Recent research has shown the relationship between an attachment to caregivers and an attachment to God, an attachment to God and adult attachment, attachment to God and religiosity, and attachment and spiritual maturity, but has failed to examine the link between attachment and faith development (which includes not only the relational but also the imaginative nature in the questioning and answering process regarding philosophical notions of existence). The current project investigated the relationship between adult romantic attachment (cf. Brennan et al., 1998) and Fowler's (1981) stages of faith development in an undergraduate sample at a private, religious university (N = 95). Attachment anxiety (but not attachment avoidance) predicted faith development, such that the higher the attachment anxiety, the lower the stage of faith development.
Introduction Although e-cigarettes are not a federally approved tobacco cessation aid in the US, many smokers use them to quit or cut down on smoking. Tailored behavioral support could improve rates of complete smoking cessation for those individuals. A novel behavioral treatment to help dual cigarette and e-cigarette users quit smoking was tested in a randomized pilot with a state tobacco quitline. Method 96 dual users of cigarettes and e-cigarettes were recruited from incoming state quitline callers and randomized to receive enhanced e-cigarette coaching (EEC) or quitline treatment as usual (TAU) to examine EEC feasibility and acceptability. Outcomes at 3 months were treatment satisfaction, engagement, beliefs, and smoking cessation. This pilot was not powered to detect differences in quit rates. Results 69% responded to the 3-month survey. EEC treatment satisfaction was noninferior to TAU: 93.8% (30/32) of EEC and 73.5% (25/34) of TAU reported being “very satisfied” or “satisfied” with treatment. EEC participants completed more coaching calls than TAU (M=3.4 vs. M=2.7, p=0.03), and the majority in both groups elected to receive nicotine replacement therapy (EEC: 100%, TAU: 94%, p=0.24). With missing data imputed as smoking, intent to treat 7-day point prevalence smoking abstinence rates were 41.3% (19/46) for EEC and 28.0% (14/50) for TAU, p=0.20. Conclusions The EEC quitline intervention for dual cigarette and e-cigarette users demonstrated high levels of treatment satisfaction and engagement. This pilot was not powered to detect significant differences in smoking cessation; however, cessation rates were promising and warrant evaluation in a fully powered trial. Implications If this scalable behavioral treatment to help dual cigarette and e-cigarette users quit smoking proves to be effective in a larger trial, quitlines could implement this harm reduction approach to improve outcomes for callers who already use e-cigarettes and are planning to use them while quitting smoking.
It is estimated that the prevalence of smoking among adults with MHDs ranges between 40-60%, as compared to about 17% among those without an MHD. In addition, smokers with MHDs smoke more cigarettes, are more nicotine dependent, and experience more difficulty quitting, compared to other smokers. The uniquely high smoking prevalence among the MHD population is a serious public health concern; unfortunately, a majority of individuals experiencing difficulty receive no treatment. The US Public Health Service guidelines, as well as the National Cancer Institute, strongly recommend quitlines as an evidence-based treatment strategy to reduce barriers to cessation treatment, especially among smokers with MHDs; however, the literature is sparse on quitline engagement trends and associated outcomes for quitline participants with MHDs. This study sought to contribute to this gap with the largest sample to-date of MHD-endorsing tobacco quitline (Oklahoma Tobacco Helpline, OTH) participants. From 2015 to 2020, ~65,000 registrants (45-50% of total registered participants) with the OTH identified as having one or more MHDs in addition to their tobacco use. This study tested for the presence of significant differences between groups with and without MHDs (as well as within the MHD-identified group) on program enrollment selections, the intensity of engagement with chosen services, NRT utilization, and quit rates. It also tested for the existence of differences and moderating effects of demographic variables associated with the comparison groups. Statistically significant differences were found between these two groups with regard to: sex, age, racial identity, education level, annual income and insurance status. Significant differences were also found with tobacco use patterns reported by individuals (e.g., timing and daily use amounts). Differences in quitline program selection were demonstrated, such that the MHD-endorsing sample were more likely to participate and agree to the most robust service available. Significantly higher rates of service intensity (number of services engaged) were demonstrated, and MHD individuals were also significantly more likely to receive NRT as a part of their treatment. This study suggests a simplistic “more is better” quitline services approach may suffer in effectiveness because it neglects barriers common to this population. Important information is provided on these unique variables associated with MHD-endorsing individuals trying to quit their tobacco use. These results can help tobacco quitlines conceptualize the unique difficulties experienced by individuals with MHDs and then tailor their approach to respond supportively and constructively to this high need group.
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