Momentary Intervention for Concurrent Smoking and Heavy Drinking, K. Witkiewitz (PI).
Heavy episodic drinking (HED) among college students is a persistent public health problem with severe consequences, including development of substance-use disorders, psychosocial problems, health risks, accidental injuries, and death. National US survey data indicate more than 80% of college students report consuming alcohol in the past year, with 44% reporting heavy episodic drinking (HED; 5/4 drinks per occasion for men/women) at least once in the previous 2 weeks. In addition, it has been reported that nearly all college smokers drink alcohol and usually smoking and HED co-occur. One National US survey found 98% of current smokers drank alcohol and 44-59% of drinkers smoked cigarettes. Furthermore, the co-occurrence risk was greatest among students who reported greater alcohol consumption (OR=4.21, p< .0001), having a drinking problem (OR = 3.31, p< .0001), and those who reported using drinking to cope with their problems (OR=2.19, p< .05). In order to achieve a better understanding of these risk behaviors and identify potential points for intervention, the overall aim of the proposed study is to develop an individually-tailored, computerized intervention targeting HED among college student smokers. The first aim of this research is to gain a better understanding of these processes using ecological momentary assessment (EMA). The information obtained from EMA daily reports of drinking and smoking will be used to model the dynamics of proximal influences on HED. The results from these models will thereby identify points of intervention for college student smokers who engage in HED. Following from this basic research, we plan to translate the models into an intervention that would be administered in real-time via an interactive program installed on an electronic device. The final aim of the proposed study will be to evaluate the efficacy of the empirically-based intervention in a randomized controlled trial comparing the computerized intervention to an electronic assessment-only control groups in a sample (n=126) of college student smokers who engage in HED. More specifically, the computerized intervention will incorporate components of the successful intervention, Brief Alcohol Screening and Intervention for College Students (BASICS), as well as a recently developed brief smoking intervention for non-treatment seeking college student smokers. The intervention, BASICS-ED, will be administered in real-time on an electronic device. The program will be developed using branching algorithms, such that ongoing assessment of momentary changes in an individual's environment will determine the selection and ordering of modules, providing individually-tailored BASICS messages and the smoking intervention in real-time.