The impact of group cognitive behavioral therapy on stress and psychological adjustment among cigarette, e-cigarette, and hookah smokers.
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BACKGROUND: The tobacco epidemic remains one of the world's major public health threats, causing preventable cancers and disabilities, and claiming over seven million lives each year. Over the past decade, the use of nicotine-containing electronic cigarettes has grown among adolescents and young adults. This study investigates the effectiveness of a group cognitive behavioral therapy program on stress and psychological adjustment among university students who want to quit smoking cigarettes or hookah. MATERIALS AND METHODS: The sample included 123 male students who smoked cigarettes and e-cigarettes and 134 students who smoked hookah, all of whom expressed a desire to quit smoking. Students who smoke both cigarettes and hookah were excluded from the study to ensure clear differentiation between the two groups of users. A nonprobability sampling method was used. Psychological stress and psychological adjustments were measured twice: before the group treatment program began and after the program was completed. The study employed an experimental pretest and posttest design to analyze data. RESULTS: The results indicated that the program had an effective impact on users of cigarettes, electronic cigarettes, and hookah in terms of stress management strategies and psychological adjustment. Specifically, the program had a positive effect on reducing psychological stress but a negative effect on psychological adjustment, meaning that while stress levels decreased, psychological adjustment also decreased. The program had a greater impact on stress management strategies and psychological adjustment among cigarette and e-cigarette smokers compared to hookah smokers. CONCLUSION: The findings suggest that smokers of cigarettes and e-cigarettes are more likely to use stress-coping strategies but have a reduced ability to maintain psychological adjustment, which may be due to their dependence on nicotine. Therefore, it is recommended that awareness be raised about the necessity of involving psychologists in future treatment programs at the national level to help reduce this phenomenon.