Effects of drinker self-schema on drinking- and smoking-related information processing and behaviors

ABSTRACT

Background: Co-occurrence of drinking and smoking is prevalent in undergraduate students. A drinker self-schema―cognition about the self as the drinker―is a common identity in undergraduates and a well-known predictor of drinking behaviors. Given that smoking commonly occurs in the context of drinking, a drinker self-schema may be a cognitive mechanism to motivate co-occurring alcohol and tobacco use (i.e., cross-substance facilitation hypothesis). This study was to determine whether the drinker self-schema influences the processing of drinking- and smoking-related information and facilitates the co-occurrence of alcohol and tobacco use in undergraduate students who drink and smoke but do not self-identify as smokers. Methods: This study was the second phase of a 2-phase study. Of the 330 who completed phase 1 (online survey), 99 completed the phase 2 study. Phase 2 was an in-person session that included a computerized information processing task to measure endorsements and response latencies for drinking- and smoking-related attributes, and a computerized Timeline Followback that was used to measure 90-day alcohol- and tobacco-use behaviors. The 5-item drinker self-schema scale, administered in phase 1, was used to measure the strength of the drinker self-schema. Results: A higher drinker self-schema score was associated with more endorsements of positive attributes for drinking and smoking, fewer endorsements of negative attributes for smoking, faster processing of agreements with positive alcohol-use-related attributes, higher levels of drinking and smoking, and more days of co-occurring alcohol and tobacco use. Conclusions: Findings provide preliminary evidence to support the cross-substance facilitation hypothesis that the drinker self-schema facilitates the processing of not only drinking-related but also smoking-related stimuli and behaviors. Undergraduates who have higher drinker self-schema scores may be vulnerable to co-occurring alcohol and tobacco use.

KEYWORDS:

• Alcohol use
• college student
• cross-substance
• drinker identity
• substance use
• tobacco use

Acknowledgments

This work was completed at the School of Nursing, University of Rochester, by Chia-Kuie Lee. Currently, she is at the Department of Nursing, College of Medicine, National Cheng Kung University.

 The authors declare that they have no conflicts of interest.

Author contributions

Chia-Kuie Lee designed the study, performed all analyses, interpreted the data, and drafted the manuscript. Karen F. Stein co-designed the study, helped oversee data collection, contributed to the conceptualization of the manuscript, and edited on the manuscript. Colleen Corte consulted on study design, contributed to the conceptualization of the manuscript, helped to interpret the data, and edited on the manuscript. All authors read and approved the final manuscript.

Additional information

Funding

This research was supported by Heilbrunn Nurse Scholar Award and Sigma Theta Tau International Small Grants. Both funding agencies had no role in the study design, collection, analysis, or interpretation of the data; writing the manuscript; or the decision to submit the paper for publication.