1
|
Three-month effects of Project EX: A smoking intervention pilot program with Korean adolescents. Addict Behav Rep 2018; 9:100152. [PMID: 31193802 PMCID: PMC6542411 DOI: 10.1016/j.abrep.2018.100152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 11/20/2022] Open
Abstract
Despite current prevention and cessation efforts, adolescent smoking remains a pressing issue worldwide, including in Korea. The current study evaluates Project EX-Korea, a teen tobacco use cessation program, three months after baseline. The quasi-experimental trial intervention involved 160 smokers in 10th to 12th grade, 85 from the program condition schools and 75 from the control. At three-month follow-up, the intent-to-treat (ITT) quit rate in the program group (30.2%) was 3.6 times that of the rate in the standard care control group (9.2%; p < 0.05). Among those who did not quit, those in the program group smoked less on average than those in the control group, but there was no difference in follow-up mFTQ scores between the two non-quitter groups. As teen tobacco use cessation programming is much needed in Korea, Project EX is a plausible program to implement among Korean adolescents. Teen tobacco use cessation programming is still much needed in Korea and worldwide. Project EX is a credible tobacco cessation program to help Korean adolescents quit. The program group's quit rate was 3.6 times that of the control group's quit rate. Non-quitters in the program group smoked less than those in the control group.
Collapse
|
2
|
Gonzálvez MT, Morales A, Orgilés M, Sussman S, Espada JP. Role of smoking intention in tobacco use reduction: A mediation analysis of an effective classroom-based prevention/cessation intervention for adolescents. Addict Behav 2018; 84:186-192. [PMID: 29723801 DOI: 10.1016/j.addbeh.2018.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/09/2018] [Accepted: 04/16/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Although some school-based tobacco cessation and prevention programs have been proven to be effective, there remains a lack of understanding of how these programs succeed. METHODS This longitudinal study aimed to test smoking intention as a mediator of Project EX's intervention efficacy to reduce tobacco use. Using a computerized random number generator, six high schools located in the Mediterranean coast were randomly selected to participate in the program condition (Spanish version of Project EX) or the waiting-list control group with baseline, immediate-posttest, and 12-month follow-up assessments. At baseline, 685 adolescents aged 14-20 years (mean age: 14.87; SD = 0.92; 47.4% were females) were evaluated using self-administered tests of tobacco, and smoking intention. A biomarker of smoke inhalation, a measurement of exhaled carbon monoxide (ECM), was used. Mediation analyses were conducted using the PROCESS v2.12 macro for Windows. RESULTS Project EX had a significant effect on smoking intention. Indirect effects indicated that Project EX reduced the ECM level, and number of cigarettes used. CONCLUSIONS This is the first Spanish study that explored intention as a mediator of the long-term efficacy of Project EX to reduce tobacco use in adolescents. Results suggested that interventions that reduce consumption intention at short-term are more likely to be successful in decreasing tobacco use in the long-term.
Collapse
Affiliation(s)
- María T Gonzálvez
- Department of Health Psychology, Miguel Hernandez University, Avda. de la Universidad, s/n., 03202 Elche (Alicante), Spain.
| | - Alexandra Morales
- Department of Health Psychology, Miguel Hernandez University, Avda. de la Universidad, s/n., 03202 Elche (Alicante), Spain
| | - Mireia Orgilés
- Department of Health Psychology, Miguel Hernandez University, Avda. de la Universidad, s/n., 03202 Elche (Alicante), Spain
| | - Steve Sussman
- Preventive Medicine/Psychology, University of Southern California, United States
| | - José P Espada
- Department of Health Psychology, Miguel Hernandez University, Avda. de la Universidad, s/n., 03202 Elche (Alicante), Spain
| |
Collapse
|
3
|
International Approaches to Tobacco Prevention and Cessation Programming and Policy among Adolescents in India. CURRENT ADDICTION REPORTS 2018. [DOI: 10.1007/s40429-018-0185-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
4
|
Gonzálvez MT, Morales A, Orgilés M, Espada JP. International Approaches to Tobacco Use Cessation Programming and Policy in Adolescents and Young Adults: the Case of Spain. CURRENT ADDICTION REPORTS 2018. [DOI: 10.1007/s40429-018-0182-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
5
|
Fanshawe TR, Halliwell W, Lindson N, Aveyard P, Livingstone‐Banks J, Hartmann‐Boyce J. Tobacco cessation interventions for young people. Cochrane Database Syst Rev 2017; 11:CD003289. [PMID: 29148565 PMCID: PMC6486118 DOI: 10.1002/14651858.cd003289.pub6] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Most tobacco control programmes for adolescents are based around prevention of uptake, but teenage smoking is still common. It is unclear if interventions that are effective for adults can also help adolescents to quit. This is the update of a Cochrane Review first published in 2006. OBJECTIVES To evaluate the effectiveness of strategies that help young people to stop smoking tobacco. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group's Specialized Register in June 2017. This includes reports for trials identified in CENTRAL, MEDLINE, Embase and PsyclNFO. SELECTION CRITERIA We included individually and cluster-randomized controlled trials recruiting young people, aged under 20 years, who were regular tobacco smokers. We included any interventions for smoking cessation; these could include pharmacotherapy, psycho-social interventions and complex programmes targeting families, schools or communities. We excluded programmes primarily aimed at prevention of uptake. The primary outcome was smoking status after at least six months' follow-up among those who smoked at baseline. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility of candidate trials and extracted data. We evaluated included studies for risk of bias using standard Cochrane methodology and grouped them by intervention type and by the theoretical basis of the intervention. Where meta-analysis was appropriate, we estimated pooled risk ratios using a Mantel-Haenszel fixed-effect method, based on the quit rates at six months' follow-up. MAIN RESULTS Forty-one trials involving more than 13,000 young people met our inclusion criteria (26 individually randomized controlled trials and 15 cluster-randomized trials). We judged the majority of studies to be at high or unclear risk of bias in at least one domain. Interventions were varied, with the majority adopting forms of individual or group counselling, with or without additional self-help materials to form complex interventions. Eight studies used primarily computer or messaging interventions, and four small studies used pharmacological interventions (nicotine patch or gum, or bupropion). There was evidence of an intervention effect for group counselling (9 studies, risk ratio (RR) 1.35, 95% confidence interval (CI) 1.03 to 1.77), but not for individual counselling (7 studies, RR 1.07, 95% CI 0.83 to 1.39), mixed delivery methods (8 studies, RR 1.26, 95% CI 0.95 to 1.66) or the computer or messaging interventions (pooled RRs between 0.79 and 1.18, 9 studies in total). There was no clear evidence for the effectiveness of pharmacological interventions, although confidence intervals were wide (nicotine replacement therapy 3 studies, RR 1.11, 95% CI 0.48 to 2.58; bupropion 1 study RR 1.49, 95% CI 0.55 to 4.02). No subgroup precluded the possibility of a clinically important effect. Studies of pharmacotherapies reported some adverse events considered related to study treatment, though most were mild, whereas no adverse events were reported in studies of behavioural interventions. Our certainty in the findings for all comparisons is low or very low, mainly because of the clinical heterogeneity of the interventions, imprecision in the effect size estimates, and issues with risk of bias. AUTHORS' CONCLUSIONS There is limited evidence that either behavioural support or smoking cessation medication increases the proportion of young people that stop smoking in the long-term. Findings are most promising for group-based behavioural interventions, but evidence remains limited for all intervention types. There continues to be a need for well-designed, adequately powered, randomized controlled trials of interventions for this population of smokers.
Collapse
Affiliation(s)
- Thomas R Fanshawe
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
| | - William Halliwell
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
| | - Nicola Lindson
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
| | - Paul Aveyard
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
| | | | | | | |
Collapse
|
6
|
Prokhorov AV, Khalil GE, Foster DW, Marani SK, Guindani M, Espada JP, Gonzálvez MT, Idrisov B, Galimov A, Arora M, Tewari A, Isralowitz R, Lapvongwatana P, Chansatitporn N, Chen X, Zheng H, Sussman S. Testing the nicotine dependence measure mFTQ for adolescent smokers: A multinational investigation. Am J Addict 2017; 26:689-696. [PMID: 28708935 DOI: 10.1111/ajad.12583] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 06/19/2017] [Accepted: 06/25/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES As a measure of nicotine dependence among adolescent smokers, the modified Fagerström Tolerance Questionnaire (mFTQ; seven items), has been successfully used in the United States (USA). Nonetheless, the validity and reliability of mFTQ at the international level is still needed. The current study is the first to test the validity and reliability of mFTQ in four countries: Thailand, Spain, the USA, and Russia. METHODS In a cross-sectional survey, mFTQ, risk factors of nicotine dependence, and sociodemographic characteristics were assessed. Risk factors included age of first cigarette, frequency of alcohol use, frequency of marijuana use, and number of cigarettes smoked yesterday. Salivary cotinine was also obtained in Thailand and Spain. RESULTS For all four countries, mFTQ exhibited a single factor structure, as supported by previous work in the USA. For all studied countries except Thailand, mFTQ presented acceptable internal reliability. Overall, risk factors of nicotine dependence have predicted mFTQ scores across countries. Frequency of alcohol use in the USA and frequency of marijuana use in Thailand and Spain were not associated with mFTQ scores. DISCUSSION AND CONCLUSIONS mFTQ is a single-factor measure of nicotine dependence that shows acceptable internal consistency and validity across countries. Further work can advance the scale and tailor it to different cultures. SCIENTIFIC SIGNIFICANCE mFTQ can be a clinically practical international measure of nicotine dependence. This study provides initial support for the utility of the mFTQ among Thai, Spanish, American, and Russian adolescents. Further research is needed to test and advance mFTQ across cultures. (Am J Addict 2017;26:689-696).
Collapse
Affiliation(s)
- Alexander V Prokhorov
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Georges E Khalil
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Dawn W Foster
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Salma K Marani
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michele Guindani
- Department of Statistics, University of California Irvine, Irvine, California
| | | | | | - Bulat Idrisov
- Bashkir State Medical University, Ufa, Bashkortostan
| | - Artur Galimov
- Bashkir State Medical University, Ufa, Bashkortostan
| | - Monika Arora
- Health Promotion and Tobacco Control Public Health Foundation of India, New Delhi.,HRIDAY, Health Related Information Dissemination Among Youth, New Delhi
| | - Abha Tewari
- Health Promotion and Tobacco Control Public Health Foundation of India, New Delhi.,HRIDAY, Health Related Information Dissemination Among Youth, New Delhi
| | | | | | | | - Xinguang Chen
- University of Florida, Gainesville, Florida.,Wuhan Center for Disease Prevention and Control, Hubei Sheng, China
| | - Hong Zheng
- WestEd, San Francisco, San Francisco, California
| | - Steve Sussman
- University of Southern California, Los Angeles, California
| |
Collapse
|
7
|
Gonzálvez MT, Espada JP, Orgilés M, Sussman S. Two-year Effects of a Classroom-based Smoking Prevention and Cessation Intervention Program. Eur Addict Res 2017; 23:122-128. [PMID: 28595196 PMCID: PMC5687913 DOI: 10.1159/000475985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 04/07/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Project EX is a classroom-based smoking prevention and cessation intervention program that has been well evaluated and designed for assessing the prevention and cessation effects among adolescents in Spain. However, its long-term efficacy is still unknown. This study deals with the outcomes of a 2-year follow-up evaluation of Project EX. METHODS The intervention was tested using a clustered randomized controlled trial involving 1,546 Spanish students from 3 program schools and 3 control schools. At the end of the 2-year follow-up period, 722 subjects had completed the questionnaires (266 in the control condition and 456 in the program condition) administered to them. RESULTS Compared to the control condition, the program condition revealed a greater reduction in nicotine dependence (p = 0.04), smoking intention (p = 0.02), and in the number of cigarettes smoked during the previous month (p = 0.03). The CO monitor repeated assessments revealed a significant decrease of ppm levels in the program group (p < 0.001). Intent-to-treat quit rates were 14.28 and 0%, respectively, for the program and control conditions. CONCLUSIONS This study provides evidence about the long-term effectiveness of the Project EX classroom-based program for smoking prevention and cessation among adolescents in Spain.
Collapse
Affiliation(s)
| | - José P. Espada
- Department of Health Psychology, Miguel Hernandez University
| | - Mireia Orgilés
- Department of Health Psychology, Miguel Hernandez University
| | - Steve Sussman
- Preventive Medicine/Psychology, University of Southern California
| |
Collapse
|
8
|
Three-month effects of Project EX: A smoking intervention pilot program with Thai adolescents. Addict Behav 2016; 61:20-4. [PMID: 27235988 DOI: 10.1016/j.addbeh.2016.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 04/22/2016] [Accepted: 05/04/2016] [Indexed: 11/20/2022]
Abstract
Adolescent smoking is a major public health problem around the world, including Thailand. The current study provides a three-month follow-up evaluation of the Project EX tobacco use cessation program among Thai adolescents. The intervention was tested involving a quasi-experimental trial with 185 smokers, with two program and two control condition schools (within each condition, one school in Bangkok Province and one school in Nakhon Pathom Province). At 3-month follow-up, the intent-to-treat (ITT) quit rate was 23% in the program group and 11% in the standard care control group (p<0.02). The intervention also lowered the level of last 30-day smoking at follow-up among persons who did not quit in the program condition, while no change in level of smoking was reported in the control condition. These results are promising for teen tobacco use cessation programming in Thailand.
Collapse
|
9
|
Gonzálvez MT, Espada JP, Orgilés M, Morales A, Sussman S. Nicotine Dependence as a Mediator of Project EX's Effects to Reduce Tobacco Use in Scholars. Front Psychol 2016; 7:1207. [PMID: 27570514 PMCID: PMC4981589 DOI: 10.3389/fpsyg.2016.01207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 07/29/2016] [Indexed: 11/13/2022] Open
Abstract
In Spain, 44% of 14-18-year-olds have smoked, and 12.5% have smoked cigarettes in the last 30 days. Nicotine is one of the most addictive substances, and can lead to serious addiction in adulthood with adverse consequences to one's health. School plays a relevant role in health promotion and preventing risk behaviors such as tobacco consumption. Despite the fact that some school-based tobacco cessation and prevention interventions prove to be effective for their purposes, there is a lack of understanding as to why these programs succeed or fail. This longitudinal study aims to test the nicotine dependence (ND) as a mediator of Project EX's effect - a tobacco-use cessation program developed for high school youth to reduce tobacco consumption in scholars. Six high schools located in the Mediterranean coast were randomized for the participation of the program (Spanish version of Project EX) or a waiting-list group with baseline, immediate-posttest, and 12-month follow-up assessments. At baseline, 1,546 adolescents aged 14-21 years old (mean age: 15.28; SD = 1.20; 46% were women) were evaluated by self-administered tests on tobacco consumption and ND. A biomarker of smoke inhalation - a measurement of exhaled carbon monoxide (ECM) - was used. Participants who were smokers (N = 501; 32%) were selected for this study. Mediation analyses were conducted using the PROCESS v2.12 macro for Windows. The significant criterion was p ≤ 0.05, and 5,000 samples were used for bias-corrected bootstrap confidence intervals. Results indicated that Project EX indirectly decreased the number of cigarettes smoked in the last month, the number of cigarettes smoked within the last 7 days, the number of daily cigarettes, and ECM level at 12-month follow up through decreasing the level of ND in the short-term. This is the first Spanish study that explores ND as a mediator of the long-term efficacy of Project EX to reduce tobacco consumption in adolescents. Results suggest that interventions that reduce ND at short-term are more likely to be successful to decrease tobacco use at long-term.
Collapse
Affiliation(s)
- María T Gonzálvez
- Department of Health Psychology, Miguel Hernández University Elche, Spain
| | - José P Espada
- Department of Health Psychology, Miguel Hernández University Elche, Spain
| | - Mireia Orgilés
- Department of Health Psychology, Miguel Hernández University Elche, Spain
| | - Alexandra Morales
- Department of Health Psychology, Miguel Hernández University Elche, Spain
| | - Steve Sussman
- Department of Preventive Medicine, University of Southern California, Los Angeles CA, USA
| |
Collapse
|
10
|
Project EX-India: A classroom-based tobacco use prevention and cessation intervention program. Addict Behav 2016; 53:53-7. [PMID: 26454232 DOI: 10.1016/j.addbeh.2015.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 08/25/2015] [Accepted: 09/11/2015] [Indexed: 11/22/2022]
Abstract
Tobacco use experimentation is most frequent between the ages of 15–24 in India. Therefore, programming to counteract tobacco use among adolescents is needed. There is a lack of evidence-based teen tobacco use prevention and cessation programs. The current study provides an outcome evaluation of the Project EX tobacco use prevention and cessation program among Indian adolescents (16–18 years). An eight-session classroom-based curriculum was adapted to the Indian context and translated from English to Hindi (local language). Next, it was tested using a quasi-experimental design with 624 Indian students at baseline, involving two program and two control schools, with a three-month post-program follow-up. Project EX involves motivation enhancement (e.g., talk shows and games) and coping skills (e.g., complementary and alternative medicine) components. Program participants rated complementary and alternative medicine (CAM) activities like meditation, yoga and healthy breathing higher than talk shows and games. Compared to the standard care control condition, the program condition revealed a prevention effect, but not a cessation effect. Implications for prevention/cessation programming among Indian teens are discussed. This study was approved by the Independent Ethics Committee, Mumbai.
Collapse
|
11
|
Espada JP, Gonzálvez MT, Orgilés M, Sussman S. One-year effects of Project EX: A smoking intervention pilot program with Spanish adolescents. J Health Psychol 2016; 22:1067-1074. [PMID: 26826168 DOI: 10.1177/1359105315623628] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Adolescent smoking is a major public health problem, which has led to the development of cessation programs such as Project EX. However, there is no evidence for the long-term efficacy of cessation among Spanish adolescents. This study provides a 1-year follow-up evaluation of the Project EX tobacco use cessation program among 211 smokers. The intent-to-treat 30-day smoking quit rate for the program group was 7.81 percent ( p = .04), whereas no smokers quit in the control group ( p = .02). The intervention had a significant influence on future smoking expectation, intention, motivation to quit, and overall level of 30-day smoking. Long-term outcomes of the Project EX clinic-based program are promising for adolescent smokers in Spain.
Collapse
|
12
|
Gonzálvez MT, Espada JP, Orgilés M, Soto D, Sussman S. One-Year Effects of Project EX in Spain: A Classroom-Based Smoking Prevention and Cessation Intervention Program. PLoS One 2015; 10:e0130595. [PMID: 26090821 PMCID: PMC4474549 DOI: 10.1371/journal.pone.0130595] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 05/21/2015] [Indexed: 11/29/2022] Open
Abstract
Background Tobacco use prevalence rates are high among Spanish adolescents. Programming to counteract tobacco use is needed. Methods and Findings The current study provides a one-year follow-up outcome evaluation of Project EX, an eight-session classroom-based curriculum. The intervention was tested using a randomized controlled trial with 1,546 Spanish students, involving three program and three control schools. Compared to the control condition, the program condition revealed a greater reduction in nicotine dependence (p < .05) and CO ppm levels (p < .001), and lower consumption of cigarettes at last month (p = .03). Conclusions Long-term outcomes of the Project EX classroom-based program are promising for adolescent prevention and possibly cessation in Spain.
Collapse
Affiliation(s)
- María T. Gonzálvez
- Department of Health Psychology, Miguel Hernandez University, Elche, Spain
- * E-mail:
| | - José P. Espada
- Department of Health Psychology, Miguel Hernandez University, Elche, Spain
| | - Mireia Orgilés
- Department of Health Psychology, Miguel Hernandez University, Elche, Spain
| | - Daniel Soto
- University of Southern California, Los Angeles, California, United States of America
| | - Steve Sussman
- University of Southern California, Los Angeles, California, United States of America
| |
Collapse
|
13
|
Pilot clinic study of Project EX for smoking cessation with Spanish adolescents. Addict Behav 2015; 45:226-31. [PMID: 25725191 DOI: 10.1016/j.addbeh.2015.02.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 02/05/2015] [Accepted: 02/11/2015] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Despite efforts to prevent smoking, the prevalence of smoking in Spanish adolescents remains high. So far, there are no evidence-based smoking cessation programs for adolescents in Spain. METHODS This study describes the evaluation of Project EX, an eight-session school-based clinic smoking cessation program, with Spanish cigarette smokers 13-19 years of age, from 9 schools (four program condition schools and five control condition schools). A group-randomized controlled trial was used. There were 211 smokers at baseline (112 program group, and 99 control group). Evaluation involved an immediate pretest and posttest survey (administered five-weeks later) and six-month follow-up (after the immediate posttest). RESULTS At immediate posttest, Project EX significantly reduced future nicotine dependence scores (mFTQ; p<.001), and increased intention to quit smoking (p<.001), and led to a higher previous day (prior to assessment) quit rate (p<.03). At the six-month follow-up, the percentage of quitters in the program group was 14.28%, whereas no smokers quit smoking in the control group (p<.04), and Project EX had a significant influence on future smoking expectation (p=.006) and overall level of 30-day smoking. CONCLUSIONS Results for the Project EX school-based clinic are promising for adolescent smokers in Spain, although difficulties in recruitment and high attrition are of concern. Findings and limitations are discussed and suggestions for future research are suggested.
Collapse
|
14
|
Espada JP, Gonzálvez MT, Guillén-Riquelme A, Sun P, Sussman S. Immediate Effects of Project EX in Spain: A Classroom-Based Smoking Prevention and Cessation Intervention Program. JOURNAL OF DRUG EDUCATION 2015; 44:3-18. [PMID: 25721322 DOI: 10.1177/0047237915573523] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Tobacco use is of high prevalence among Spanish adolescents. Programming to counteract tobacco use has been needed. There is a lack of knowledge on the efficacy of teen tobacco use cessation programming. The current study provides an immediate outcome evaluation of the Project EX tobacco use prevention and cessation program among Spanish adolescents. An eight-session, classroom-based curriculum was translated from English to Spanish and adapted to the Spanish culture. Next, it was tested using a randomized controlled trial with 1,546 Spanish students, involving three program and three control high schools. Participants at the program group provided moderately favorable process ratings of the program. Compared to the standard care control condition, the program condition revealed a greater reduction in smoking intentions and CO ppm levels.
Collapse
Affiliation(s)
| | | | | | - Ping Sun
- University of Southern California, Los Angeles, USA
| | | |
Collapse
|
15
|
Sussman S, Leventhal A. Substance misuse prevention: addressing anhedonia. NEW DIRECTIONS FOR YOUTH DEVELOPMENT 2014; 2014:45-56, 10. [PMID: 24753277 PMCID: PMC4181563 DOI: 10.1002/yd.20085] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Anhedonia refers to the inability of experiencing pleasure in positive life events. It has been conceptualized as a stable yet malleable characteristic and is associated with hypoactivity in the mesolimbic and mesocortical dopaminergic systems. Very recently, it has been posited as an etiologic factor associated with drug addiction onset, escalation, and relapse. Prevention programming could be developed to counteract the harmful impact of anhedonia, so as to minimize its impact on drug misuse. Remedial efforts are those that either (1) permit the individual to tolerate low levels of pleasure without resorting to drug misuse or other maladaptive behaviors that may unhealthily besot pleasure (for example, through normalization, structuring time, or meditation) or (2) counteract anhedonia by enhancing ones capability to experience pleasure (for example, behavioral activation, positive psychology, pharmacotherapy, or pursuit of positive addictions). School-based activities could be developed that can be completed by individuals, small workgroups, or the whole classroom. The concept of anhedonia is described in this chapter, and possible prevention strategies that might be utilized in schools as well as other contexts are discussed.
Collapse
Affiliation(s)
- Steve Sussman
- Preventive Medicine and Psychology, University of Southern California
| | | |
Collapse
|
16
|
Idrisov B, Sun P, Akhmadeeva L, Arpawong TE, Kukhareva P, Sussman S. Immediate and six-month effects of Project EX Russia: a smoking cessation intervention pilot program. Addict Behav 2013; 38:2402-8. [PMID: 23639851 PMCID: PMC3715312 DOI: 10.1016/j.addbeh.2013.03.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 01/24/2013] [Accepted: 03/25/2013] [Indexed: 10/27/2022]
Abstract
This study evaluates the performance of the Project EX tobacco use cessation program in Russian summer recreational camps. An eight-session clinic-based tobacco use cessation program for adolescents was tested during the summer of 2011 in an experimental pilot trial that involved different youth that rotated through camps. Conditions were nested within camps. Two rotations of unique subject groups of smokers (program and standard care control) through each of five camps provided the means of controlling for campsite by condition. Assignment of condition by rotation was random (by a flip of a coin), achieving reasonable baseline comparability (total n=164 smokers at baseline, 76 program group, 88 standard care control group). Evaluation involved an immediate pretest and posttest and a six-month telephone follow-up. At immediate posttest, Project EX was moderately well-received, significantly reduced future smoking expectation (46% reduction in EX program condition versus 8% in control, p<.0001), decreased intention to not quit smoking (-5.2% in EX versus +1.4% in control, p<.05), and increased motivation to quit smoking (0.72 versus -0.04, p<.0001). At the six-month follow-up, program subjects reported a higher intent-to-treat quit rate during the last 30days (7.5% versus 0.1%, p<.05). For the subjects who remained monthly smokers at the six-month follow-up, Project EX reduced subjects' level of nicotine dependence (-0.53 versus +0.15, p<.001). The results were quite promising for this program, which included motivation enhancement, coping skill, and alternative medicine material. However, further research on teen tobacco use cessation programming in Russia with larger sample sizes, involving other locations of the country, and with stronger research designs is needed.
Collapse
Affiliation(s)
- Bulat Idrisov
- Bashkortostan State Medical University, Pediatrics Department, 3 Lenina Street, Ufa, Russia, 450008;
| | - Ping Sun
- University of Southern California, Department of Preventive Medicine, 2001 N. Soto Street, SSB MC 9239, Los Angeles, CA 90032, USA;
| | - Leila Akhmadeeva
- Bashkortostan State Medical University, Department of Neurology, Neurosurgery and Medical Genetics, 3 Lenina Street, Ufa, Russia, 450008;
| | - Thalida Em Arpawong
- University of Southern California, Department of Preventive Medicine, 2001 N. Soto Street, SSB MC 9239, Los Angeles, CA 90032, USA;
| | - Polina Kukhareva
- University of North Carolina at Chapel Hill, Collaborative Studies Coordinating Center, 137 E. Franklin Street, Suite 203, Chapel Hill, NC 27514, USA;
| | - Steve Sussman
- University of Southern California, Departments of Preventive Medicine and Psychology, 2001 N. Soto Street, SSB Room 302A, Los Angeles, CA 90032, USA;
| |
Collapse
|