (Mean age = 20.43, SD = 1.333). Video platforms and social media were ranked frequently used by the participants and were deemed to be more trustworthy. Perceived trustworthiness of online media was the most influential predictor of motivation to quit EC. Those who reported a higher frequency of accessing video platforms and medical health applications recorded higher motivation to quit EC use. Source credibility of news portals were associated higher motivation to quit EC. The association between higher nicotine dependence and lower motivation to quit EC was attenuated when media source credibility and trustworthiness of online media were added into the fully adjusted regression models. Conclusion There is an association between media use frequency and source credibility to search for EC health information and motivation to quit vaping. More studies could be conducted to examine the effects of media use content on perceptions towards vaping and their motivation to quit vaping.
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Affiliation(s)
- Li Wang
- Ya’an Polytechnic College, Ya’an, Sichuan, 625000, People’s Republic of China
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Ching Sin Siau
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Nizam Baharom
- Primer Healthcare Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, 71800, Malaysia
| | - Mohd Izzuddin Hairol
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Lixin Huang
- Chengdu Sport University, Chengdu, Sichuan, 610000, People’s Republic of China
| | - Lei Hum Wee
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University, Subang Jaya, Selangor, 47500, Malaysia
- Non-Communicable Diseases and Public Health Research Group, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, 47500, Malaysia
- Digital Health and Innovations Impact Lab, Taylor’s University, Subang Jaya, 47500, Malaysia
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Aweau K, Erari S, Im S, Murphy K, Pokhrel P, Herzog TA. What Motivates Betel Quid Chewers to Quit? An Analysis of Several Cessation-Relevant Variables. Subst Use Misuse 2024; 59:1095-1101. [PMID: 38403997 PMCID: PMC11014757 DOI: 10.1080/10826084.2024.2320388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Introduction: Betel quid (BQ) is globally the fourth most consumed psychoactive substance. It is consumed by an estimated 600 million people worldwide, accounting for nearly 8% of the world's population. There have been very few studies assessing chewers' motivation to quit. Objectives: In the current study, we sought to understand the relationship between several cessation-relevant variables and chewers' motivation to quit. Hypotheses: Based on analogous research on cigarette smoking, we hypothesized that the following cessation-relevant variables would be associated with motivation to quit: health risk perceptions, number of chews per day, cost, degree of BQ dependence, withdrawal symptoms, number of quit attempts, reasons for use, personal health improvement, and type of BQ chewed. Methods: A total of 351 adult BQ chewers from Guam participated in the survey and served as the sample for the analyses. Results: Majority of chewers want to quit and intend to quit. Chewers relatively high in motivation to quit evinced greater health risk perceptions of BQ chewing, greater perceived health benefits to quitting, and a greater number of past quit attempts, compared to those relatively low in motivation to quit. Conclusions: Understanding which factors are associated with chewers' motivation to quit can be helpful for designing BQ cessation programs. The results suggest that BQ cessation programs could be improved by an increased emphasis on information about the negative health effects of BQ chewing and relapse-prevention.
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Affiliation(s)
| | - Silvera Erari
- Office of Public Health Study, Thompson School of Social Work & Public Health, University of Hawaii at Mānoa, Honolulu, Hawaii, USA
| | - Soksamphoas Im
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Kelle Murphy
- Center on Disability Studies, University of Hawaii at Mānoa, Honolulu, Hawaii, USA
| | - Pallav Pokhrel
- University of Hawaii Cancer Center, Honolulu, Hawaii, USA
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Smiley SL, Shin H. Motivation to Quit Smoking Among Black Adults Residing in Los Angeles County Communities With Menthol Cigarette Sales Restrictions. Subst Use Misuse 2024; 59:727-731. [PMID: 38226661 DOI: 10.1080/10826084.2023.2294984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Background: Research is needed to identify the determinants of motivation to quit smoking among non-Hispanic Black (NHB) adults who smoke menthol cigarettes and reside in communities covered by menthol cigarette bans. Objectives: This study examined the associations between motivation to quit smoking and a range of individual-level predictors, including measures of demographics, harm/risk perception of menthol cigarettes, and awareness of a ban on menthol cigarettes in Los Angeles County unincorporated communities. Self-identified NHB adults who currently smoke menthol cigarettes (N=50; M=47.2 years; SD=13.7; 46% female) were recruited in Los Angeles County unincorporated communities. Participants completed an interviewer-administered cross-sectional survey between January to September 2021. Results: Participants (74%) reported an annual household income of less than $25,000. Participants' mean age at cigarette initiation was 15.7 years old (SD=5.68). Most (88%) were aware of the ordinance banning menthol cigarette sales. Employing multivariable linear regression analysis, harm/risk perception of menthol cigarettes (B=14.69, p<0.01) and awareness of the local menthol ban (B=26.18, p<0.05) were found to be independently associated with motivation to quit smoking. Conclusions: Findings from this community-based sample suggest that among NHB adults who smoke menthol cigarettes, motivation to quit smoking is influenced by their perception of menthol cigarettes as harmful and awareness of local policy banning the sale of menthol cigarettes. Findings underscore the need for community-centered and culturally grounded interventions to facilitate quitting among NHB adults who smoke in order for communities covered by menthol bans to achieve health equity in reducing preventable racial inequities due to menthol cigarettes.
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Affiliation(s)
- Sabrina L Smiley
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, California, USA
| | - Heesung Shin
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, California, USA
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Kumari L, Sood M, Gupta S. Motivation to quit tobacco; Impact of different types of Anti-tobacco state-sponsored media propaganda messages. J Family Med Prim Care 2023; 12:708-716. [PMID: 37312770 PMCID: PMC10259574 DOI: 10.4103/jfmpc.jfmpc_1661_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 12/08/2022] [Accepted: 01/13/2023] [Indexed: 06/15/2023] Open
Abstract
Introduction Antitobacco media messages can easily reach the mass and play a very positive and significant role in changing the motivational stages among recent quitters. Motivation is the key to changing human behaviour. Motivation can be intrinsic and extrinsic. To modify tobacco-related behaviour, one must have an inherent motivation to quit tobacco. However, the outside factors, for example, protobacco advertisements, antitobacco advertisements, peer pressure, celebrity influence, and family members' influence cannot be ignored. Method A total of 400 recent tobacco quitters were enrolled from four colleges via a multistage sampling method. Time series research design was used for data collection at three time periods 0, 1, and 3 months. Study participants were divided into four groups: 1) personal testimony group, 2) health warning group, 3) celebrity-influenced public service announcements, and 4) natural exposure group. Media messages containing antitobacco video clippings and pictures were delivered to the participants via phone thrice a week, as per the groups assigned. All four groups were assessed for the motivational stage via contemplation ladder at 0, 1, and 3 months of intervals. Results Antitobacco personal testimonial media messages are most effective in enhancing the motivation to quit tobacco, followed by the antitobacco health warning messages, which are also proven to be effective in maintaining high motivation levels to remain abstinent from smoking. However, public service announcements are ineffective in keeping the motivation to quit tobacco at higher smoking. Conclusion Overall, the antitobacco state-sponsored media messages, personal testimonials, and health warnings about tobacco products effectively maintain and enhance motivation to quit tobacco.
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Affiliation(s)
- Laxmi Kumari
- Chitkara School of Health Sciences, Chitkara University, Punjab, India
| | - Meenakshi Sood
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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Kertes J, Neumark Y, Grunhaus L, Stein-Reisner O. Comparison of Perceptions and Smoking Cessation Experiences Between Smokers With and Without Serious Mental Illness in a Large Health Maintenance Organization. J Dual Diagn 2021; 17:284-295. [PMID: 34651553 DOI: 10.1080/15504263.2021.1979348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Smoking prevalence is threefold higher among people with serious mental illness (PWSMI) than in the general population, yet smoking cessation rates for PWSMI are lower. Numerous reasons have been posited as to why tobacco use is higher and abstinence rates are lower among PWSMI. This study explores smoking cessation perceptions and experiences among PWSMI and people without serious mental illness (SMI). METHODS Participants in this cross-sectional study were recruited from among members of a large health maintenance organization (HMO) in Israel who had registered for or commenced a smoking cessation program in 2015 through 2017. The sample comprised 208 PWSMI and a matched sample of people without SMI (N = 428). Telephone surveys were used to collect information about smoking status and smoking/cessation history, use of smoking cessation programs and aids (prescription medications, nicotine replacement therapy, electronic cigarettes), motivation and intention to quit, self-efficacy (to quit), smoking cessation outcome expectancies, physician support to quit, barriers and facilitators for those who had not quit, and reinforcements/challenges for those who had quit. RESULTS Of those without SMI, 27% quit smoking compared to 20% of PWSMI (p = .051). Irrespective of mental health status, the most significant predictor of abstinence was the use of smoking cessation prescription medications. Family physicians were significantly less likely to inquire about motivation to quit, refer to smoking cessation programs, or prescribe smoking cessation medications for PWSMI than for people without SMI. Beyond these factors, no differences were noted between respondents with and without SMI regarding motivation to quit, intention to quit, and abstinence self-efficacy. PWSMI who had not quit were more likely to be concerned about how quitting might affect their functioning and how they would pass the time without cigarettes. CONCLUSIONS PWSMI have similar levels of motivation and intention to quit smoking as those without SMI. However, they are disadvantaged by the reduced support received from their family physicians and lower cessation medication usage. Efforts to promote the implementation of smoking cessation treatment guidelines will help promote smoking abstinence among PWSMI.
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Affiliation(s)
- Jennifer Kertes
- Department of Health Evaluation & Research, Maccabi HealthCare Services, Tel Aviv, Israel
| | - Yehuda Neumark
- Hadassah Braun School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel
| | - Leon Grunhaus
- School of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Orit Stein-Reisner
- Head of Department of Mental Health Services, Maccabi HealthCare Services, Tel Aviv, Israel
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Farran D, Khawam G, Nakkash R, Lee J, Abu-Rmeileh N, Darawad MW, Mostafa A, Kheirallah KA, Salama M, Hamadeh RR, Thrasher JF, Salloum RG. Association of health warning labels and motivation to quit waterpipe tobacco smoking among university students in the Eastern Mediterranean Region. Tob Prev Cessat 2021; 7:44. [PMID: 34141959 PMCID: PMC8176861 DOI: 10.18332/tpc/134561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/01/2021] [Accepted: 03/17/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to determine associations between health warning label content and motivation to quit waterpipe smoking by gender and smoking location. METHODS Convenience samples of university students in three Eastern Mediterranean countries – Egypt (n=442), Jordan (n=535) and Palestine (n=487) – completed an online survey assessing health warning labels. Multinomial logit regression models were conducted to determine the association between different variables, particularly gender and smoking location, with motivation to quit. RESULTS In Palestine, female smokers were more motivated to quit waterpipe smoking when seeing textual warning labels related to children (T2) and pregnancy (T6) [T2: 1.8 (95% CI: 1.1–2.8), T6: 2.7 (95% CI: 1.6–4.3)] compared to males. Similar results were found in Jordan [T2: 1.6 (95% CI: 1.0–2.6), T6: 1.8 (95% CI: 1.1–3.0)]. As for the smoking location, home-only smokers in Palestine were more likely to quit in response to the following warnings: waterpipe smoking is addictive T1: 2.3 (95% CI: 1.4–3.7), harmful for children T2: 2.3 (95% CI: 1.4–4.1), harmful for the baby during pregnancy T6: 2.4 (95% CI: 1.3–4.3), and to believe that quitting reduces the health risks T9: 1.8 (95% CI: 1.0–3.1). These results were not found in Jordan nor Egypt. Smokers reported that the most noticeable location of a HWL on a waterpipe device is the mouthpiece. CONCLUSIONS A better understanding of motivation to quit and its association with various warnings and smoking location could guide countries on which warnings to require in legislation and where best to require them particularly in relation to location.
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Affiliation(s)
- Dina Farran
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Grace Khawam
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.,Centre for Development and Emergency Practices, Oxford Brookes University, Oxford, United Kingdom
| | - Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Juhan Lee
- College of Health and Human Performance, University of Florida, Gainesville, United States
| | - Niveen Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | | | - Aya Mostafa
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Khalid A Kheirallah
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohamed Salama
- Institute of Global Health and Human Ecology, American University in Cairo, Cairo, Egypt
| | - Randah R Hamadeh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - James F Thrasher
- Arnold School of Public Health, University of South Carolina, Columbia, United States
| | - Ramzi G Salloum
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.,College of Medicine, University of Florida, Gainesville, United States
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Rajani NB, Mastellos N, Filippidis FT. Self-Efficacy and Motivation to Quit of Smokers Seeking to Quit: Quantitative Assessment of Smoking Cessation Mobile Apps. JMIR Mhealth Uhealth 2021; 9:e25030. [PMID: 33929336 PMCID: PMC8122290 DOI: 10.2196/25030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/18/2021] [Accepted: 04/02/2021] [Indexed: 01/19/2023] Open
Abstract
Background Decreasing trends in the number of individuals accessing face-to-face support are leaving a significant gap in the treatment options for smokers seeking to quit. Face-to-face behavioral support and other interventions attempt to target psychological factors such as the self-efficacy and motivation to quit of smokers, as these factors are associated with an increased likelihood of making quit attempts and successfully quitting. Although digital interventions, such as smoking cessation mobile apps, could provide a promising avenue to bridge the growing treatment gap, little is known about their impact on psychological factors that are vital for smoking cessation. Objective This study aims to better understand the possible impact of smoking cessation mobile apps on important factors for successful cessation, such as self-efficacy and motivation to quit. Our aim is to assess the self-efficacy and motivation to quit levels of smokers before and after the use of smoking cessation mobile apps. Methods Smokers seeking to quit were recruited to participate in a 4-week app-based study. After screening, eligible participants were asked to use a mobile app (Kwit or Quit Genius). The smoking self-efficacy questionnaire and the motivation to stop smoking scale were used to measure the self-efficacy and motivation to quit, respectively. Both were assessed at baseline (before app use), midstudy (2 weeks after app use), and end-study (4 weeks after app use). Paired sample two-tailed t tests were used to investigate whether differences in self-efficacy and motivation between study time points were statistically significant. Linear regression models investigated associations between change in self-efficacy and change in motivation to quit before and after app use with age, gender, and nicotine dependence. Results A total of 116 participants completed the study, with the majority being male (71/116, 61.2%), employed (76/116, 65.6%), single (77/116, 66.4%), and highly educated (87/116, 75.0%). A large proportion of participants had a low to moderate dependence on nicotine (107/116, 92.2%). A statistically significant increase of 5.09 points (95% CI 1.83-8.34) from 37.38 points at baseline in self-efficacy was found at the end of the study. Statistically significant increases were also found for the subcomponents of self-efficacy (intrinsic and extrinsic self-efficacies). Similarly, a statistically significant increase of 0.38 points (95% CI 0.06-0.70) from 5.94 points at baseline in motivation to quit was found at the end of the study. Gender, age, and nicotine dependence were not statistically significantly associated with changes in self-efficacy and motivation to quit. Conclusions The assessed mobile apps positively impacted the self-efficacy and motivation to quit of smokers making quit attempts. This has important implications on the possible future use of digitalized interventions and how they could influence important psychological factors for quitting such as self-efficacy and motivation. However, further research is needed to assess whether digital interventions can supplement or replace traditional forms of therapy.
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Affiliation(s)
- Nikita B Rajani
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Nikolaos Mastellos
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
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8
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Rajani NB, Mastellos N, Filippidis FT. Impact of Gamification on the Self-Efficacy and Motivation to Quit of Smokers: Observational Study of Two Gamified Smoking Cessation Mobile Apps. JMIR Serious Games 2021; 9:e27290. [PMID: 33904824 PMCID: PMC8114162 DOI: 10.2196/27290] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/24/2021] [Accepted: 04/02/2021] [Indexed: 02/06/2023] Open
Abstract
Background The proportion of smokers making quit attempts and the proportion of smokers successfully quitting have been decreasing over the past few years. Previous studies have shown that smokers with high self-efficacy and motivation to quit have an increased likelihood of quitting and staying quit. Consequently, further research on strategies that can improve the self-efficacy and motivation of smokers seeking to quit could lead to substantially higher cessation rates. Some studies have found that gamification can positively impact the cognitive components of behavioral change, including self-efficacy and motivation. However, the impact of gamification in the context of smoking cessation and mobile health has been sparsely investigated. Objective This study aims to examine the association between perceived usefulness, perceived ease of use, and frequency of use of gamification features embedded in smoking cessation apps on self-efficacy and motivation to quit smoking. Methods Participants were assigned to use 1 of the 2 mobile apps for a duration of 4 weeks. App-based questionnaires were provided to participants before app use and 2 weeks and 4 weeks after they started using the app. Gamification was quantitatively operationalized based on the Cugelman gamification framework and concepts from the technology acceptance model. The mean values of perceived frequency, ease of use, and usefulness of gamification features were calculated at midstudy and end-study. Two linear regression models were used to investigate the impact of gamification on self-efficacy and motivation to quit. Results A total of 116 participants completed the study. The mean self-efficacy increased from 37.38 (SD 13.3) to 42.47 (SD 11.5) points and motivation to quit increased from 5.94 (SD 1.4) to 6.32 (SD 1.7) points after app use. Goal setting was perceived to be the most useful gamification feature, whereas sharing was perceived to be the least useful. Participants self-reported that they used the progress dashboards the most often, whereas they used the sharing feature the least often. The average perceived frequency of gamification features was statistically significantly associated with change in self-efficacy (β=3.35; 95% CI 0.31-6.40) and change in motivation to quit (β=.54; 95% CI 0.15-0.94) between baseline and end-study. Conclusions Gamification embedded in mobile apps can have positive effects on self-efficacy and motivation to quit smoking. The findings of this study can provide important insights for tobacco control policy makers, mobile app developers, and smokers seeking to quit.
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Affiliation(s)
- Nikita B Rajani
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Nikolaos Mastellos
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
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Klemperer EM, Villanti AC. Why and how do dual users quit vaping? Survey findings from adults who use electronic and combustible cigarettes. Tob Induc Dis 2021; 19:12. [PMID: 33603595 PMCID: PMC7885258 DOI: 10.18332/tid/132547] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Most adults who use electronic cigarettes (ECs) also smoke combustible cigarettes (CCs). Quitting ECs appears common among dual users but little is known regarding adult dual users’ motivations and methods to quit ECs or how this relates to quitting CCs. METHODS We used Amazon Mechanical Turk, a web-based crowd-sourcing service, to survey 366 US adults with a history of regular EC and CC use. This analysis examined motivations and methods to quit both products among a subset of 204 (55.7%) respondents with dual use and a history of one or more attempts to quit ECs. RESULTS Most respondents (95%) were using ECs at the time of this survey and had a lifetime median of five EC quit attempts. The most common motivations to quit ECs were health (74%), money/cost (45%), and to reduce risk of COVID-19 (25%). The most common EC quit methods were cutting down (68%), getting advice from a doctor (28%), quitting 'cold turkey' (24%), nicotine replacement therapy (24%), and switching to ECs with less nicotine (24%). Most motivations and methods to quit ECs and CCs were moderately to highly correlated, suggesting similarity in dual users’ approach to quitting the two products. CONCLUSIONS Dual users had a range of motivations and methods to quit ECs, most of which were similar to their motivations and methods to quit CCs. These findings support the need to develop treatment for adults motivated to quit ECs and demonstrate that dual users may currently engage in similar strategies to quit both products.
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Affiliation(s)
- Elias M Klemperer
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, United States.,Department of Psychological Science, University of Vermont, Burlington, United States
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, United States.,Department of Psychological Science, University of Vermont, Burlington, United States
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Blondé J, Falomir-Pichastor JM. Accounting for the Consequences of Tobacco Dependence on Cravings, Self-efficacy, and Motivation to Quit: Consideration of Identity Concerns. Span J Psychol 2020; 23:e34. [PMID: 32895063 DOI: 10.1017/SJP.2020.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Tobacco dependence has been found to increase smoking cravings, and reduce both self-efficacy and motivation to quit. The present research proposes to test the hypothesis that such negative consequences are related to identity concerns and should thus appear more strongly in dependent smokers with a high (vs. low) smoker identity. In two correlational studies, daily smokers (Study 1: N = 237; Study 2: N = 154) were assessed for tobacco dependence, smoker identity, self-efficacy, craving to smoke (Study 1), and motivation to quit (Study 2). Among smokers who declared to be strongly dependent, those scoring high in smoker identity reported more smoking cravings (β = .28, p = .008, 95% CI [0.084, 0.563], $ {\upeta}_p^{{}^2} $ = .03) and less motivation to quit than those scoring low (β = -.58, p = .003, 95% CI [-1.379, -0.282], $ {\upeta}_p^{{}^2} $ = .06). Smoker identity was unrelated to these variables among non-dependent smokers (ps > .40). The relationship between tobacco dependence and self-efficacy was not affected by smoker identity (ps > .45). Through these studies, we provided evidence that the implications of tobacco dependence on smoking maintenance and difficulties in quitting may be, in part, explained by identity mechanisms.
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Abstract
Objectives: The purpose of this study was to explore the characteristics of hardcore smokers who were previously hospitalized. Study design: A descriptive qualitative design was used to investigate a sample of 29 male Taiwanese smokers. Methods: Male hardcore smokers were recruited at a hospital in southern Taiwan and their smoking behaviors and attitudes were explored in semistructured interviews. Inclusion criteria were: (1) smoking at least weekly or daily during the past year, (2) 100 cigarettes during the lifetime, (3) persistent smoking, or (4) at least one hospitalization. Audio-recorded interview data were analyzed using content categorization of the responses. Results: Four main themes emerged to describe characteristics of Taiwanese hardcore smokers: (1) physiological and psychological dependence, (2) no motivation to quit despite knowledge of negative health consequences, (3) social interaction and cultural norms, and (4) negative attitudes toward, but compliance with, smoking-free policies. Conclusions: The results can inform public health nurses of characteristics of Taiwanese hardcore smokers, which in turn may develop effective smoking cessation program to increase smoking cessation rate among Taiwanese hardcore smokers.
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Affiliation(s)
- Hui-Wen Huang
- Department of Nursing, Chung Hwa University of Medical Technology, Taiwan
| | - Kuang-Chieh Hsueh
- b Department of Family Medicine, Kaohsiung Veterans General Hospital, Taiwan
| | - Wen-Wen Li
- c School of Nursing, San Francisco State University, United States
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Abstract
BACKGROUND People with a severe and persistent mental illness are far more likely to smoke than others. While a large portion would like to quit, they are less likely to make quit attempts and succeed. OBJECTIVE This study used an Randomized Controlled Trial (RCT) to test an intervention designed to increase engagement in cessation treatment, quit attempts, and quitting in smokers who did not want to quit in the next 30 days. It also compared these smokers with those who were motivated to quit in the next 30 days. METHODS Participants (N = 222), were smokers with significant mental illness receiving intensive outpatient care from Wisconsin Community Support Programs who were not interested in quitting in the next 30 days. They were randomly assigned to either an intervention group or an attention control group. The intervention, administered during four weekly sessions, included a motivational element, components designed to prepare the smoker for a quit attempt, and pre-quit nicotine patch. Additionally, 48 smokers motivated to quit in the next 30 days served as a comparison group. RESULTS Compared to control participants, smokers receiving the intervention were more likely to be abstinent at the three month follow-up (biochemically verified, intent to treat, 8.5% vs. 1.0%, respectively, p = .01). They were also more likely to accept four more quitting preparation sessions (intent to treat, 50.8% vs 29.2%, respectively, p < .001) but were not more likely to call a telephone tobacco quit line. Conclusion/Importance: Brief motivational interventions increased engagement in cessation treatment and abstinence among smokers with signification mental illness.
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Affiliation(s)
- Bruce A Christiansen
- a Center for Tobacco Research and Intervention , University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin , USA
| | | | - Erin TerBeek
- c Greater Milwaukee Foundation , Milwaukee , Wisconsin , USA
| | - Michael C Fiore
- a Center for Tobacco Research and Intervention , University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin , USA
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13
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Elkholy H, Nagy N, Taha GRA, Elhabiby M, Yosef M, Azzam L. Stop Turning a Blind Eye: Tobacco Smoking Among Egyptian Patients With Schizophrenia. Front Psychiatry 2018; 9:703. [PMID: 30687137 PMCID: PMC6338023 DOI: 10.3389/fpsyt.2018.00703] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 12/03/2018] [Indexed: 11/17/2022] Open
Abstract
Background: Patients with schizophrenia have considerably higher rates of mortality than general population. Multiple factors may play a role in this. Despite being a major preventable cause of death, smoking is usually overlooked when dealing with patients with schizophrenia. Understanding the pattern of smoking, its severity, and the reasons to quit might be helpful in managing patients with schizophrenia and decreasing the mortality gap. Subjects and Methods: The study included smokers divided into two groups; the first included 346 patients with schizophrenia while the second group had 150 smokers with no mental illness. Both groups were assessed and compared regarding sociodemographic variables, pattern of smoking, severity of nicotine dependence, and motivation to quit smoking. Results: Earlier age of starting to smoke, higher number of cigarettes per day, and lower dependency scores were noted in patients with Schizophrenia. Positive correlation was found between positive symptoms and severity of dependence. Specific positive symptoms were correlated to number of cigarettes per day and time before first cigarette. Patients with Schizophrenia showed a significant difference in intrinsic reasons to quit (health concerns and self-control), which were also positively correlated to their positive symptoms score. Linear regression analysis for predictors of FTND score revealed that only age, sex, and schizophrenia were significant predictors of FTND score. Conclusion: Patients with schizophrenia smoke at earlier ages and smoke more cigarettes per day, yet, have less severe dependence than non-schizophrenic counterparts. Positive symptoms play a role in their smoking pattern and severity. Health concerns and self-control are their main motives to quit smoking.
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Affiliation(s)
- Hussien Elkholy
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nahla Nagy
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ghada R A Taha
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud Elhabiby
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mostafa Yosef
- Community Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Lobna Azzam
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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14
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Abstract
This research examined main and interactive associations of perceived risk and worry of health and appearance smoking consequences on motivation to quit and the relative importance of each of these. Hierarchical regressions controlling for other measures found that perceived conditional risk and worry of health consequences were associated with motivation to quit; only conditional risk of appearance consequences was associated with motivation to quit. Relative weights analysis indicated that perceived conditional risk of appearance consequences and worry about health consequences were the most important variables in the model. Consideration of appearance consequences may aid in motivating smokers to try quitting.
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15
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Peckham E, Bradshaw TJ, Brabyn S, Knowles S, Gilbody S. Exploring why people with SMI smoke and why they may want to quit: baseline data from the SCIMITAR RCT. J Psychiatr Ment Health Nurs 2016; 23:282-9. [PMID: 26147943 DOI: 10.1111/jpm.12241] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 11/28/2022]
Abstract
ACCESSIBLE SUMMARY People with severe mental ill health are up to three times more likely to smoke than other members of the general population. Life expectancy in this client group is reduced by up to 30 years, and smoking is the single most important cause of premature death. The aim of this study was to explore why people with severe mental ill health smoked and why they might want to stop smoking or cut down on the amount of cigarettes that they smoked. The study found that people with severe mental ill health are motivated to cut down or stop smoking, and this is mainly due to concerns about their own health. The reasons people gave for smoking were to relieve stress, to help relax and for something to do when they are bored. Health professionals should offer evidence supported smoking cessation therapy to people with severe mental ill health. In addition to standard National Health Service smoking cessation treatments such as pharmacotherapy and behavioural support. Practitioners should help people with serious mental ill health to identify meaningful activities to relieve boredom and challenge any incorrect beliefs they hold that smoking helps relaxation and relieves stress. ABSTRACT Smoking is the single most preventable cause of premature mortality for people with serious mental ill health (SMI). Yet little is known about the reasons why service users smoke or what their motivations for quitting might be. The aim of this paper is to explore smoking behaviours, reasons for smoking and motivations for cutting down/stopping smoking in individuals with SMI who expressed an interest in cutting down or stopping smoking. Prior to randomization, the smoking behaviours and motivations for wanting to cut down or stop smoking of participants in a randomized trial were systematically assessed. Participant's primary reasons for continuing to smoke were that they believed it helped them to cope with stress, to relax and relieve boredom. Participant's main motivations for wanting to cut down or stop smoking were related to concerns for their own health. Previous attempts to stop smoking had often been made alone without access to evidence supported smoking cessation therapy. Future recommendations include helping people with SMI to increase their activity levels to relieve boredom and inspire confidence in their ability to stop smoking and challenging beliefs that smoking aids relaxation and relieves stress.
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Affiliation(s)
| | | | | | - S Knowles
- University of Manchester, Manchester, UK
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16
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Abstract
BACKGROUND Despite its potential for usefulness in informing the development of smoking cessation interventions, short-term fluctuations in motivation to quit is a relatively understudied topic. OBJECTIVES To assess the prevalence of smokers' day-to-day fluctuations in motivation to quit, and to assess associations of day-to-day fluctuations in motivation to quit with several established cessation-related variables. METHODS A cross-sectional survey was administered to smokers in Hawaii (N = 1,567). To assess short-term fluctuations in motivation to quit smoking, participants were asked to respond "True" or "False" to the statement: "My motivation to quit smoking changes from one day to the next." Other items measured desire to quit smoking, intention to quit, confidence in quitting, cigarette dependence, and other cessation-related variables. RESULTS "My motivation to quit smoking changes from one day to the next" was endorsed as true by 64.7% of smokers, and false by 35.3%. Analyses revealed that smokers who indicated fluctuating motivation were significantly more interested in quitting as compared to smokers without fluctuations. Fluctuations in motivation to quit also were associated with greater confidence in quitting, lesser cigarette dependence, and more recent quitting activity (all p < .01). CONCLUSIONS Day-to-day fluctuations in motivation to quit are common. Day-to-day fluctuations in motivation to quit are strongly associated with higher motivation to quit, greater confidence in future quitting, and other positive cessation-relevant trends.
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Affiliation(s)
- Thaddeus Herzog
- University of Hawaii Cancer Center, Honolulu, Hawaii, United States
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17
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Dahne J, Hoffman EM, MacPherson L. The association between anxiety sensitivity and motivation to quit smoking among women and men in residential substance use treatment. Subst Use Misuse 2015; 50:72-8. [PMID: 25265420 PMCID: PMC4457284 DOI: 10.3109/10826084.2014.958856] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Smoking-attributed mortality is the leading cause of death among individuals in residential substance use treatment. As such, identifying factors that influence smoking cessation is highly relevant and important for this group. Motivation to quit (MTQ) smoking is one such factor that is related to smoking cessation. OBJECTIVES In the present study we examine the relationship between Anxiety Sensitivity (AS) and MTQ among individuals enrolled in a residential substance use treatment center in Washington, DC. In light of gender differences in smoking cessation as well as factors that contribute to cessation, we examined this relationship by gender in men and women using multiple group path analysis. METHODS Participants (n = 472) completed a measure of MTQ, the structured clinical interview for DSM-IV (SCID-IV-TR), a measure of AS, and self-reported their number of cigarettes smoked per day prior to entering a restricted environment. RESULTS RESULTS indicated that AS was significantly related to MTQ in women (standardized path estimate = 0.21, p = .01), but was not significantly related to MTQ in men. Conclusions/Importance: Findings suggest the importance of considering AS as a factor in MTQ for women and subsequent smoking cessation among individuals in residential substance use treatment. RESULTS of this study contribute to the extant literature on predictors of MTQ and highlight the need for tailored cessation interventions with AS as one potential cessation treatment target.
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Affiliation(s)
- Jennifer Dahne
- Department of Psychology, University of Maryland, College Park, Maryland, USA
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18
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Abstract
OBJECTIVE To examine if motivation to quit is associated with parental smoker's perceived presence of a personal or child health illness or risk due to tobacco use. DESIGN/METHODS This was a cross-sectional study of a convenience sample of 218 parental smokers who presented to the pediatric emergency department with their child. We assessed factors related to motivation to quit, including personal and child smoking-related illness, perceived personal and child health risk, smoking behaviors, and demographic characteristics. Motivation to quit was measured using the Contemplation Ladder score. RESULTS The mean score on the Contemplation Ladder was 6.2 (SD, 2.5), representing the response: thinking about cutting down or quitting . Eighty-four participants (39%) had high motivation to quit (Contemplation Ladder score 8). Bivariate analysis showed significant associations between high motivation to quit and perceived child health risk with continued smoking and perceived personal and child health benefit following smoking cessation. Parents with high motivation to quit were more likely to have high perceived self-efficacy and confidence in their ability to quit, prior quit attempts, and lower nicotine dependence. With the exception of race/ethnicity, demographic variables were not associated with motivation to quit. CONCLUSIONS A significant proportion of parental smokers who present to the pediatric emergency department endorse strong motivation to quit. Parents who endorse health risk or quitting-related health benefits in their child are more likely to have high motivation to quit smoking. Future studies are needed to determine if high motivation translates into smoking cessation.
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