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O'Logbon J, Wickersham A, Williamson C, Leightley D. The effectiveness of digital health technologies for reducing substance use among young people: a systematic review & meta-analysis. J Ment Health 2023:1-29. [PMID: 37664884 DOI: 10.1080/09638237.2023.2245902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/22/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Substance use amongst young people poses developmental and clinical challenges, necessitating early detection and treatment. Considering the widespread use of technology in young people, delivering interventions digitally may help to reduce and monitor their substance use. AIMS We conducted a systematic review and two meta-analyses to assess the effectiveness of digital interventions for reducing substance use (alcohol, smoking, and other substances) among young people aged 10 to 24 years old. METHOD Embase, Global Health, Medline, PsychINFO, Web of Science and reference lists of relevant papers were searched in November 2020. Studies were included if they quantitatively evaluated the effectiveness of digital health technologies for treating substance use. A narrative synthesis and meta-analysis were conducted. RESULTS Forty-two studies were included in the systematic review and 18 in the meta-analyses. Digital interventions showed small, but statistically significant reductions in weekly alcohol consumption compared to controls (SMD= -0.12, 95% CI= -0.17 to -0.06, I2=0%), but no overall effect was seen on 30-day smoking abstinence (OR = 1.12, 95% CI = 0.70 to 1.80, I2=81%). The effectiveness of digital interventions for reducing substance use is generally weak, however, promising results such as reducing alcohol use were seen. Large-scale studies should investigate the viability of digital interventions, collect user feedback, and determine cost-effectiveness. PRISMA/PROSPERO This systematic review was conducted following Cochrane methodology PRISMA guidelines. The review was registered with PROSPERO in November 2020 (CRD42020218442).
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Affiliation(s)
| | - Alice Wickersham
- Department of Psychological Medicine, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
| | - Charlotte Williamson
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, London, UK
| | - Daniel Leightley
- Department of Psychological Medicine, King's College London, London, UK
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, London, UK
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Alalwan MA, Keller-Hamilton B, Long L, Lipkus I, Wagener TL, Mays D. Correlates of motivation to quit waterpipe tobacco smoking among US young adults: implications for cessation interventions. HEALTH EDUCATION RESEARCH 2023; 38:338-349. [PMID: 36880171 PMCID: PMC10558042 DOI: 10.1093/her/cyad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Waterpipe tobacco smoking is a public health concern that poses many of the same health risks as cigarette smoking, especially among young adults-a subpopulation characterized by the highest prevalence of waterpipe tobacco smoking. Nevertheless, it remains understudied relative to other forms of tobacco use. We examined sociodemographic, behavioral and cognitive factors associated with young adults' motivation to quit waterpipe smoking using a theory-informed approach. We completed a secondary analysis of baseline data on waterpipe tobacco smoking beliefs and behavior collected from 349 US young adults aged 18-30 years. We analyzed sociodemographics, tobacco use and cessation behaviors and perceptions, and theory-related constructs associated with motivation to quit waterpipe tobacco smoking using linear regression. Overall, participants reported low motivation (mean = 2.68, SD = 1.56, scale range 1-7) and high self-efficacy (mean = 5.12, SD = 1.79) to quit waterpipe tobacco smoking. In multivariable analysis, prior quit attempts (β = 1.10, P < 0.01), greater perceived risks of waterpipe tobacco smoking (β = 0.42, P < 0.01) and increasingly negative attitudes toward waterpipe tobacco smoking (β = 0.29, P < 0.01) were associated with higher motivation to quit. These findings highlight the importance of those factors as potential cessation determinants. These findings can help guide the development and refinement of interventions targeting young adult waterpipe tobacco smoking.
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Affiliation(s)
- Mahmood A Alalwan
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Ave., Columbus, OH 43210, USA
| | - Brittney Keller-Hamilton
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
| | - Lauren Long
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
| | - Isaac Lipkus
- Duke University School of Nursing, 307 Trent Dr., Durham, NC 27710, USA
| | - Theodore L Wagener
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
| | - Darren Mays
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
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Pérez A, Kuk AE, Bluestein MA, Chen B, Sterling KL, Harrell MB. Age of initiation of hookah use among young adults: Findings from the Population Assessment of Tobacco and Health (PATH) study, 2013-2017. PLoS One 2021; 16:e0258422. [PMID: 34637482 PMCID: PMC8509879 DOI: 10.1371/journal.pone.0258422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/27/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To prospectively estimate the age of initiation of ever, past 30-day, and fairly regular hookah use among young adults (ages 18-24) overall, by sex, by race/ethnicity, and to explore the association of prior use of other tobacco products with these hookah use behaviors. METHODS Secondary data analyses of the first four waves (2013-2017) of the PATH study, a nationally representative longitudinal cohort study of US young adults. Young adult never hookah users at the first wave of adult participation in PATH waves 1-3 (2013-2016) were followed-up into waves 2-4 (2014-2017) to estimate the age of initiation of three outcomes: (i) ever use, (ii) past 30-day use, and (iii) fairly regular hookah use. Weighted interval-censoring Cox proportional hazards regression models were used to examine the differences in the estimated age of initiation by sex and by race/ethnicity while controlling for the total number of other tobacco products ever used at participants' first wave of PATH participation. In addition, to examine if prior use of other tobacco products was associated with the age of hookah initiation behaviors, six additional Cox models are reported for each hookah initiation behaviors. RESULTS The largest increase in hookah use occurred between ages 18 and 19: 5.8% for ever use and 2.7% for past 30-day hookah use. By age 21, 10.5%, 4.7% and 1.2% reported initiation of ever, past 30-day and fairly regular hookah use, respectively. There were statistically significance differences in the age of initiation of hookah use behaviors by race/ethnicity. CONCLUSION Educational interventions should target young adults before the age of 21, focusing efforts specifically on males, non-Hispanic Blacks and Hispanics, to stall initiation and progression of hookah use behaviors.
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Affiliation(s)
- Adriana Pérez
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas, United States of America
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas, United States of America
- * E-mail:
| | - Arnold E. Kuk
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas, United States of America
| | - Meagan A. Bluestein
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas, United States of America
| | - Baojiang Chen
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas, United States of America
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas, United States of America
| | - Kymberle L. Sterling
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Dallas, Texas, United States of America
| | - Melissa B. Harrell
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, Texas, United States of America
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health in Austin Campus, Austin, Texas, United States of America
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Mays D, Johnson AC, Phan L, Sanders C, Shoben A, Tercyak KP, Wagener TL, Brinkman MC, Lipkus IM. Tailored Mobile Messaging Intervention for Waterpipe Tobacco Cessation in Young Adults: A Randomized Trial. Am J Public Health 2021; 111:1686-1695. [PMID: 34436927 PMCID: PMC8589064 DOI: 10.2105/ajph.2021.306389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 11/04/2022]
Abstract
Objectives. To test a tailored mobile health (i.e., mHealth) intervention for waterpipe tobacco cessation in young adults. Methods. From 2018 to 2020 at 2 US sites, we conducted a randomized trial with 349 waterpipe tobacco smokers aged 18 to 30 years randomized to control (no intervention), untailored, or tailored intervention arms. Intervention arms received a 6-week mHealth intervention conveying risks of waterpipe tobacco through text and images and strategies to enhance motivation and support quitting. The tailored intervention was personalized to baseline measures and intervention text message responses. Risk appraisals, motivation to quit, waterpipe smoking frequency, and cessation were assessed at 6 weeks, 3 months, and 6 months. Results. At 6 months, cessation was higher in the tailored (49%) than the control arm (29%; odds ratio = 2.4; 95% confidence interval = 1.3, 4.2) and smoking frequency was lower in the tailored (mean = 3.5 days) than the control arm (mean = 4.3 days; P = .006). At interim follow-ups, significant differences in other outcomes favored the tailored intervention. Conclusions. Tailored mobile messaging can help young adult waterpipe tobacco smokers quit. This scalable intervention is poised for population implementation.
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Affiliation(s)
- Darren Mays
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Andrea C Johnson
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Lilianna Phan
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Camilla Sanders
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Abigail Shoben
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Kenneth P Tercyak
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Theodore L Wagener
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Marielle C Brinkman
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Isaac M Lipkus
- Darren Mays and Theodore L. Wagener are with the Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus. Andrea C. Johnson is with the Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Lilianna Phan is with the National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD. Camilla Sanders and Isaac M. Lipkus are with the Duke University School of Nursing, Durham, NC. Abigail Shoben and Marielle C. Brinkman are with the College of Public Health, The Ohio State University, Columbus. Kenneth P. Tercyak is with the Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
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