An Age-Progression Intervention for Smoking Cessation: A Pilot Study Investigating the Influence of Two Sets of Instructions on Intervention Efficacy.

BACKGROUND: Research on age-progression facial morphing interventions for smoking cessation has not investigated the effect of different instructions for intervention delivery. The objective of this pilot study was to investigate the influence of two instruction types used to deliver the intervention on efficacy of the intervention. METHOD: Women were recruited and randomly allocated to an age-progression intervention session with (i) neutral instructions; (ii) instructions designed to reassure; or (iii) a condition that controlled for participant engagement ("control"). The conditions were delivered in a one-time procedure, after which primary (quitting intentions) and secondary (cigarettes/week, quit attempts) outcomes were measured immediately post-intervention, and at 1 and 3 months. RESULTS: Seventy-two women (M = 25.7; SD = 0.9) were recruited and randomly allocated to condition (Neutral n = 27, Reassuring n = 22, Control n = 23). Quitting intentions were higher in the Reassuring versus Control arm (3 months post-intervention, F = 4.37, p = 0.016, 95% CI [0.231, 2.539], eta2 = 0.11); quit attempts were greater in the two intervention arms (58%) versus Control (1-month post-intervention, 15%) (χ2 = 9.83, p < 0.05, OR 1.00 [0.28, 3.63]). CONCLUSIONS: Findings highlight the importance of optimising instructions to enhance intervention efficacy. TRIAL REGISTRATION: clinicaltrials.gov Record: NCT03749382.

Men's experiences of a personalised, appearance-based, facial-morphing, safer drinking intervention.

Risky alcohol consumption behaviours remain commonplace, representing a major threat to health and safety, and are especially evidenced by young university students. Consequently, new interventions targeting this high-risk group are required. The current study investigated young male university students' experiences of a personalised, appearance-based, facial morphing, safer drinking intervention. Twenty-five male student participants were recruited, aged 18-34 years. Inductive thematic analysis of data gathered whilst participants were immersed in the intervention, and thereby exposed to alcohol-aged images of their own faces, produced four primary themes: alcohol as a threat to appearance and health, motivations to protect appearance, motivational aspects of the intervention, and proposed improvements and applications. The results of the current study suggested that participants expressed intentions towards healthier consumption/maintenance of already non-risky intake, supporting the potential of the facial-morphing appearance-based approach to address risky alcohol consumption, even in high-risk groups.

UK women smokers' experiences of an age-progression smoking cessation intervention: Thematic analysis of accounts.

Objectives: Appearance-related interventions to promote healthy behaviour have been found effective to communicate health risks. The current study aimed to explore women smokers' experiences of age-progression software showing the effects of smoking on the face. Methods: A qualitative design was implemented, utilizing both individual interviews and focus groups within a critical realist framework. Fifteen, 19-52 year-old women smokers were administered an age-progression intervention. All participants responded to the intervention, engaged in semi-structured interviews, and were invited back to attend one of three focus groups. Data were analysed using inductive thematic analysis. Results: Four main themes were identified: Health versus Appearance, Shock Reaction, Perceived Susceptibility, and Intention to Quit. Participants found the intervention useful, voicing need for a comprehensive approach that includes both appearance and health. Despite increases in appearance-based apps which could diminish impact, women's accounts of shock induced by the aged smoking-morphed images were similar to previous work conducted more than ten years previously. Conclusions: The study provides novel insights in how women smokers currently perceive, and react to, an age-progression intervention for smoking cessation. Innovation: Findings emphasise the implementation of this intervention type accompanied by health information in a range of patient settings.

Students' experiences of a facial morphing intervention designed to encourage safer drinking.

Objective: The study was designed to investigate women's experiences of an age-appearance, facial-ageing, morphing intervention to show the effect of alcohol consumption on their skin. Design: Seventeen women aged 19-32 took part in the study, using individual sessions where they viewed the intervention. Main Outcome Measures: Participants were recorded during their viewing of the facial-ageing software, and the recordings of the sessions were then transcribed. Results: Transcripts were analysed using inductive thematic analysis. The women were shocked about the possible impact of alcohol consumption on their skin and appearance, and all of the women stated that the intervention had made them think about changing their alcohol consumption behaviours in the future, after viewing the images of themselves which were morphed to show the effects of both moderate and excessive alcohol consumption. Conclusion: The results are discussed in relation to suggestions for interventions aimed at women. It is concluded that appearance-based interventions do have a role to play with regards to alcohol consumption interventions.

Effectiveness and cost-effectiveness of repeated implementation intention formation on adolescent smoking initiation: A cluster randomized controlled trial.

OBJECTIVE: Forming implementation intentions (if-then plans) about how to refuse cigarette offers plus antismoking messages was tested for reducing adolescent smoking. METHOD: Cluster randomized controlled trial with schools randomized (1:1) to receive implementation intention intervention and messages targeting not smoking (intervention) or completing homework (control). Adolescents (11-12 years at baseline) formed implementation intentions and read messages on 8 occasions over 4 years meaning masking treatment allocation was not possible. Outcomes were: follow-up (48 months) ever smoking, any smoking in last 30 days, regular smoking, and breath carbon monoxide levels. Analyses excluded baseline ever smokers, controlled for clustering by schools and examined effects of controlling for demographic variables. Economic evaluation (incremental cost effectiveness ratio; ICER) was conducted. Trial is registered (ISRCTN27596806). RESULTS: Schools were randomly allocated (September-October 2012) to intervention (n = 25) or control (n = 23). At follow-up, among 6,155 baseline never smokers from 45 retained schools, ever smoking was significantly lower (RR = 0.83, 95% CI [0.71, 0.97], p = .016) in intervention (29.3%) compared with control (35.8%) and remained so controlling for demographics. Similar patterns observed for any smoking in last 30 days. Less consistent effects were observed for regular smoking and breath carbon monoxide levels. Economic analysis yielded an ICER of $134 per ever smoker avoided at age 15-16 years. CONCLUSIONS: This pragmatic trial supports the use of repeated implementation intentions about how to refuse the offer of a cigarette plus antismoking messages as an effective and cost-effective intervention to reduce smoking initiation in adolescents. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Patterns and predictors of e-cigarette, cigarette and dual use uptake in UK adolescents: evidence from a 24-month prospective study.

BACKGROUND AND AIMS: To assess prevalence and predictors of e-cigarettes/cigarettes patterns of use in adolescents in England. DESIGN: Prospective study with 24-month follow-up of e-cigarette/cigarette ever/regular use with data from an intervention evaluation. SETTING: Forty-five schools in England (Staffordshire and Yorkshire). PARTICIPANTS: A total of 3210 adolescents who, at baseline, were aged 13-14 years and had never used e-cigarettes/cigarettes. MEASUREMENTS: Based on e-cigarette/cigarette ever use at follow-up, six groups were created: (a) never user, (b) e-cigarette only, (c) cigarette only, (d) dual use-order of use unclear, (e) dual use-e-cigarettes used first and (f) dual use-cigarettes used first. Baseline measures were: gender, ethnicity, socio-economic status, impulsivity, family plus friend smoking and smoking-related beliefs (attitude and perceived behavioural control). FINDINGS: In groups (a) to (f), there were 71.5, 13.3, 3.3, 5.7, 2.9 and 3.4% adolescents, respectively. Among groups using cigarettes, regular smoking was more prevalent in group (f) (dual use-cigarettes used first) [17.6%, 95% confidence interval (CI) = 10.4, 24.8] than in groups (c), (d) and (e) combined (7.3%, 95% CI = 4.7, 9.9). Among groups using e-cigarettes, regular use was less prevalent in group (b) (e-cigarette only) (1.9%, 95% CI = 0.6, 3.2) than in groups (d), (e) and (f) combined (12.2%, 95% CI = 8.9, 15.5). Higher impulsivity plus friends and family smoking were predictive of being in groups (b) to (f) compared with group (a) (never users). Males were more likely to be in group (b) compared to group (a); females were more likely to be in groups (c) to (f) compared to group (a). CONCLUSIONS: Regular use of e-cigarettes/cigarettes varies across groups defined by ever use of e-cigarettes/cigarettes. Interventions targeted at tackling impulsivity or adolescents whose friends and family members smoke may represent fruitful avenues for future research.