Comparison of Allen Carr's Easyway programme with a specialist behavioural and pharmacological smoking cessation support service: a randomized controlled trial.

BACKGROUND AND AIMS: A combination of behavioural and pharmacological support is judged to be the optimal approach for assisting smoking cessation. Allen Carr's Easyway (ACE) is a single-session pharmacotherapy-free programme that has been in operation internationally for 38 years. We compared the effectiveness of ACE with specialist behavioural and pharmacological support delivered to the national standard in England. DESIGN: A two-arm, parallel-group, single-blind, randomized controlled trial. SETTING: London, UK, between February 2017 and May 2018. PARTICIPANTS: A total of 620 participants (310 in ACE and 310 in the combined behavioural and pharmacological support condition) were included in the analysis. Adult (≥ 18 years) smokers wanting to quit were randomized in a 1 : 1 ratio. Mean age for the total sample was 40.8 years, with 53.4% being male. Participant baseline characteristics (ethnicity, educational level, number of previous quit attempts, nicotine dependence) were evenly balanced between treatment groups. INTERVENTION AND COMPARATOR: The intervention was the ACE method of stopping smoking. This centres on a 4.5-6-hour session of group-based support, alongside subsequent text messages and top-up sessions if needed. It aims to make it easy to stop smoking by convincing smokers that smoking provides no benefits for them. The comparator was a specialist stop smoking service (SSS) providing behavioural and pharmacological support in accordance with national standards. MEASUREMENTS: The primary outcome was self-reported continuous abstinence for 26 weeks from the quit/quit re-set date verified by exhaled breath carbon monoxide measurement < 10 parts per million (p.p.m.). Primary analysis was by intention to treat. Secondary outcomes were: use of pharmacotherapy, adverse events and continuous abstinence up to 4 and 12 weeks. FINDINGS: A total of 468 participants attended treatment (255 ACE versus 213 SSS, P < 0.05). Of those who did attend treatment, 100 completed 6-month measures (23.7% ACE versus 20.7% SSS). Continuous abstinence to 26 weeks was 19.4% (60 of 310) in the ACE intervention and 14.8% (46 of 310) in the SSS intervention [risk difference for ACE versus SSS 4.5% (95% confidence interval (CI) = -1.4 to 10.4%, odds ratio (OR) = 1.38)]. The Bayes factor for superiority of the ACE condition was 1.24. CONCLUSION: There was no clear evidence of a difference in the efficacies of the Allen Carr's Easyway (ACE) and specialist smoking cessation support involving behavioural support and pharmacotherapy

Mission impossible? Identity based incompatibilities amongst academic job roles relate to wellbeing and turnover.

Academic staff experience high levels of work-related stress and poor mental health. As a result, many institutions face high staff turnover. These outcomes may be driven by the complexity and, at times, apparently oppositional objectives academics need to meet around research and teaching. These factors may present both practical and social identity-based incompatibilities. The current study tested the role of these incompatibilities upon mental well-being and turnover. A sample of 141 UK resident academics completed scales measuring levels of social identification with being an academic, an educator and a researcher, identity based and practical incompatibility, mental health, experience of the workplace and turnover intention. No direct links were found between practical incompatibility and outcomes. However, higher identity incompatibility was related to poorer mental health. Identity incompatibility was also related to turnover intention, mediated by both mental health and workplace experience. Contrary to predictions, these effects were not moderated by identity difference or identity strength. The current findings present evidence that role-based incompatibilities have both practical and identity-based foundations and highlight important caveats to the benefits of multiple identities on well-being observed in other domains. The findings also suggest practical steps through which complex occupational roles can be best structured to improve mental health and reduce turnover

When ingroup identities “clash”: The influence of beliefs about incompatibilities between being a Christian and a drinker affect motivation to change drinking behaviour.

Whilst research has demonstrated the influence of individual and social identities on drinking-related beliefs and behaviours, none evaluates how identities’ incompatibilities are associated with mental health, current drinking status nor intentions and motivations to change drinking behaviour. The current study explored how variability in incompatibilities between the social identities of being a drinker and a Christian related to mental health, alcohol use behaviour and intentions to change drinking behaviour. A cross-sectional online survey (via a recruitment platform, Prolific) recruited n = 180 US resident Christians who drank alcohol (56.4% male, 46.6% female, mean age = 37 years). Increased incompatibility between identities moderated the effect of current Christian identity on drinking change motivations – with the strongest links amongst those with the highest levels of incompatibility. A similar effect was also shown for increasing incompatibility between perceptions of the self as an individual and drinking behaviour (self/drinker incompatibility). The relationship between Christian identity on current drinking behaviour was also shown to be moderated by decreased Christian/drinker identity incompatibility but not self/drinker incompatibility. No effects were shown for general mental well-being. The study highlights that differences in the protective role of religious identities likely depend on how they relate to others, and the key role of identity incompatibility

The relationship between attitudes, beliefs and physical activity in older adults with knee pain: secondary analysis of a randomised controlled trial

Objective To investigate how attitudes and beliefs about exercise relate to physical activity behavior in older adults with knee pain attributable to osteoarthritis (OA). Methods We conducted secondary data analyses of a randomized controlled trial of exercise interventions (ISRCTN: 93634563). Participants were adults ≥45 years old with knee pain attributable to OA (n = 514). Crude and adjusted cross‐sectional and longitudinal associations between baseline Self‐Efficacy for Exercise (SEE), Positive Outcome Expectations for Exercise (POEE), Negative Outcome Expectations for Exercise scores, and physical activity level, at baseline, 3 months, and 6 months (measured by self‐report using the Physical Activity Scale for the Elderly [PASE]), and important increases in physical activity level (from baseline to 6‐month followup) were investigated using multiple linear and logistic regression. Results Cross‐sectional associations were found between SEE and PASE scores (β = 4.14 [95% confidence interval (95% CI) 0.26, 8.03]) and POEE and PASE scores (β = 16.71 [95% CI 1.87, 31.55]), adjusted for sociodemographic and clinical covariates. Longitudinal associations were found between baseline SEE and PASE scores at 3 months (β = 4.95 [95% CI 1.02, 8.87]) and 6 months β = 3.71 (0.26, 7.16), and baseline POEE and PASE at 3 months (β = 34.55 [95% CI 20.13, 48.97]) and 6 months (β = 25.74 [95% CI 11.99, 39.49]), adjusted for baseline PASE score and intervention arm. However, no significant associations with important increases in physical activity level were found. Conclusion Greater exercise self‐efficacy and more positive exercise outcome expectations were associated with higher current and future physical activity levels. These may be targets for interventions aimed at increasing physical activity

Intoxicated eyewitnesses: The effect of a fully balanced placebo design on event memory and metacognitive control.

Few studies have examined the impact of alcohol on metacognition for witnessed events. We used a 2x2 balanced placebo design, where mock-witnesses expected and drank alcohol, did not expect but drank alcohol, did not expect nor drank alcohol, or expected but did not drink alcohol. Participants watched a mock-crime in a bar-lab, followed by free recall and a cued-recall test with or without the option to reply ‘don’t know’ (DK). Intoxicated mock-witnesses’ free recall was less complete but not less accurate. During cued-recall, alcohol led to lower accuracy, and reverse placebo participants gave more erroneous and fewer correct responses. Permitting and clarifying DK responses was associated with fewer errors and more correct responses for sober individuals; and intoxicated witnesses were less likely to opt out of erroneous responding to unanswerable questions. Our findings highlight the practical and theoretical importance of examining pharmacological effects of alcohol and expectancies in real-life settings. This is the peer reviewed version of the following article:Gawrylowicz, J., Scorboria, A., Teodorini, R., and Albery, I. (2018). Intoxicated eyewitnesses: The effect of a fully balanced placebo design on event memory and metacognitive control. Applied Cognitive Psychology, which has been published in final form at xxxx. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions

Components of Identity Expression in Problem and Non-Problem Gamblers.

Few studies have examined whether specific aspects of group identification predict problematic and non-problematic addictive behaviours and none have focused on gambling. Applying Leach et al.’s (2008) hierarchical model of in-group identification, we tested the associations between components of self-investment (satisfaction, solidarity, and centrality) and components of self-definition (individual self-stereotyping, in-group homogeneity) on distinguishing between problem and non-problem gambling (n = 10,157) and on the severity of problematic gambling behaviour (n = 2,568). Results showed that (i) in-group-based identities are important in predicting problematic vs. non-problematic gambling behaviours; (ii) in-group-based identities are important in predicting the severity of problematic gambling; (iii) how self-invested an individual is with their in-group and aspects associated with self-definition processes are both important predictors; (iv) perceptions related to how chronically salient one’s group membership is for the self (centrality) are essential features of the self-investment mechanism; and (v) self-stereotypical beliefs about one’s essential similarities to the prototypical gambling group member norm are fundamental for the defining oneself as a gambler

Development and Testing of Relative Risk-based Health Messages for Electronic Cigarette Products

Background: Health messages on e-cigarette packs emphasise nicotine addiction or harms using similar wording to warnings on cigarette packs. These may not be appropriate for e-cigarettes which constitute a reduced risk alternative for smokers. This research aimed to i) develop and test a selection of relative risk messages for e-cigarette products; ii) compare these to the two current EU Tobacco Products Directive (TPD) nicotine addiction messages; and iii) explore differences between smokers, non-smokers and dual users. Method: Twenty-six messages focusing on either harm-reduction or cessation were developed and rated by multidisciplinary experts for accuracy, persuasiveness and clarity. The eight highest ranking messages were compared alongside the TPD messages in a sample of 983 European residents (316 smokers, 327 non-smokers, 340 dual users) on understandability, believability and convincingness. Results: On all three constructs combined, the two TPD messages rated the highest, closely followed by four relative risk messages “Completely switching to e-cigarettes lowers your risk of smoking related diseases”, “Use of this product is much less harmful than smoking”, “Completely switching to e-cigarettes is a healthier alternative to smoking”, and “This product presents substantially lower risks to health than cigarettes” which did not differ statistically from the TPD messages. Non-smokers rated TPD1 significantly higher overall than dual users. Dual users rated “This product is a safer alternative to smoking” significantly higher than non-smokers. Messages did not differ on understandability. Conclusions: These alternative messages provide a useful resource for future research and for policy makers considering updating e-cigarette product labelling

Development and Testing of Relative Risk-based Health Messages for Electronic Cigarette Products

Background: Health messages on e-cigarette packs emphasise nicotine addiction or harms using similar wording to warnings on cigarette packs. These may not be appropriate for e-cigarettes which constitute a reduced risk alternative for smokers. This research aimed to (1) develop and test a selection of relative risk messages for e-cigarette products; (2) compare these to the two current EU Tobacco Products Directive (TPD) nicotine addiction messages; and (3) explore differences between smokers, non-smokers and dual users. Method: Twenty-six messages focusing on either harm-reduction or cessation were developed and rated by multidisciplinary experts for accuracy, persuasiveness and clarity. The eight highest ranking messages were compared alongside the TPD messages in a sample of 983 European residents (316 smokers, 327 non-smokers, 340 dual users) on understandability, believability and convincingness. Results: On all three constructs combined, the two TPD messages rated the highest, closely followed by four relative risk messages “Completely switching to e-cigarettes lowers your risk of smoking related diseases”, “Use of this product is much less harmful than smoking”, “Completely switching to e-cigarettes is a healthier alternative to smoking”, and “This product presents substantially lower risks to health than cigarettes” which did not differ statistically from the TPD messages. Non-smokers rated TPD1 significantly higher overall than dual users. Dual users rated “This product is a safer alternative to smoking” significantly higher than non-smokers. Messages did not differ on understandability. Conclusions: These alternative messages provide a useful resource for future research and for policy makers considering updating e-cigarette product labelling

Change in vaping, smoking and dual use identities predicts quit success and cigarette usage: A prospective study of people quitting smoking with electronic cigarette support

OBJECTIVE: Electronic cigarettes (ECs) are an efficacious support for some but not all people wishing to stop using tobacco. While advice and practical support have been identified as increasing quit success, little research has explored the role of changes in smoking and EC-related social identities. METHODS: A prospective study following 573 people attempting to quit smoking with EC support. Self-report measures of identification with being a smoker, non-smoker, vaper, and dual user (people using ECs and tobacco products) were taken prior to the quit attempt and at a 12-week follow-up. RESULTS: Baseline identifications with being a smoker, non-smoker or dual user were not associated with smoking outcomes. Baseline vaper identity baseline was linked to more frequent tobacco abstinence at follow-up and lower levels of cigarette smoking. Levels of social identification at follow-up were consistently linked with outcomes, with vaper identity and non-smoking identities being protective, and dual user identity being related to lower abstinence rates but decreased tobacco usage. Changes in identity over time were the most consistent predictor of outcomes. CONCLUSIONS: Findings have implications for smoking cessation practice, informing how and when identity-based interventions may be effective and our understanding of how identity transitions occur

Pseudo-single crystal electrochemistry on polycrystalline electrodes : visualizing activity at grains and grain boundaries on platinum for the Fe2+/Fe3+ redox reaction

The influence of electrode surface structure on electrochemical reaction rates and mechanisms is a major theme in electrochemical research, especially as electrodes with inherent structural heterogeneities are used ubiquitously. Yet, probing local electrochemistry and surface structure at complex surfaces is challenging. In this paper, high spatial resolution scanning electrochemical cell microscopy (SECCM) complemented with electron backscatter diffraction (EBSD) is demonstrated as a means of performing ‘pseudo-single-crystal’ electrochemical measurements at individual grains of a polycrystalline platinum electrode, while also allowing grain boundaries to be probed. Using the Fe2+/3+ couple as an illustrative case, a strong correlation is found between local surface structure and electrochemical activity. Variations in electrochemical activity for individual high index grains, visualized in a weakly adsorbing perchlorate medium, show that there is higher activity on grains with a significant (101) orientation contribution, compared to those with (001) and (111) contribution, consistent with findings on single-crystal electrodes. Interestingly, for Fe2+ oxidation in a sulfate medium a different pattern of activity emerges. Here, SECCM reveals only minor variations in activity between individual grains, again consistent with single-crystal studies, with a greatly enhanced activity at grain boundaries. This suggests that these sites may contribute significantly to the overall electrochemical behavior measured on the macroscale