EFFECTIVENESS OF SELF-CONTROL TECHNIQUES AND A COMBINATION OF SELF-CONTROL AND RELAPSE PREVENTION THERAPY ON SMOKING BEHAVIOUR AMONG UNIVERSITY UNDERGRADUATES IN ABIA STATE, NIGERIA.

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ABSTRACT

 

The study investigated the Effectiveness of self-control techniques, relapse prevention therapy and a combination of smoking  behaviour among university undergraduates in Abia state, Nigeria. Seven research questions and seven null hypotheses tested at 0.05 level of significance guided the study. The study adopted quasi-experimental research design employing non-randomized, pre-test posttest control group design. The population of the study comprised 602 students made up of 298 in MOUAU and 304 in ABSU in the 2017/2018 academic session. The sample size was 36 smokers assigned to the two treatment groups and the control group. The instruments for data collection were the “Students’ Smoking Behaviour Identification Scale” (SSBIS) and “Students’ Reinforcer Identification Schedule” (SRIS). The instruments were validated by three experts. The reliability index for SSBIS was 0.82, while that of SRIS was 0.72. The internal consistency of the instruments was determined using Cronbach Alpha method and the indices obtained were 0.86 and 0.75 for SSBIS and SRIS, respectively. The study adopted a systematic procedure for data collection. Data were collected in three phases, pre-treatment phase, post-treatment phase and the follow-up phase. Self-control techniques were intricately weaved into the counselling process and exposed to those in the self-control group in five sessions of approximately 45 minutes each and the SSBIS reshuffled and administered after two week’s interval to obtain the posttest score. Self-control and relapse prevention therapy techniques were exposed to those in the second treatment group in six sessions of approximately 45 minutes each and the SSBIS reshuffled and administered after a week’s interval to obtain the posttest score for that group. Data was also collected after a one-month period. The control group was a wait-list control group. Data obtained were analyzed using mean and standard deviation to answer the research questions while Student t-test was used for hypotheses 1, 2, 3, 4, 5 and 6, and Analysis of Variance (ANOVA) used to test null hypothesis 7. Findings revealed that counselling interventions using self-control and a combination of self-control and relapse prevention therapy were effective in the reduction of smoking behaviour among undergraduates at posttest. However, a combination of self-control and relapse prevention therapy was more efficacious than single treatment. Treatment efficacies were maintained at follow-up. The null hypotheses one to six were not rejected. The findings of the study revealed gender differences at follow-up. It was thus concluded that self-control techniques and relapse prevention therapy were effective in the reduction of smoking behaviour among undergraduates in Abia State, Nigeria. It was thus recommended among others that professional counsellors should utilize these techniques in assisting smokers to quit their smoking behaviour which could help to improve their academic performance, enhance their interpersonal relationships and help them live meaningful and fulfilled lives.







TABLE OF CONTENTS

Title Page                                                                                                        i

Declaration                                                                                                      ii

Certification                                                                                                    iii

Dedication                                                                                                      iv

Acknowledgements                                                                                        v

Table of contents                                                                                            vi

List of tables                                                                                                   vii

List of figures                                                                                                 vii       

Abstract         


CHAPTER 1: INTRODUCTION

1.1       Background to the study                                                                    1

1.2       Statement of the problem                                                                   11

1.3       Purpose of the study                                                                           12

1.4       Significance of the study                                                                    13       

1.5       Research questions                                                                              15

1.6       Hypotheses                                                                                         16

1.7       Scope of the study                                                                              17


CHAPTER 2: REVIEW OF RELATED LITERATURE

2.1        Conceptual Framework                                                                       18

2.1.1    Smoking Behaviour                                                                            18

2.1.2    Smoking behaviour and academic performance                                 22.

2.1.3    Smoking behaviour and gender                                                          22

2.1.4.   Concept of behaviour modification                                                    23

2.1.5    Self-control technique                                                                         26

2.1.7    Relapse prevention therapy (RPT)                                                      36

2.2       Theoretical Framework                                                                       49

2.2.1    Theory of planned behaviour (Ajzen, 1991)                                       49

2.2.2    Social cognitive theory (SCT) (Bandura, 1986)                                 50

2.2.3    Relapse prevention theory by Marlatt and Gordon (1985).                51

2.3              Review of Empirical Studies                                                              52     

2.4       Summary of Review of Related Literature                                       65    


CHAPTER 3: METHODOLOGY

3.1       Design of the Study                                                                            67

3.2       Area of the Study                                                                               68

3.3       Population of the Study                                                                      69

3.4       Sample and Sampling Technique                                                        69

3.5       Instrument for Data Collection                                                          70

3.6       Validation of the Instruments                                                                         71

3.7       Reliability of the Instruments                                                            71

3.8       Method of Data Collection                                                                 72

3. 9      Method of Data Analysis                                                                   102

 

CHAPTER 4: RESULTS AND DISCUSSION

4.1       Result Presentation                                                                           103

4.2       Discussion of Findings                                                                       110

 

CHAPTER 5: SUMMARY, CONCLUSION AND RECOMMENDATIONS

5.1       Summary                                                                                             112

5.2       Conclusion                                                                                         112

 5.3      Recommendations                                                                             113

5.4       Educational Implications of the Study                                               113

 5.5      Limitations of the Study                                                                     114

5.6       Suggestion for Further Studies                                                          115

REFERENCES

APPENDICES                                                                                              125





LIST  OF  TABLES

 

3.1:      3 x 2 Factorial Matrix                                                                                         66

 

3.1:      Summary of pre-treatment activities                                                                   72  

3.3:      Summary of Self-control treatment plan                                                                        79

3.4:      Summary of self-control and relapse prevention treatment programme                         92

4.1:      Mean and standard deviation of the mean difference in the rate of reduction of    

            smoking behaviour between those in self-control group and control at posttest           102

4.2:      t-test analysis of mean difference in the rate of reduction of smoking behaviour

            between those in self-control group and the control group at posttest                          103

4.3:      Mean and standard deviation of the mean difference in the rate of reduction of

            smoking behaviour between those in self-control and relapse prevention therapy

            group and control at posttest                                                                                        103

4.4:      t-test analysis of mean difference in the rate of reduction of smoking behaviour

             between those in self-control and relapse prevention therapy group and the

             control group at posttest                                                                                                103                         

4.5:      Mean and standard deviation of mean difference in the rate of reduction of smoking

           behaviour between those in self-control group and self-control and relapse

           prevention therapy group at posttest                                                                             104

4.6:      t-test analysis of mean difference in the rate of reduction of smoking behaviour  

            between those in self-control group and self-control and relapse prevention

            therapy group at posttest                                                                                                 104

4.7:      Mean and standard deviation of the mean difference in the rate of reduction of

        

             smoking behaviour between those in self-control group and control group at

             follow- up                                                                                                                       105

4.8:       t test analysis of mean difference in the rate of reduction of smoking behaviour    

             between those in self-control group and control group at follow-up                              105

 

4.9:      Mean and standard deviation of the mean difference in the rate of reduction of  

            smoking behaviour between those in self-control and Relapse Prevention Therapy

            group and control group at follow-up                                                                              106

 

4.10:    t test analysis of mean difference in the rate of reduction of smoking behaviour

            between those in self-control and Relapse Prevention therapy group and control

            group at follow-up                                                                                                            106

 

4.11:    Mean and standard deviation of the mean difference in the rate of reduction of smoking behaviour between those in self-control group and self-control and Relapse Prevention Therapy group at follow-up                                                                                                  107

4.12:    t test analysis of mean difference in the rate of reduction of smoking behaviour

           between those in self-control group and self-control and Relapse Prevention                107

           therapy group at follow-up                                                                                                   

 

4.13:    Mean and Standard Deviation in the rate of reduction of smoking behaviour

            among self-control, self-control and relapse prevention therapy and control at

            follow-up by gender.                                                                                                       108

 

4.14:    Analysis of Variance on gender differences in the rate of reduction of smoking

           behaviour in the self-control group, self-control and relapse prevention therapy

           group and control group at follow-up?                                                                            108            

 

 

 

 

 

 

 

 

 

LIST OF FIGURES

 

 

2.1:   A Cognitive Behavioural Model of the Relapse Process Beginning With

 

         the Exposure to a high risk                                                                                  47

 

3.1:   Diagrammatic Representation of Subject Distribution                                        68 

 

 

 

 

 

 

 

 

CHAPTER 1

INTRODUCTION


1.1       BACKGROUND TO THE STUDY

Tobacco is a herb that belongs to the Nicothmiana genus which has been smoked, chewed or sniffed for over five hundred years. Tobacco seems to be one of the world’s foremost drugs that originated from the new world known as Americas. Human beings have sought for substance that would not only sustain and protect humanity but would also act on people’s mind to produce various effects. One of such substance is tobacco.

The intake of tobacco fumes is called smoking. “Smoking is a practice whereby a substance is scorched and the ensuing smoke inhaled to be savored and ingested into the bloodstream” (U.S. Department of Health and Human Services, 2010). Eriksen, Mackay and Ross (2014) enumerated some of the drugs that could be smoked as marijuana, hashish, cigars, pipe, cigarettes and others. The cigarettes commonly used by smokers are small tubes of paper containing tobacco that are refined and smoked by adding any source of fire to it in order to light it. Some of the brands of cigarette in Nigeria include, Benson and Hedges (B&H), Rothmans, St. Moritz, Bohem Grip, Aspen Export and Pall Mall to mention but a few. However, the street names employed so as to confuse the public by concealing the names are Chocolate, Sticks, Fire and so forth.

Tobacco use among young people is a global public health issue (Eriksen et al, 2014). The majority of smokers started smoking during their youth (Song & Glantz, 2015).  The annual tobacco-related deaths estimated is to escalate from 5 million in 2010 to over 10 million by 2030 (Jha & Peto, 2014). Tobacco triggered morbidity and mortality is the most avoidable disease among humans (Fryer, Seaman, Clark, & Plano-Clark, 2017). Consequently, tobacco usage amid young people is a widespread challenge requiring combined efforts among tobacco control experts to improve effective prevention, cure, and termination modalities. This study is geared towards achieving that.

Evidence from research report high dominance of tobacco usage disorder among University Undergraduates. The percentage of high school students using any tobacco product remains high 24.6% in 2014 (Centers for Disease Control and Prevention, 2015), reflecting the increasing diversity of tobacco product use among adolescents. In addition, a growing percentage of young adults initiate tobacco use after age 18 and escalate that use both in frequency and intensity during the young adult years (U.S. Department of Health and Human Services, 2010). These findings highlight the need for new approaches to reduce tobacco use during adolescence and the young adult years and increase efforts to treat those who are addicted to it.

Tobacco use in Nigeria is not different from the rest of the world. Oyewole, Animasahan and Chapman (2018) found that prevalence of smoking ranged from 0.2% to 32.5%, females ranged between 2.2% to 10% while that of males ranged from 1% to 32.5%. Amorha, Jiburu, Okonta and Nduka (2017) found that 1/5 of undergraduates surveyed reported having smoked. The incidence of smoking in Nigeria is on the increase especially among the youth (Emerole, Chineke, Diwe & Onubeze, 2013; Ukwuayi, Eja, & Unwanede, 2012).  Efforts should be made to assist the youths quit smoking for good health and well-being. Preventing escalation and entrenchment of smoking in the young adult is critically important to reducing the long term health effect of smoking.

For accurate classification of individuals who engage in smoking behaviour, this study will make use of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) criteria for smoking behaviour. Tobacco Use Disorder classified in the DSM-5 (fifth edition) (APA, 2013). Diagnosis is allocated to individuals who rely on the drug nicotine due to usage of Tobacco produces. To get an accurate classification of individuals who engage in smoking behaviour, this study X-rayed the DSM 5 criteria for smoking behaviour.

Substance use disorders comprise a vast variety of problems emanating from substance use, and cover 11 different criteria:

1.      Consuming the substance in higher amounts or for longer than you are meant to.

2.      Intending to reduce or stop utilising the substance but not managing to.

3.      Expending so much time getting, utilising, or recovering from utilising the substance.

4.      Yearnings and urges to consume the substance.

5.      Not handling ones job at work, home, or school because of substance usage.

6.      Persistent usage, even when it causes hitches in relationships.

7.      Foregoing important social, occupational, or recreational undertakings because of substance usage.

8.      Using substances repeatedly, not minding putting you in danger.

9.      Continuous usage, even when one knows of impending physical or psychological problem that may be triggered or made worse by the substance.

10.  Craving for more substance to get the effect you want (tolerance).

11.  Exhibiting of withdrawal symptoms, which could be calmed by taking of the substance the more.

Two criteria have been specified for Tobacco dependence. They are craving and withdrawal. Tobacco yearning reflects a mindful desire or intention to use tobacco. Many instances of Tobacco Dependence (TD) consist of craving as a vital dependence symptom is correlated meaningfully with smoking immensity and is highly associated with other important features of Tobacco Dependence (Skinner, 2010). The concern of this study is on those addicted to smoking. They are smokers who smoke relatively constantly.

There are several factors that influence people to smoking, one of such is social pressure. Osu and Olunkwa (2010) indicated that people often start using tobacco to be like someone they admire – a friend, a parent, or a famous person. Many young people view tobacco usage as a sign of adulthood. They think that using tobacco will make them appear sophisticated or in control in social situations. Some teachers, parents, other adult role models use tobacco. It may seem natural for a teenager to try tobacco products. Conversely, some children of non–smokers try to show their independence by smoking. Most young people start to utilise tobacco when it is offered to them by a friend.

An undergraduate is a student at the university or college who is studying for his or her first degree. Undergraduate students can be 18 years and above, but the majority of them are in their late teens and early twenties. They fall within the adolescence stage of development. The transition from secondary school to University begins at a time of personal growth accompanied by normal developmental stressors. Some undergraduates use smoking as a coping mechanism. Studies have found a high smoking rate among undergraduates (Karadogan, Onal and Kanbay, 2018). Reports also show that smoking occurrence upsurges in university students from first year to final year raising serious concerns about preventative and curative measures ( Abdulsalam & Zhang, 2019).

Peer pressure is a very strong force. If one’s friends use tobacco, refusing to try it may be difficult. Many young people know the threats of tobacco usage but they think they will be protected. They also underestimate the power of tobacco and think they can give it up anytime they want (Centers for Disease Control and Prevention, 2015). It has been observed that much of substance use among youths take place in schools. The occurrence of smoking amongst students is high. Smoking among adolescence is almost always a social experience and a learned behaviour. One of the important psychological phenomena observed during this period of adolescence is experimentation.

Psychological undertone is another reason why people smoke. Song and Glantz (2015) point out that those smokers have feelings that it reduces their boredom and fatigue, enhances pleasure at that moment and provides a way out from the realities of existence. They added that they use such smoking activities like; handling the cigarette, cigar or pipe to enhance self-image, to build self-confidence, to gain approval and acceptance of one’s peers, to heal psychological hurts that may have to do with coping with stressful situations and feelings of fear, anger and anxiety. Smokers are attracted to smoking due to the notion that it reduces stress. Most young people commence using tobacco as a way of managing stress or uncomfortable feelings such as depression, anger, frustration, boredom, anxiety and nervousness.

Unrealistic optimism about the personalized risk of smoking is another cause why many adolescents may believe that there is no health risks related to smoking in the first few years, and they believe that they will stop smoking before any damage is done. Existing evidence suggests that adolescents and adults exhibit unrealistic optimism about the personalized risk of smoking (Fryer, Seaman, Clark & Plano-Clark, 2017).

Tobacco smoking is the leading cause of preventable premature death worldwide. Whereas most smokers would like to stop, the habitual and addictive nature of smoking makes cessation difficult (WHO, 2011). According to World Health Organization, WHO (2011), 3.5 Million lives were lost in 1998 as a result of smoking. Tobacco smoke is a deadly cocktail of over 4000 chemicals and poisons including tar, nicotine, carbon monoxide, cyanide and ammonia. The addiction in smoking has resultant unpleasant effect such as the physical, social, psychological, neurological and cognitive effects in the human body functioning of smokers. Smoking harms almost all organs of the body and affects overall health. These effects, including the physical discomforts are also suffered by non-smokers. Smoking prematurely ages the skin by between 10 and 20 years and makes it three times more likely to get facial wrinkling, particularly around the eyes and mouth. Smoking even gives one a shallow, yellow-grey complexion and hallows checks, which can cause one to look gaunt (US Department of Health and Human Services, 2010).

Smoking causes innumerable number of health issues. Osu and Olunkwa (2010) reported that by smoking, one doubles one’s risk of dying from a stroke, in addition, one way that smoking can increase one’s risk of stroke is by increasing one’s chances of developing a brain Aneurysm. This is a swell in a blood vessel instigated by a flaw in the blood vessel wall. This could break or spurt which could lead to a tremendously serious condition known as a subarachnoid haemorrhage, which is a kind of stroke, and could create extensive brain injury and death. For smokers, according to Tomioka, Sekiya, Nishio and Ishimoto (2014), smoking termination is the single most significant change they can make to their behaviour to enhance their life expectancy and quality of life. Most smokers want to stop smoking but only very few succeed (Pierce, Cummins, White, Humphrey &Messer, 2012).

Considering the negative effects of smoking as highlighted above, there is need to identify measures that will assist smokers reduce or totally abstain from smoking. Smoking behaviour is a learnt response, it can also be unlearned. One of the behaviour modification techniques that has been effective in helping individuals change their behaviour is self-control technique. Low self-control is connected with amplified consumption of alcohol, tobacco, and unwholesome food (Stautz, Zupan, Field & Marteau, 2018).  Self-control in this context is a process through which an individual becomes the principal agent in guiding, directing and regulating those features of his own behaviour that might eventually lead to desired positive consequences (De ridder in Obi, 2015). Self-control is the characteristic replicating the capability to apply control over one’s emotions, thoughts, actions and impulses, and prioritizing distal purposes over proximal reasons (Fujita, 2011). It is the capability for deliberate self-governance (Duckworth & Kern, 2011). Self-control is equally linked with a behavioural propensities labelled impulsivity in a person’s differences’ works, explained by the non-reflective collection of stimulus-evoked reactions, or non-reflective inclination for directly rewarding reactions (Nigg, 2017). The strong cessation goals that characterize smokers suggest that their attitude represent a self-control problem (Daly, Delaney & Baumeister, 2015).

 

Self-control is one of the most vital human bequests because it permits people to limit impulsive behaviours. Poor self-control has been established to be connected to numerous glitches, such as fatness, delinquency, risky sexual behavior, drug and alcohol usage, together with other negative upshots (Conor, Stein & Longshore, 2009). Equally, high self-control was established to be connected with better grades, fewer psychopathology, better relationships, better relational skills, healthier eating habits, better emotional control, along with other positive outcomes (Lee  & Kemmelmeier, 2017).

 Self-control is an individual dissimilarity revealing the capability to exercise control over one’s opinions, activities, feelings, and desires, and to rank distal reasons above proximal motives (Fujita, 2011). It encompasses the capability to modify habitual (or dominant) reactions and to substitute them with non-dominant reactions to attain lasting goals, standards or recompenses (Fujita, 2011; Inzlicht, Schmeichel and Macrae, 2014). That is, it is the capability for deliberate self-governance (Duckworth and Kern, 2011).

Self-control as a behaviour modification therapy is a systematic procedural approach involving mastery of special techniques. Exercise of self-control is a conscious effort acquired through learning and practice (Moffit & Kern, 2011). The term self-control had been used variously as; self-regulation, self-discipline, willpower, inhibitory control, self-esteem strength and proactive control (Duckworth & Kern, 2011).

 

 Self-reported slight self-control is connected with distinctive and difficult levels of alcohol usage, enlarged body mass index, and a developed probability of instigating smoking (Coskunpinar, Dir, & Cyders, 2013). Gillebaart and De-Ridder (2017) advocate that having abundant self-control is connected with an improved capability to instigate goal hunt and participate in goal-oriented behaviour. That is, persons with great self-control are much able to outline goals, behave in manners that would help attain these goals, and experience liking from doing so.

To avoid terminological confusion, it has been suggested to allocate self-control as the intentional, conscious, effortful subset of self-regulation (Baumeister, Vohs & Tice, in Obi, 2015). The aptitude of the self to adjust itself by changing or overriding its prevailing response propensities is known as self-control (Bandura, 2009). Self-control is viewed as standard about how behaviour should be regulated in a given domain of life (such as standard for keeping diet, or remaining faithful to one’s romantic partner or abstinence from smoking). It is a strenuous act that needs our attention and puts our life discipline or will power to test.

The controlling behaviour involves implementing self-control tactics in which the precursors and penalties of the target behaviour or alternative behaviours are adapted. These tactics make the controlled behaviour (target behaviour) more likely. Self-control ensues when a person indulge in behaviours at a time to regulate the manifestation of another (target behaviour) at later time (Liu, Wang, Dou & Zhang, 2015).One wonders the extent self-control could be effective in cessation of smoking behaviour among undergraduates in Abia State.

Indulging in addictive behaviour typically offers instant rewards that increase pleasure and /or decrease pain. That is, people participate in addictive behaviours to feel good (greater pleasure) or to feel better (self-medication of pain) though both reasons could exist simultaneously. The rewards following addictive behaviours serve to sustain their excessive frequency, intensity, and duration, notwithstanding the deferred negative consequences which can be pretty serious and long–lasting.

 

Smoking cessation treatment is replete with relapse. Relapse prevention (RP) is a tertiary interference strategy for mitigating the chances and sternness of relapse ensuing the termination or lessening of difficult behaviours (Hendershot, Witkiewitz, George & Marlatt, 2011). Relapse is a hindrance that emanates during the behaviour change process, whereby advancement toward the start or maintenance of a behaviour change goal (for example, abstinence from smoking) is interjected by a return to the desired behaviour. Relapse is also seen as a vibrant, continuing process instead of a discrete or mortal event (Kirchner, Shiffman, & Wileyto, 2011). Relapse Prevention Therapy (RPT) is suspected to have the potential of maintaining cessation of smoking behaviour after treatment has been achieved.

The unrelenting effect of RP is demonstrated by its incorporation in many cognitive-behavioral substance usage mediations. Nevertheless, the penchant to incorporate RP inside other handling modalities has created a barrier to systematic appraisal of the RP model. Generally, RP remains a prominent cognitive-behavioral outline that could create both theoretical and clinical methods to understanding and expediting behavior change (Hendershot et al, 2011).

 

Relapse prevention therapy (RPT) utilizes therapeutic strategies that may be useful for cessation of smoking behaviour. Such strategies include: coping skills training, relapse road map and lifestyle modification techniques (Hasher & Sack, 2009). Relapse prevention therapy (RPT) approaches are now essential to most psychosocial cures for substance usage (Agboola, Coleman, Leonardi-Bee, McEwen, & McNeill, 2010).

Relapse stands as a barricade to the cure of addictive behaviors. For instance, 12-month relapse rates resulting from alcohol or tobacco stoppage attempts, usually from 80-95% (Hendershot et al, 2011) and evidence recommends comparable relapse curves across several forms of substance usage (Kirshenbaum, Olsen & Bickel in Hendersho et al, 2015)). Averting relapse or abating its magnitude is thus a precondition for any effort to enhance successful, lasting modifications in addictive behaviours.

Relapse prevention Therapy (RPT) is an intervention strategy, at tertiary level, for decreasing the possibility and sternness of relapse following the termination or lessening of problematic behaviours. Studies revealed that smoking behaviour can be managed effectively with self-control techniques and relapse prevention therapy (Muraven, 2010). In view of the pernicious consequences of smoking to smokers and those around them and the positive effects of quitting, it is expedient to work out modalities that could be used to proactively assist smokers to reduce or quit smoking. It is on this note that the researcher intends to investigate the effectiveness of self-control techniques and relapse prevention therapy in the cessation of smoking behaviour among undergraduates in Abia State.

 

1.2       STATEMENT OF THE PROBLEM

Universities are citadels of learning where undergraduates acquire knowledge and skills to become productive members of the society. This is to enable them to contribute meaningfully to national development. However, certain behaviour deficits like smoking could hamper the actualization of such goals. Research indicates that a number of students engage in smoking behaviour in our tertiary institutions. Smoking has been noted to be associated with cancer, asthma, heart disease and most importantly, smoking affects the self-esteem and academic performance of smokers. A report given by Onu and Olunkwa (2010) showed the prevalence of smoking for Nigerian adolescents of age 18 – 25 (undergraduates fall within this age bracket) as 25% and 17% for adolescents and adolescent at puberty stage, respectively. Despite the efforts of Government to reduce smoking among undergraduates, it has continued to be on the increase. Behaviour modification techniques could be utilized to assist undergraduates to handle their smoking behaviour. The burden of this research is to investigate the effectiveness of Self-Control Techniques and Relapse Prevention Therapy in the reduction of smoking behaviour among undergraduates in Abia State. The problem of this study put in a question form is: How  Self-Control Technique and Relapse Prevention Therapy and combination of smoking behaviour among undergraduates in Abia State?


1.3       PURPOSE OF THE STUDY

The main purpose of this study was to investigate the effectiveness of Self-Control Techniques and Relapse prevention therapy on cessation of smoking behaviour among University undergraduates in Abia State, Nigeria. Specifically, the study sought to:

1)      determine the rate of reduction of smoking behaviour between those exposed to  self-control techniques and the control at post-test.

2)      determine the rate of reduction of smoking behaviour between those exposed to self-control techniques and relapse prevention therapy and the control at post-test

3)      determine if there is a difference in the rate of reduction of smoking behaviour between those in the self-control group and self-control and relapse prevention therapy at posttest.

4)      ascertain if there is a difference in the rate of reduction of smoking behaviour between those in the self-control group and  control group at follow -up.

5)      determine if there is difference in the rate of reduction of smoking behaviour between those in self-control and relapse prevention therapy and control at follow-up.

6)      determine if there is difference in the rate of reduction of smoking behaviour between those in self-control and self-control relapse prevention therapy at follow-up.

7)      determine if there is a difference in the rate of reduction of smoking behaviour between those in the self-control and relapse prevention therapy and control by gender.


1.4       SIGNIFICANCE OF THE STUDY

The findings of this study when published have both theoretical and practical significance. The findings of this study will authenticate the basic assumptions of the theories that underpinned this study. Specifically, self-control and relapse prevention theories will be further validated by the findings of this study. The findings of this study also have practical significance. The findings would be beneficial to: smokers, students, counsellors, parents, health workers, the society and researchers when published. The findings of the study may help to restore lost moral standard and social status of undergraduates. The findings of the study may reveal to smokers the dangers and health risks associated with smoking. It may also serve as guide for prevention of students from smoking behaviour. It will also help the smokers attribute failures in stopping smoking to lack of skills and commitment to stopping smoking behaviour and not lack of will power.

The findings of the study may also help school counsellors and clinical psychologists with valuable information to assist youths to handle their smoking challenges. This will help school counsellors and clinical psychologists to utilize the relevant behaviour modification techniques to assist youths with smoking behaviour. The findings of this study equally will guide the Guidance counsellors, educational psychologists, social workers and others within the helping profession to get relevant and well-defined information on the efficacy of self-control techniques and relapse prevention therapy in stopping smoking behaviour. This in turn will serve as a guide to the university counsellors to understand how effective self-control and relapse prevention therapy may be in reduction of smoking behaviour. It will motivate them to utilize these techniques to assist other youths to quit smoking. It will also create more awareness on useful intervention strategies and professional development programmes on ways to prevent or stop smoking behaviour among undergraduate students and other smokers.

 

The findings of the study would be of benefit to medical doctors, health workers, even Ministry of Health to create more awareness to the general public on dangers of cigarette smoking and the likelihood that smokers could quit smoking with psychological interventions. The findings of the study may also provide them with well-defined information on the usefulness of self-control techniques and relapse prevention therapy in reducing smoking behaviour. They may want to refer smokers to professional counsellors for remediation.

Finally, the findings of the study when completed and disseminated will inform the researchers on the effects of self-control and relapse prevention therapy in reducing smoking behaviour. The findings of the study may serve as springboard for future researchers who may wish to carry out a study on the same variables or related ones.

 

1.5       RESEARCH QUESTIONS

The following research questions will guide the study.

i.        What is the mean difference in the rate of reduction of smoking behaviour between those in self-control group and control at post-test?

ii.      What is the mean difference in the rate of reduction of smoking behaviour between those in Self-control and Relapse Prevention therapy group and control at posttest?

iii.    What is the mean difference in the rate of reduction of smoking behaviour between those in the self-control group and self-control and relapse prevention therapy at post-test?

iv.    What is the mean difference in the rate of reduction of smoking behaviour between those in the self-control group and control at follow-up?

v.      What is the mean difference in the rate of reduction of smoking behaviour between those in the self-control and relapse prevention therapy and control at follow-up?

vi.    What is the mean difference in the rate of reduction of smoking behaviour between those in self-control and self-control and relapse prevention therapy at follow-up?

vii. What is the mean difference in the rate of reduction of smoking behaviour between those in self-control and self-control and relapse prevention therapy at follow-up by gender?


1.6       HYPOTHESES

The following null hypotheses were formulated to guide the study and will be tested at 0.05 level of significance.

H01:     There is no significant mean difference in the rate of reduction of smoking behaviour between those in the self-control and control group posttest?

H02:     There is no significant mean difference in the rate of reduction of smoking behaviour between those in the self-control and Relapse Prevention Therapy group and control at posttest.

H03:     The mean score difference in the rate of reduction of smoking behaviour between those in the Self Control group and Self control and Relapse prevention therapy do not differ significantly at posttest?

HO4:    There is no significant mean difference in the rate of reduction of smoking behaviour between those in the self-control and control group at follow-up?

HO5:    The mean score difference in the rate of reduction of smoking behaviour between those in the self-control and the self-control and relapse prevention therapy group do not differ significantly at follow-up?

HO6:    There is no significant difference in the rate of reduction of smoking behaviour in the self-control and the self-control and relapse prevention therapy group at follow-up?

Ho7 : There is no significant gender difference in the rate of reduction of smoking behaviour in the self-control and the self-control and relapse prevention therapy group and control group at follow-up?

 

1.7        SCOPE OF THE STUDY

The study was delimited to undergraduates with smoking behaviour in Michael Okpara University of Agriculture, Umudike and Abia State University, Uturu, all in Abia State. The study focuses on the establishing the effects of Self-Control Techniques and Relapse Prevention Therapy on smoking behaviours among university undergraduates in Abia State, Nigeria. The self-control techniques used include self-control, self-evaluation, orientation for change, behavioural contracts, modification of the environment, tasks and assignment and self-reinforcement; while RPT used in this study include coping skills training, relapse road map and lifestyle modification techniques. Smoking behaviour is defined according to the DSM-5 criteria for smoking behaviour disorder. Gender was used as a moderator variable and it means male and female between the ages  of 18 – 25 years.

 

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