The aim of this cross-sectional study was to understand the relationships between the constructs of positive psychology ( Resilience, Self-efficacy, Optimism) with Health values and Spiritual well-being, and their possible influences as protective factors against risk factors of Nicotine Dependence, stress, and familial problematic substance use. It also investigated the association of above risk factors with primary living place, parents' education and parents' monthly income. The constructs were tested in pairs and as a composite variable. The research design included a 65-item web-based self-administrated survey among a sample of (n=419) university students attending three government universities (Institute of Business Administration University, Sindh university, and Chandka Medical College) in Pakistan during the fall semester of 2022. Correlational and mean differences pertaining to students' scores for the constructs under investigation were explored within ranges of calculated risk for Nicotine Dependence, stress and familial problematic substance use. Risk ranges were determined as categories of low, low to moderate, moderate, and high.
Method: The sample was drawn using a random sampling method in which a number generator determined which departments and classes to select, resulting in the selection of equal classes from each of the three universities. Students ranged from a variety of academic ranks and academic programs in the universities. The overall response rate to the survey was 93.45% which constituted a student sample of n=419. Seven scales were utilized in the design of the survey including Connor Davidson Resilience Scale (CD-RISC-10), New General Self-efficacy Scale (NGSE),) Revised Life Orientation Scale (LOT-R), Modified Health as a Value (mod-HAV) Scale, Spiritual Well-Being Scale (SWBS-10), Fagerstrom Test for Nicotine Dependence (FTND), and Perceived Stress Scale (PSS).
Results: A variety of comparisons were made and the most prominent results revealed. First, Resilience and Self-efficacy demonstrated a medium positive relation with each other whereas Optimism had a small positive correlation with Self-efficacy and Resilience. Second, Health as a value demonstrated a small positive relation with Resilience, Self-efficacy, and Optimism whereas Spiritual well-being demonstrated a small negative relation with Resilience, Self-efficacy, and Optimism. Spiritual wellbeing also demonstrated a small negative relationship with Health as a Value. Third, it was observed that there was a large positive correlation between stress and Nicotine Dependence. Fourth, Nicotine Dependence had a high negative relationship with Resilience and Self-efficacy, and a small negative relationship with Optimism and Health as a value. Stress had a medium negative relationship with Resilience, Self-efficacy, and Optimism and a small negative relationship with Health as a value. Spiritual well-being had a small positive relationship with Nicotine Dependence and stress. Fifth, Resilience, Self-efficacy, and Optimism with health as a value showed significant differences among all four groups of Nicotine Dependence risk (low, low to moderate, moderate, and high). As the initial tests show that the moderate and high-risk group displayed a high decrease in Resilience, Self-efficacy, and Optimism in comparison to low and low to moderate-risk groups whereas health as a value showed a medium decrease. On the contrary Spiritual well-being mildly increased with the risk of Nicotine Dependence. A significant relationship between the levels of Nicotine Dependence risk and the major constructs of Resilience, Self-efficacy, Optimism, and health as a value as a composite variable was also observed. Sixth, Group 1 (individuals with Familial substance use history) showed a large correlation between Resilience and Self-efficacy whereas in Group 2 (individuals with no Familial history of substance use disorder) the correlation was medium size. Optimism in Group 2 showed a small positive relation with Resilience and Self-efficacy whereas in Group 1 Optimism showed a small positive relation with Resilience only and no relation existed between Optimism and Self-efficacy. Spiritual well-being had higher significant relationships and values in Group 1 than in Group 2. Seventh, Primary living place, mothers' education, and parents' monthly income had significant associations with smoking status (smokers and non-smokers), except the fathers' education did not have any association. The primary living place had a higher effect size in comparison to the mother's education and parents' monthly income. No significant associations were found in the primary living place, fathers' education, mothers' education, and parents' monthly income tested with Familial problematic substance use (individuals with Familial substance use history and individuals with no substance use history).
Conclusion: Results appear to be consistent with a number of earlier research investigations despite study limitations. For the disciplines of Nicotine Dependence, substance use disorder, allied health, and rehabilitation counseling implications, and future research recommendations are discussed.