How a 5-Day Stay in the Tobacco-Free Environment of the Stoptober House Supports Individuals to Quit Smoking: A Mixed Methods Pilot Study.

INTRODUCTION: The Stoptober House is part of the annual national Stoptober smoking cessation campaign in the Netherlands. During the first week of October, 48 volunteers resided in the tobacco-free Stoptober House for 5 days and received smoking cessation counseling. This pilot study explored how the Stoptober House may have facilitated smoking cessation among participants. METHODS: We included 48 individuals who were selected for the Stoptober House (intervention group) and 67 individuals who were not selected (control group). Surveys were conducted at baseline, immediately after 2 and 8 weeks of post-intervention. We compared self-reported abstinence, psychosocial mediators related to smoking cessation, and perceived active elements of the Stoptober House between the intervention and control groups using t/χ2 tests and linear mixed model (LMM) analysis. Sixteen semi-structured qualitative interviews were conducted to explore participants' perspectives on the elements contributing to their success in quitting smoking. RESULTS: At 8 weeks of follow-up, a higher proportion of participants in the intervention group (24/48 [50%]) reported being abstinent compared to the control group (5/67 [7%]; p < 0.001). Among participants who reported making a quit attempt, 22/38 (57.9%) in the intervention group remained abstinent compared to 4/17 (23.5%) in the control group (p = 0.022). The intervention group also exhibited higher self-efficacy to quit smoking throughout the follow-up period and higher social support immediately after the Stoptober House. No significant differences were observed in other psychosocial factors. The interviews highlighted several perceived elements of the Stoptober House that contributed to smoking cessation success, including restricted smoking opportunities, access to smoking cessation counselors, and peer support. CONCLUSION: This pilot study suggests that the Stoptober House provides support that can help people quit smoking. Further research is needed to confirm these findings and determine the cost-effectiveness of this intervention in promoting long-term abstinence among specific groups of smokers.

Is smoking an independent risk factor for developing cervical intra-epithelial neoplasia and cervical cancer? A systematic review and meta-analysis.

Introduction: Cervical cancer is the fourth most common form of cancer among women. Smoking tobacco seems to be a risk factor for the development of cervical intra-epithelial neoplasia (CIN) and cervical cancer, but the exact role of smoking in the process of cervical carcinogenesis is not known. The aim of this study is to investigate the relationship between smoking and the development of CIN and cervical cancer. Areas covered: We searched Embase, Medline, Cochrane Central, Web of Science, and Google Scholar for studies on smoking and CIN and cervical cancer, published between 2009 and 2018. The following were the outcomes: CIN3 alone, CIN2 and CIN3 combined, CIN2+, CIN3+, and cervical cancer alone. We included 49 studies in our review and 45 in our meta-analyses. Expert opinion: Based on the available evidence it can be - cautiously - concluded that smoking increases the risk of cervical abnormalities. However, the high risk of bias indicates that for future studies, it will be important to adjust for relevant predictors, to separate CIN from cervical cancer as outcome measures, and to report research methods in detail.

How can vulnerable groups be recruited to participate in a community-based smoking cessation program and perceptions of effective elements: A qualitative study among participants and professionals.

INTRODUCTION: Smokers from vulnerable groups, such as smokers with a low socioeconomic position, often have more difficulty quitting smoking and often are more difficult to recruit for smoking cessation programs. It is important to know how vulnerable groups can be recruited and motivated to participate in a smoking cessation program and what participants and professionals perceive as effective elements. METHODS: Qualitative interviews were performed with participants of a communitybased smoking cessation program in the Netherlands (n=18) and professionals involved in the recruitment of participants or as trainers in the community-based smoking cessation program (n=8). They were interviewed twice: once before the program had started and once after the program had ended. Interviews were semi-structured and conducted between September 2018 and February 2019. RESULTS: We found that organizing the program in the neighborhood lowered the threshold to participate, that registration should be quick and easy, that an active approach is needed, and that personal contact is important. This study also showed that information sharing, social support, commitment of the trainer, and personal contact are perceived as effective elements of such a program. CONCLUSIONS: This study shows that vulnerable smokers can be successfully recruited for a smoking cessation program. We recommend that such interventions include a group setting, extensive personal contact between participants and a committed trainer, and implementation of the program at a location in the neighborhood of the target group. Practical recommendations for professionals are to personally approach people multiple times if needed, to make sure that registration is quick and easy, and to fill in the registration form immediately during recruitment.

Three Diagnoses for Problematic Hypersexuality; Which Criteria Predict Help-Seeking Behavior?

This study aimed to assess the best combination of indicators of problematic hypersexuality (PH), in a survey (n = 58,158) targeting individuals wondering if they were sex addicted. The survey allowed for testing of criteria from three theoretical models used to conceptualize PH. Factor analyses for women and men yielded an interpretable grouping of indicators consisting of four factors. In subsequent logistic regressions, these factors were used as predictors for experiencing the need for help for PH. The factors Negative Effects and Extreme positively predicted experiencing the need for help, with Negative Effects as the most important predictor for both women and men. This factor included, among others, withdrawal symptoms and loss of pleasure. The Sexual Desire factor negatively predicted the need for help, suggesting that for the targeted population more sexual desire leads to less PH. The Coping factor did not predict experiencing the need for help. Outcomes show that a combination of indicators from different theoretical models best indicates the presence of PH. Therefore, a measurement instrument to assess existence and severity of PH should consist of such a combination. Theoretically, this study suggests that a more comprehensive model for PH is needed, surpassing existing conceptualizations of PH.

Language and stigmatization of individuals with mental health problems or substance addiction in the Netherlands: An experimental vignette study.

Persons with mental health problems and/or substance addictions (MHPSA) are stigmatised more than persons with physical conditions. This includes stigmatisation by care professionals. Stigma is considered one of the most important barriers for recovery from these conditions. There is an ongoing debate that use of language can exacerbate or diminish stigmatisation. Therefore, we conducted an experiment examining how four different ways of referring to a person with (a) alcohol addiction, (b) drug addiction, (c) depression and (d) schizophrenia are related to stigmatising attitudes by care professionals in the Netherlands. We partially replicated two studies performed in the United States and used surveys with vignettes containing either 'disorder-first', 'person-first', 'victim' and 'recovery' language, which were randomly assigned to participants (n = 361). No significant differences between language conditions were found for any of the vignettes. Our findings suggest that subtle differences in language to refer to persons with mental health problems or substance addictions have no effect on stigmatising attitudes by care professionals in the Netherlands. However, more research is needed to determine the effect of language use on other groups, such as individuals with MHPSA.

Alcohol Marketing and Underage Drinking: Which Subgroups Are Most Susceptible to Alcohol Advertisements?

OBJECTIVES: The aim of this study was as follows: (a) to study the relation between alcohol advertisement exposure and the initiation of (binge) alcohol drinking among secondary school students, and (b) to identify subgroups of students that may be more vulnerable for the influence of alcohol marketing than others. METHODS: A longitudinal survey was conducted with three waves (12- and 24-month interval). Eight secondary schools of various school levels in the Netherlands participated. Participants included 942 second grade students, average age 13.2 years, 46.0% boys. Exposure to alcohol and non-alcohol advertisements was measured at baseline with images of 16 commercial advertisements with all brand information removed. Students were asked to indicate contact frequency and recall brand names. Outcome measure was initiation of (binge) alcohol drinking between baseline and 12- and 24-month follow-up. RESULTS: The results showed small but statistically significant associations between alcohol advertisement exposure and both drinking and binge drinking initiation over a 12-month interval. Over a 24-month interval, a statistically significant association was only found for initiation of binge drinking. The association was stronger for students from the lowest school level. CONCLUSION: The study confirms previous longitudinal studies demonstrating an association between exposure to alcohol marketing and initiation of (binge) drinking among adolescents. This association is moderated by school level. Students from the lower school levels may therefore be the most appropriate target group for selective prevention efforts and should be taken particularly into account when formulating policies to reduce and prevent underage drinking.

Internet-Related Disorders: Development of the Short Compulsive Internet Use Scale.

The addiction treatment system only reaches a small number of individuals suffering from Internet-related disorders. Therefore, it is important to improve case detection for preventive measures and brief interventions. Existing screening instruments are often time-consuming and rarely validated using clinical criteria. The aim of this study is to develop an optimized short screening for problematic Internet use and Internet addiction (IA). A regression analysis was conducted in random subsamples of a merged sample (N = 3,040; N = 1,209) to examine the item performance of the Compulsive Internet Use Scale (CIUS). Based on the results, a short version of the CIUS was developed and compared with the original CIUS. A fully structured diagnostic interview, covering the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for the Internet gaming disorder with a broader focus on all Internet activities, was conducted. A five-item version of the short screening performed best across the samples. Comparing the area under the curve (AUC) of the receiver operating characteristic between the Short CIUS and the original test revealed no significant difference (AUC = 0.968; 0.977). A cutoff point of 7 turned out to perform best for case detection and yielded a sensitivity of 0.95 and a specificity of 0.87, Cronbach's alpha was 0.77. The analysis showed that the performance of the Short CIUS is just as good in detecting problematical Internet use and IA as the performance of the original CIUS. The Short CIUS provides an economical and valid instrument for the assessment of problematic Internet use and IA.

An fMRI study of cognitive control in problem gamers.

A small proportion of video game players develop uncontrolled gaming behavior. A dysfunctional cognitive control circuit may explain this excessive behavior. Therefore, the current study investigated whether problem gamers are characterized by deficits in various aspects of cognitive control (inhibitory control, error processing, attentional control) by measuring brain activation using functional magnetic resonance imaging during Go-NoGo and Stroop task performance. In addition, both impulsivity and attentional control were measured using self-reports. Participants comprised 18 problem gamers who were compared with 16 matched casual gaming controls. Results indicate significantly increased self-reported impulsivity levels and decreased inhibitory control accompanied by reduced brain activation in the left inferior frontal gyrus (IFG) and right inferior parietal lobe (IPL) in problem gamers relative to controls. Significant hypoactivation in the left IFG in problem gamers was also observed during Stroop task performance, but groups did not differ on behavioral and self-reported measures of attentional control. No evidence was found for reduced error processing in problem gamers. In conclusion, the current study provides evidence for reduced inhibitory control in problem gamers, while attentional control and error processing were mostly intact. These findings implicate that reduced inhibitory control and elevated impulsivity may constitute a neurocognitive weakness in problem gamers.

Occurence of internet addiction in a general population sample: a latent class analysis.

BACKGROUND: Prevalence studies of Internet addiction in the general population are rare. In addition, a lack of approved criteria hampers estimation of its occurrence. AIMS: This study conducted a latent class analysis (LCA) in a large general population sample to estimate prevalence. METHODS: A telephone survey was conducted based on a random digit dialling procedure including landline telephone (n=14,022) and cell phone numbers (n=1,001) in participants aged 14-64. The Compulsive Internet Use Scale (CIUS) served as the basis for a LCA used to look for subgroups representing participants with Internet addiction or at-risk use. CIUS was given to participants reporting to use the Internet for private purposes at least 1 h on a typical weekday or at least 1 h on a day at the weekend (n=8,130). RESULTS: A 6-class model showed best model fit and included two groups likely to represent Internet addiction and at-risk Internet use. Both groups showed less social participation and the Internet addiction group less general trust in other people. Proportions of probable Internet addiction were 1.0% (CI 0.9-1.2) among the entire sample, 2.4% (CI 1.9-3.1) in the age group 14-24, and 4.0% (CI 2.7-5.7) in the age group 14-16. No difference in estimated proportions between males and females was found. Unemployment (OR 3.13; CI 1.74-5.65) and migration background (OR 3.04; CI 2.12-4.36) were related to Internet addiction. CONCLUSIONS: This LCA-based study differentiated groups likely to have Internet addiction and at-risk use in the general population and provides characteristics to further define this rather new disorder.

Compulsive use of social networking sites in Belgium: prevalence, profile, and the role of attitude toward work and school.

A representative sample (n=1,000) of the Belgian population aged 18 years and older filled out an online questionnaire on their Internet use in general and their use of social networking sites (SNS) in particular. We measured total time spent on the Internet, time spent on SNS, number of SNS profiles, gender, age, schooling level, income, job occupation, and leisure activities, and we integrated several psychological scales such as the Quick Big Five and the Mastery Scale. Hierarchical multiple regression modeling shows that gender and age explain an important part of the compulsive SNS score (5%) as well as psychological scales (20%), but attitude toward school (additional 3%) and income (2.5%) also add to explained variance in predictive models of compulsive SNS use.

Factor structure of the compulsive internet use scale.

An important step in Internet addiction research is to develop standardized instruments for assessing Internet addiction-related symptoms. The Compulsive Internet Use Scale (CIUS) is a promising brief questionnaire. The aim of this study was to examine the factor structure of a German version of the CIUS with confirmatory factor analysis in a general population sample. In addition, the best fitting structure was tested for factorial invariance across sex, age, education level, and weekly Internet use. We used a weighted general population sample (N=8,132) of 14-64 years olds spending at least 1 hour online for private purposes per typical working or weekend day. Findings include that a one-factor model was found to fit well. It was invariant across sex, age, education level, and weekly Internet use. The findings support the validity of the CIUS as a short screening instrument.

Daily and compulsive internet use and well-being in adolescence: a diathesis-stress model based on big five personality traits.

This study examined the associations between adolescents' daily Internet use and low well-being (i.e., loneliness, low self-esteem, and depressive moods). We hypothesized that (a) linkages between high levels of daily Internet use and low well-being would be mediated by compulsive Internet use (CIU), and (b) that adolescents with low levels of agreeableness and emotional stability, and high levels of introversion would be more likely to develop CIU and lower well-being. Data were used from a sample of 7888 Dutch adolescents (11-21 years). Results from structural equation modeling analyses showed that daily Internet use was indirectly related to low well-being through CIU. In addition, daily Internet use was found to be more strongly related to CIU in introverted, low-agreeable, and emotionally less-stable adolescents. In turn, again, CIU was more strongly linked to loneliness in introverted, emotionally less-stable, and less agreeable adolescents.

Online communication, compulsive Internet use, and psychosocial well-being among adolescents: a longitudinal study.

The present study investigated the relationships between adolescents' online communication and compulsive Internet use, depression, and loneliness. The study had a 2-wave longitudinal design with an interval of 6 months. The sample consisted of 663 students, 318 male and 345 female, ages 12 to 15 years. Questionnaires were administered in a classroom setting. The results showed that instant messenger use and chatting in chat rooms were positively related to compulsive Internet use 6 months later. Moreover, in agreement with the well-known HomeNet study (R. Kraut et al., 1998), instant messenger use was positively associated with depression 6 months later. Finally, loneliness was negatively related to instant messenger use 6 months later.

Predicting compulsive Internet use: it's all about sex!

The objective of this research was to assess the predictive power of various Internet applications on the development of compulsive Internet use (CIU). The study has a two-wave longitudinal design with an interval of 1 year. The first measurement contained 447 adult heavy Internet users who used the Internet at least 16 h per week and had Internet access at home for at least 1 year. For the second measurement, all participants were invited again, of whom 229 responded. By means of an online questionnaire, the respondents were asked about the time spent on various Internet applications and CIU. On a cross-sectional basis, gaming and erotica seem the most important Internet applications related to CIU. On a longitudinal basis, spending a lot of time on erotica predicted an increase in CIU 1 year later. The addictive potential of the different applications varies; erotica appears to have the highest potential.

Accuracy of carbohydrate-deficient transferrin in the detection of excessive alcohol consumption: a systematic review.

AIMS: Excessive alcohol consumption is a common problem in society and medical practice. There is a need for a diagnostic tool with both high sensitivity and specificity for the detection of excessive alcohol consumption in unselected medical populations. Therefore, we evaluated the diagnostic accuracy of carbohydrate-deficient transferrin (CDT) in the detection of excessive alcohol consumption. METHODS: Computerised literature searches in Medline, Embase and Current Contents databases (01/1966-06/2003) and reference checking. Articles on the detection of excessive alcohol consumption reporting CDT levels and self-reported alcohol consumption as a reference test were selected (n = 101). Studies concerning treatment, relapse detection and traffic offenders were excluded. Quality assessment and data-extraction was done by two reviewers independently. Only studies scoring positive on core validity criteria by Lijmer were eligible for quantitative analysis (n = 29). RESULTS: Only two CDT-assays (CDTect and CDTriTIA) were evaluated in more than two high validity studies fulfilling the criteria for inclusion in the statistical analysis. Sensitivity of CDTect (14 data points) ranged from 20 to 85%, whereas specificity ranged from 77 to 95%. A summary ROC curve was computed for CDTect. Sensitivity of CDTTriTIA (4 data points) ranged from 10 to 67%, and specificity ranged from 90 to 100%. No summary measure could be computed for CDTTriTIA. The heterogeneity of results could not be explained clinically. CONCLUSIONS: The validity of CDT as a diagnostic tool is still questionable. If the higher values for sensitivity that some studies report can be confirmed by others it is a useful diagnostic tool in unselected populations. However, more methodologically sound, comparable studies need to be performed before firm conclusions can be drawn.