Treatment non-response: Associations with smoking expectancies among treatment-seeking smokers

Indonesian adolescents' perspectives on smoking habits: a qualitative study

Background

The prevalence of smoking among adolescents is high in Indonesia. Therefore, this qualitative research aimed to explore the perspectives of Muslim adolescents on smoking habits as a reference for developing effective prevention programs.

Methods

Three focus group discussions involving 24 junior high school male students (mean age = 13.75 years) were the main source of data for this phenomenological qualitative study. The discussion guide was developed by the researchers based on the reviewed literature and validated by experts. The research findings were analyzed using an inductive content analysis with systematic steps based on the stages of qualitative data analysis.

Results

Adolescent perspectives on smoking were grouped into two themes: perception of smoking and smoking-related factors. The perception of smoking encompassed three sub-themes: smoking as a social habit, contradictive feelings, and the Islamic perspective. The smoking-related factors included peer pressure, the parents’ smoking status, masculinity and curiosity. The results indicated that adolescents consider smoking as a social habit but with contradictory feelings. The smoking habit was also stimulated by peer pressure, imitating parents who smoke, feeling masculine and curiosity.

Conclusion

We suggest that health professionals who are interested in developing smoking prevention programs in Indonesia should consider the adolescent perspective on smoking so that the prevention program will be more effective and appropriate for adolescents.

The Effect of Positive and Negative Affect on Early Treatment Milestones in the Context of Integrated Smoking Treatment

: Smoking is the leading cause of preventable death in the United States. Efforts have been made to develop effective, integrated smoking-cessation treatments for individuals with greater difficulty quitting, including individuals with elevated anxiety sensitivity (AS). Despite initial evidence for the efficacy of these treatments, little is understood about pretreatment predictors of early treatment milestones, including treatment initiation and response. Positive affectivity (PA) and negative affectivity (NA) are unique mood traits that may be related to early treatment milestones. Indeed, PA and NA are related to smoking and mood outcomes generally. Yet, it is presently unknown if pretreatment PA or NA predict early treatment milestones within the context of an integrated smoking-cessation treatment. The current study sought to evaluate the independent effect of PA and NA on early treatment milestones within the context of an integrated smoking-AS treatment protocol. Smoking and AS outcomes were evaluated independently. Participants included 288 (50% female; Mage = 38.66, SD = 13.67) treatment-seeking adult daily cigarette users. Results indicated that higher pretreatment NA was associated with an increased likelihood of early dropout versus responding to treatment across both outcomes (smoking: odds ratio [OR] 0.93, 95% confidence interval [CI] 0.88-0.99; AS: OR 0.92, 95% CI 0.88-0.98). Pretreatment PA did not significantly differentiate any of the groups. Overall, the present study serves as an initial investigation of the role of pretreatment NA in identifying those at greatest risk for dropping out of treatment (cf. responding to treatment).

Addressing Outcomes Expectancies in Behavior Change

Individuals commonly seek help for problem health behaviors, such as excessive drinking, smoking, and weight gain. Yet, there is a high rate of recidivism in these behaviors because outcome expectancies are either too high, negative outcome expectancies are not considered, or outcome expectancies are not properly addressed. Healthcare providers are recommended to list the outcome expectancy for the problem behavior and corresponding treatment for their patient. Through the process it is important to acknowledge both the positive and negative outcomes of engaging in the problem behavior. Healthcare providers are then encouraged to have their patient identify the goals and objectives that will assist in achieving the desired outcome. By recognizing and addressing outcome expectancies, it is more likely that the patient will be less resistant to the healthcare provider's recommendations to change problematic behavior.