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Biomedical subjects

S Sussman

Publications and source records attributed to S Sussman.

At least 55 records · Page 3Linked to original sources
PubMed1994

Differential influence of parental smoking and friends' smoking on adolescent initiation and escalation of smoking.

Smoking-related behaviors and attitudes of significant others (especially friends and parents) are among the most consistent predictors of adolescent smoking. However, theorists remain divided on whether the behaviors of significant others influence adolescent smoking directly or indirectly, and the relative influence of parental and peer smoking on adolescents' own smoking is still a matter of debate. In addition, little research has examined the role of significant others' behavior on different stages of smoking onset. In particular, not much information is available regarding gender and ethnic differences in social influences on smoking behavior. We use structural equation modeling to address these issues. Different theoretical perspectives from cognitive-affective theories (Ajzen 1985; Ajzen and Fishbein 1980) and social learning theories (Akers et al. 1979; Bandura 1969, 1982, 1986) have been integrated into a structural model of smoking influence. The results show that friends' smoking affects adolescent initiation into smoking both directly and indirectly, whereas parental smoking influences smoking initiation only indirectly. The data also show that friends' and parents' smoking affect smoking escalation only indirectly. In general, friends' smoking has a stronger effect on adolescents' smoking behavior, particularly on initiation. Multiple group comparisons of the structural models predicting smoking initiation among males and females reveal that parental approval of smoking plays a significant mediating role for females, but not for males. Comparisons of Whites, Blacks, Hispanics, and other ethnic groups reveal that there are some significant differences in the pathways of friends' influences among the four groups.

Adolescent↗
PubMed1993

Refusal assertion versus conversational skill role-play competence: relevance to prevention of tobacco use.

Conversational and refusal assertion skills of 768 seventh grade youth were assessed through ratings of global (for example, effectiveness) and non-verbal (for example, eye contact) behaviour performed in two role-play scenarios. The ratings were completed after each scenario by the subjects themselves, as well as by classmate and trained adult observers. Use of the Hays and Hayashi multitrait scaling method to interpret these data revealed two results. First, the items used to measure role-play behaviour did not achieve sufficient internal consistency to create global and non-verbal composites. Second, inter-rater agreement and discriminant validity were obtained only for ratings of the global effectiveness of each of the two social skills. Next, a series of multiple regression analyses indicated that an index of the global effectiveness of refusal assertion skill, but not of conversational skill, was predictive of intention to use tobacco. Those who were relatively unskillful at refusing offers were more likely to intend to use tobacco. Analyses exploring relations of trained observer ratings of the effectiveness of both role-play types, trained observer ratings of the other global and non-verbal items, and subjects' intention to use tobacco indicated that only a hesitant voice pattern was both negatively predictive of effective refusal assertion and positively predictive of intention to use tobacco in the future. In other words, those who are hesitant when they refuse a tobacco offer are the ones most likely to report an intention to use tobacco in the future. The consistency of this last finding in the tobacco use prevention literature is discussed.

Assertiveness↗
PubMed1993

Project Towards No Tobacco Use: implementation, process and post-test knowledge evaluation.

This paper describes the curricula contents, and presents data to evaluate the implementation, process and immediate post-test knowledge of Project Towards No Tobacco Use (Project TNT). Four different school-based tobacco use prevention curricula were developed to counteract the effects of three types of tobacco use acquisition variables typically addressed within a comprehensive social influences program: (1) peer approval for using tobacco (normative social influence), (2) incorrect social informational provided about tobacco use (information social influence) and (3) lack of knowledge or misperceptions about physical consequences resulting from tobacco use. Three curricula were designed to counteract the effects of single acquisition variables, whereas a fourth curriculum was designed to counteract the effects of combined social and physical consequences-related influences. These curricula were delivered to seventh grade students by trained project health educators to maximize implementation. 'Program' schools, those schools that received one of these curricula, were compared to 'control' schools that provided asystematic health education delivered by school personnel. A total of five conditions were contrasted through use of a randomized experiment involving 48 southern California junior high schools. This paper documents high levels of implementation in all program conditions. Also, favorable process ratings were obtained across the four program conditions, using multiple measures and sources of ratings (students, health educators and classroom teachers who observed curricula delivery). Finally, knowledge item sets completed by the students demonstrated discriminant validity across all five conditions. Because the program conditions were discriminable, yet were quite similar in implementation and process ratings, planned future study of behavioral outcomes can be interpreted as relatively uncontaminated by delivery or credibility confounds.

Adolescent↗
PubMed1993

Project towards no tobacco use: 1-year behavior outcomes.

OBJECTIVES: We present 1-year follow-up data from a school-based tobacco use prevention project designed to test the effectiveness of three main components of social influence programs. The components teach refusal skills, awareness of social misperceptions about tobacco use, and misconceptions about physical consequences. METHODS: Four different curricula were developed and tested in a randomized experiment involving 48 junior high schools. The outcome variables examined were changes in initial and weekly cigarette and smokeless tobacco use 1 year after the intervention. RESULTS: Analyses indicated that each of the component programs were effective in decreasing both the initial and the weekly use of cigarettes except for the curriculum in which refusal skills were taught. Also, each curriculum was effective in decreasing the initial use of smokeless tobacco except for the one aimed at correcting social misperceptions. Only the combined curriculum showed an effect on the weekly use of smokeless tobacco. CONCLUSIONS: The combined intervention was the most effective overall in reducing the initial and weekly use of cigarettes and smokeless tobacco. This suggests that different reasons for use exist and need to be counteracted simultaneously. However, since single programs were also effective in reducing all but weekly smokeless tobacco use, any of these components may be worthwhile prevention tools.

Adolescent↗
PubMed1993

Relations of coping effort, coping strategies, perceived stress, and cigarette smoking among adolescents.

Coping strategies may influence adolescent smoking behaviour because they provide alternative behavioral and cognitive outlets which facilitate or inhibit smoking, or because they are expressions of general coping effort to smoke or not smoke. The present investigation examined three possibilities regarding how coping strategies versus coping effort compare as predictors of adolescent smoking: (1) general coping effort to not smoke may be a better predictor of adolescent smoking behaviors than are specific coping strategies; (2) coping strategies may be relatively better predictors of smoking behaviors; or (3) these two constructs may be relatively better predictors of different parameters of smoking behavior. Analytic strategies included calculation of a series of multiple regression models, involving (a) 11 coping strategies previously studied in adolescent smoking research, (b) a new simple measure of coping effort to not smoke, and (c) perceived stress, as concurrent predictors of four smoking-related items. Of the 11 coping strategies, partying, relaxation, seeking spiritual guidance, and getting revenge were related to at least one of the four cigarette smoking items. Only coping effort was directly related to recent smoking behavior, whereas only the coping strategies were related to cumulative smoking. Both types of items predicted refusal self-efficacy and intention to smoke in the future. Apparently, these two types of items show unique as well as common predictive variance. These results suggest that coping strategies are related to cumulative smoking for reasons other than motivation to not smoke.

Adaptation, Psychological↗
PubMed1993

Naturalistic observation of adolescent tobacco use.

A naturalistic observation study of adolescent tobacco use was conducted to corroborate previous studies which used self-report questionnaire or structured interview methods to study this problem behavior. Several findings converged with previous accounts of adolescent tobacco use. For example, most use occurred in small groups. However, other findings diverged somewhat from previous research in that an unexpectedly low number of offers of tobacco was observed, nonusers were present in smoking groups, and solitary smoking was common. These data suggest that direct, normative social pressure to use tobacco may not be as frequent as more subtle informational social influence, at least in high school adolescent tobacco use groups.

Adolescent↗
PubMed1993

Which lesson components mediate refusal assertion skill improvement in school-based adolescent tobacco use prevention?

Any of three components of current school-based refusal assertion training might mediate improvement of seventh grade students' ability to refuse tobacco use offers: 1) teaching students knowledge of ways to say "no," 2) engaging students in the practice of refusal assertion, or 3) motivating students to perform refusal assertion in a socially skilled way. A 3-condition true field experimental "component study" of the differential effects of these three components yielded improvement in role-played behavioral skill to refuse tobacco offers that was evident in both the Knowledge and Practice conditions but not in the Motivation condition. In these same two conditions, skills training led to a significant decrease in students' intention to use smokeless tobacco in the future but not cigarettes. A focus on engaging students in Knowledge and Practice components of refusal assertion training appears warranted.

Adolescent↗
PubMed1991

Availability of tobacco products at stores located near public schools.

The nearby store is an obvious major site where adolescents obtain tobacco products. We investigated availability of tobacco products to adolescents at those stores located closest to public junior high and high schools by using 3 novel methods: (1) interviewing store personnel; (2) recording types and location of tobacco products, promotional items, and the legal age warning signs within stores; and (3) observing purchasing behavior. Store personnel were interviewed at randomly selected Southern California stores (n = 36) and Illinois stores (n = 12). Results showed that store personnel used tobacco at twice the rate of the general public, and that they often use tobacco while working at the store. Promotional advertisements were present at many stores, while tobacco use legal age signs were posted at few stores. Approximately 50% of the store personnel admitted that they would sell to minors, and many reported that they had seen teenagers using tobacco near the stores. Several apparently illegal purchases were observed. Tobacco use prevention program and policy implications are discussed.

Adolescent↗
PubMed1990

Adolescents' first and most recent use situations of smokeless tobacco and cigarettes: similarities and differences.

This study compared first and most recent use situations of adolescent smokeless tobacco experimenters with those of adolescent cigarette experimenters. Structured, open-ended interviews were conducted with 320 seventh and tenth grade youths in 16 Southern California schools. Students were categorized as nonusers (those who had never experimented with any tobacco product), minimal experimenters (those who had experimented with smokeless tobacco or cigarettes between 1 and 9 times), and persistent experimenters (those who had experimented with smokeless tobacco or cigarettes 10 or more times). The situations reported by smokeless tobacco were similar to those reported by cigarette experimenters. The most important differences between the two groups are highlighted. In particular, smokeless tobacco users seemed less concerned about negative social consequences of use than cigarette smokers. In addition, nonusers' observations of use and implications for prevention and cessation are discussed.

Adolescent↗
PubMed1990

Peer-group association and adolescent tobacco use.

Mosbach & Leventhal (1988) examined the relation of cigarette smoking to peer-group identification in rural Wisconsin adolescents. They found that among dirts (problem-prone youth), regulars (average youth), hot-shots (good social or academic performers), and jocks (athletes), youth most likely to smoke were dirts and hot-shots. We performed a replication with a Southern California cohort and also for use of smokeless tobacco. We hypothesized that jocks would be the main users of smokeless tobacco. We identified the same groups and an additional one, skaters (skateboarders or surfers). As Mosbach & Leventhal found, cigarettes were used most by dirts. Contrary to their results, but consistent with other research, we found that hot-shots were least likely to smoke. Contrary to our prediction, we found that skaters and dirts were more likely to use smokeless tobacco than were jocks. Our data show that both tobacco forms are used by problem-prone youth.

Adolescent↗
PubMed1990

Cue-exposure interventions for alcohol relapse prevention: need for a memory modification component.

The ability of cue-conditioned responses (CCRs) to predict relapse in problem drinkers across a wide variety of situations is better appreciated when one considers that encoded alcohol-related stimuli can be retrieved from memory and, consequently, serve as symbolic cues. By decreasing retrieval strength to such cues one might: (1) decrease the possibility that such cues elicit alcohol-related CCRs (urges), which may lead to drinking, and (2) decrease the possibility of relapse resulting directly from thinking about drinking. A memory modification approach, as compared to cue exposure, may be relatively effective with old versus young alcoholics.

Alcohol Drinking↗
PubMed1990

Physical features, physical attractiveness, and psychological adjustment among alcohol abuse inpatients.

Relations between specific physical features, attractiveness, and psychological adjustment of alcoholic inpatients were examined. Measures were obtained during the first week of admission and 6 weeks later (within 2 weeks of discharge). The nine physical features assessed formed three factors: face, facial expression, and body. The face factor was more strongly related to history of substance abuse than was either of the other factors. Further, the results suggested that alcoholism-related face features may be responsible for the documented relation between ratings of overall physical attractiveness and ratings of adjustment obtained at admission to a chemical dependency program; however, positive changes in body features less specifically related to a history of substance abuse (posture and grooming) are associated with counselors' ratings of improved patient adjustment over time.

Adaptation, Psychological↗
PubMed1989

The television, school, and family project. V. The impact of curriculum delivery format on program acceptance.

Social psychological interventions have been successful in preventing drug and tobacco use in adolescents, but target audience involvement has not been well documented. Examination of program acceptance is necessary to avoid ambiguity when interpreting findings within and across studies. This report presents results from a program acceptance study of a seventh-grade smoking/drug-use prevention and cessation field trial. The research design is an assessment of two experimentally manipulated variations in program delivery on the program acceptance of all provider and target groups involved. Experimental manipulations included classroom and mass broadcast television demonstrations of social resistance skills against pressures to smoke and use drugs. Three aspects of target audience program acceptance were assessed: participation, satisfaction, and perceived program efficacy. Respondents included the target audience (seventh-grade students and parents), instructors, classroom observers, and school administrative staff. Strong main effects of television delivery on student and parent participation were observed. The findings suggest the usefulness of student homework assignment to view television segments with parents at home as a strategy to achieve family involvement in school-based programs. Both television and classroom delivery separately demonstrated significant positive effects on overall program acceptance with moderate interactive effects on perceived program efficacy. While classroom teacher/observers and school administrators reported strong preferences for the experimental (social resistance) classroom curriculum, acceptance of experimental and comparison (information-based) curricula by the student/parent target audience was equivalent.

Curriculum↗
PubMed1989

The television, school and family smoking prevention/cessation project. IV. Controlling for program success expectancies across experimental and control conditions.

A major issue in smoking prevention research is that no study has tried to equate program success expectancies across experimental and placebo control conditions. Equivalent overall program success expectancies should be established to help rule out the effects of extra-theoretical variables which influence program outcomes. The present study tested whether an attention-placebo (information based) smoking prevention program would produce equivalent expectancies about the likelihood of program success in comparison to an experimental social influences program. To try to equate program success expectancies, the design of the two programs differed in content but was similar in procedure. Fourteen middle schools were randomly assigned to the two conditions. As hypothesized, baseline expectancies were found to predict outcome measures, even after controlling for baseline smoking intentions, ethnic group, and gender. Second, the equivalence of program expectancies at posttest was tested. Youths held equivalent overall expectancies for success across conditions. This study suggested the need to control for program expectancies in prevention research, and showed that program expectancies could be controlled for by equating process of program delivery.

Adolescent↗
PubMed1989

Joiners and non-joiners in worksite smoking treatment: pretreatment smoking, smoking by significant others, and expectation to quit as predictors.

Treatment joiners were differentiated from non-joiners when examined across six worksite clinic locations in the Los Angeles area. Predictors examined included preprogram smoking, demographic variables, smoking by significant others, behavioral expectations to quit, and self-efficacy regarding completing treatment and resisting urges to smoke. Non-joiners reported higher preprogram smoking levels and more friends and children who smoked.

Adult↗