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Urbán Róbert PhD Eötvös Loránd University

Are outcome expectancies the possible targets of smoking prevention ? T he roles of smoking outcome expectancies in adolescent smoking. Urbán Róbert PhD Eötvös Loránd University. Funding.

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Urbán Róbert PhD Eötvös Loránd University

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  1. Are outcome expectancies the possible targets of smoking prevention?The roles of smoking outcome expectancies in adolescent smoking Urbán Róbert PhD Eötvös Loránd University

  2. Funding • This presentation was made possible by grant number 1 R01 TW007927-01 from the Fogarty International Center, the National Cancer Institute, and the National Institutes on Drug Abuse, within the National Institutes of Health.

  3. Outcome expectancies • Social-learning theory proposes two types of expectancies: • Self-efficacy • Outcome expectancies • Other theories and models also use the outcome expectancies • Theory of reasoned action / theory of planned behavior models • Social-cognitive theory • Recent research demonstrated that outcome expectancies mediate between antecedents like personality and drug-use behavior, including • alcohol ( e.g. Williams & Clark, 1998, Urbán et al., 2008) • marijuana (Vangsness,Bry, & LaBouvie, 2004 ) • cocaine use ( Stacy et al., 1995).

  4. Outcome expectancies in the present research • Negative consequences • long-term negative health consequences of smoking • Positive/sensory reinforcement • expectancies of individual sensory satisfaction from smoking • Negative reinforcement • expectancies regarding coping and negative emotion regulation through smoking • Appetite and weight control • expectancies that smoking helps to manage appetite and weight • (Short-term negative consequences) • (Boredom reduction)

  5. Budapest Adolescent Smoking Study Methodology

  6. Longitudinal design Fall 2008 Spring 2009. Fall 2009 Spring 2010 Fall 2010 Sampling method: cluster sampling Sampling unit: classes

  7. Representative sample of the highschools in Budapest Sample • 70 schools • 106 classes (9th grade) • The total number of participants: 3565 students (49.8 % boys and 50.2 % girls). • Mean age 15.3 yrs (SD=0.56) in the first wave.

  8. Data collection • During a class hour • Self-report questionnaire includes: • Question related to smoking, nicotine addiction, perceived parental attitude, peer smoking, parental smoking, etc. • The Short form of Smoking Consequences Questionnaire • A short form of Sensation Seeking questionnaire • Susceptibility to smoking scale for the nonsmokers • Tobacco Advertisement Receptivity scale • Alcohol use, physical activity • Depression (CESD) • Body image questions and many others

  9. Parental attitude toward smoking Household smoking Nicotine dependence Negative consequences Availability of cigarette Age TAR Positive reinforcement Sensation seeking Susceptibility to smoking Smoking status Peer norms and pressure Negative reinforcement Delinquency First exp. from smoking Readiness to quit Depressive symptoms Appetite and weight control Alcohol use Weight concerns Smoking prevention Physical activity

  10. Parental attitude toward smoking Household smoking Nicotine dependence Negative consequences Availability of cigarette Age TAR Positive reinforcement Sensation seeking Susceptibility to smoking Smoking status Peer norms and pressure Negative reinforcement Delinquency First exp. from smoking Readiness to quit Depressive symptoms Appetite and weight control Alcohol use Weight concerns Smoking prevention Physical activity

  11. The role of expectancies in smoking initiation Are the outcome expectancies important before the experimentation with smoking?

  12. Predictors of experimentation with smoking between Wave 1 and Wave 2 Negative consequences -0.095 (0.022)*** 0.060 (0.016)*** Positive reinforcement R²=18% Susceptibility (intention) to smoking Trying smoking 0.63 (0.016)*** Negative reinforcement 0.034 (0.015)** R²=9% Unstandardized coefficients (SE) Appetite and weight control χ²=566.7 df=284; CFI=.933 TLI=.923 RMSEA=.032 [.028-.036]; N=828. Based on students who had not tried smoking in Wave 1 and provided data in Wave 2

  13. The role of outcome expectancies in smoking initiation • Expectancies are developed far before the experimentation with smoking. • Thinking about the possible negative consequences can reduce the risk of smoking initiation. • Thinking about the reinforcement properties of smoking can increase the intention to try and the risk of smoking initiation.

  14. The role expectancies in smoking intensity Crosslagged analysis – an analysis of the cause and effect

  15. Smoking intensity • Smoking intensity is defined with • number of days smoked during the past 30 days • number of cigarettes smoked a day on average • Smoking intensity is a rough estimation of the number of cigarettes during the past 30 days.

  16. Cross-lagged association between negative reinforcement expectancies and smoking intensity Wave1 Wave2 Wave 3 Wave4 Wave5 R²=27.2% R²=50.6% R²=59.4% R²=55.0% Smoking intensity Smoking intensity Smoking intensity Smoking intensity Smoking intensity 0.07** 0.14*** 0.08* 0.11** 0.06** Negative reinforcement Negative reinforcement Negative reinforcement Negative reinforcement Negative reinforcement Correlations between uniquenesses are not presented. χ²=48.1 df=15; RMSEA=0.025 [0.018-0.034]; CFI=0.99 TLI=0.97

  17. The role expectancies in smoking intensity Two parallel process models

  18. A growth model Time 1 Time 2 Time 3 Time 4 Time 5 1 1 1 1 2 9 3 4 16 1 1 4 1 Intercept Slope Quadratic Linear change Non-linear change

  19. Smoking intensity_1 Smoking intensity_2 Smoking intensity_3 Smoking intensity_4 Smoking intensity_5 Intercept Smoking Slope Smoking Quadratic Smoking -0.26*** 0.26*** 0.77*** Intercept NR Slope NR Quadratic NR NR_1 NR_2 NR_3 NR_4 NR_5 NR=negative reinforcement

  20. Smoking intensity_1 Smoking intensity_2 Smoking intensity_3 Smoking intensity_4 Smoking intensity_5 Intercept Smoking Slope Smoking Quadratic Smoking -0.90*** 1.16*** -1.50*** 0.97*** Intercept PR Slope PR Quadratic PR PR_1 PR_2 PR_3 PR_4 PR_5 PR=positive reinforcement

  21. Further questions: Do expectancies change over time? A latent class growth analysis (LCGA)

  22. A latent class growth analysis (LCGA) Time 1 Time 2 Time 3 Time 4 Time 5 1 1 1 1 2 9 3 4 16 1 1 4 1 Intercept Slope Quadratic Latent classes

  23. Days of smokingduring the last 30 days Based on the students who provided data at least 3 occasions, and smoked a cigarette at least on day during the research. N=1147.

  24. Negative consequences Based on all students.

  25. Positive reinforcement Based on all students.

  26. Negative reinforcement Based on all students.

  27. Appetite and weight control Based on all students.

  28. Conclusions • Outcome expectancies are important factors in smoking initiation and smoking intensity in adolescents. • Outcome expectancies are changing in time. In different age, the strength of these expectancies change. • Targeting outcome expectancies is an important focus of prevention work, but one time shot might be not enough.

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