Journal of studies on alcohol and drugs最新文献

Objective: Attentional bias, defined as the preferential focus on personally salient--compared with neutral--cues, has a hypothesized link to substance use disorders and chronic pain. Although growing research demonstrates that cognitive bias modification (CBM) can alter attentional biases, evidence is lacking to assess the extent to which such alterations predict changes in clinical symptoms or behaviors (e.g., pain severity, craving).

Method: We conducted a secondary analysis of a clinical trial examining the feasibility, acceptability, and preliminary effectiveness of a 4-week CBM adjunct for veterans (N = 28) receiving medication treatment for opioid use disorder (mOUD) with moderate pain for the past 3 months. We examined CBM effects versus control on pain severity, interference, and catastrophizing, as well as opioid craving and withdrawal.

Results: CBM for opioid and pain cues did not correspond with changes in the primary clinical outcomes of opioid craving and pain intensity (ps > .111). Additional analyses of other possible outcomes, including pain interference, pain catastrophizing, and subjective opioid withdrawal, were also not associated with CBM (ps > .125).

Conclusions: Results from this pilot study did not show changes in pain severity or opioid craving corresponding to CBM for opioid and pain. Findings should be considered preliminary given our small sample size; however, findings indicate a distinction between attentional biases, their modification, and clinically salient outcomes. Future research should examine CBM in larger, more diverse samples and assess the impacts of addiction severity, substance type, naturalistic settings, and more engaging methodologies (e.g., gamification of CBM tasks, using gaze-contingent paradigms).

Objective: Cigarette use has declined over the last decade, yet electronic nicotine delivery systems (ENDS) have gained popularity with younger individuals. Although age differences have been established, it is unclear if there are generational differences in ENDS and cigarette use patterns. The objective of this study was to describe tobacco use patterns by generation and examine factors associated with these patterns.

Method: This study used data from the sixth wave of the Population Assessment of Tobacco and Health Study (PATH; N = 25,199). Adjusted multinomial logistic regression models were used to examine the association between factors, including demographics, tobacco use characteristics, and social influences, and tobacco use patterns by generation.

Results: Generation X had the highest cigarette-exclusive use (32.1%), whereas Generation Z led in ENDS-exclusive use (13.5%). Millennials showed the highest dual use of cigarettes and ENDS (6.4%). Except for Baby Boomers, there were decreased odds of ENDS and dual use when ENDS were perceived as about the same or more harmful compared with cigarettes. Social media demonstrated a protective effect against cigarette use for Generation Z (adjusted odds ratio = 0.51, 95% CI [0.35, 0.74]) and Generation X (adjusted odds ratio = 0.80, 95% CI [0.64, 0.99]). Social influences had strong effects on use across all generations. Specifically, when important people in the participants' lives used a product, the odds of them using the same product increased.

Conclusions: Tobacco use patterns differed by generation. These findings highlight the need for targeted public health interventions to address generational-specific tobacco use behaviors.

Objective: Excessive alcohol consumption can lead to adverse consequences, including physical and mental health problems. Although there are many empirically supported cognitive and behavioral therapies for alcohol use disorder, the most widely available in-person treatments focus on abstinence rather than moderation. Moderation strategies are historically less common and are typically reported to be less effective, despite moderation being a common primary goal. In addition, most individuals with alcohol-related problems will never seek formal assistance from a health care provider. Technology-delivered interventions that focus on moderation strategies address several treatment needs.

Method: We developed and tested the initial efficacy and usability of a mobile application focused on improving alcohol moderation through real-time pacing of consumption. Participants (n = 59) were randomized to use the experimental application or, conversely, moderation strategies proposed by the National Institute on Alcohol Abuse and Alcoholism, including a drink-tracking card. Participants provided follow-up data regarding their alcohol consumption and alcohol-related consequences over a 14-day period.

Results: The sample reported statistically significant and clinically meaningful reductions in alcohol consumption and alcohol-related consequences. However, the effect of the experimental condition was not significant. In addition, participants provided descriptive feedback on their user experience. Participants' ratings revealed significantly lower satisfaction and ease of understanding of the experimental application compared with their ratings of using the drink-tracking card in the control condition.

Conclusions: Results indicate specific revisions to the design and further evaluation of barriers to successful moderation to increase the efficacy of the mobile application examined. The current study provides initial evidence of the effectiveness of a mobile application aimed at moderating alcohol use. These findings can inform future studies aiming to provide mobile application interventions to individuals wanting immediate assistance to moderate their use without the help of a health care professional.

Objective: Sexual assault is a prevalent public health concern linked to numerous negative health consequences, including increased alcohol use and related harm. The current cross-sectional study examined the roles of shame and emotional avoidance in the association between a history of sexual assault and alcohol use and related harm among adults receiving residential substance use treatment. Specifically, we examined whether a history of sexual assault related to alcohol use and related harm indirectly through heightened shame and greater emotional avoidance.

Method: Participants were 140 adults in residential substance use treatment (M age = 40.6 years, 50.8% women, 70.0% White) who completed self-report measures assessing sexual assault, shame, emotional avoidance, and alcohol use and related harm.

Results: Cross-sectional mediation analyses indicated that a history of sexual assault was indirectly associated with increased alcohol use and related harm via heightened shame and greater emotional avoidance.

Conclusions: Findings suggest that interventions targeting alcohol use and related harm may benefit from reducing shame and decreasing emotional avoidance among individuals with a history of sexual assault.

Objective: Intergenerational conflict (IGC) occurs when cultural beliefs, values, and attitudes differ between a parent and child. The present study examined the psychometric properties of an IGC scale within Hispanics and the association between IGC and alcohol outcomes.

Method: Participants were n = 144 Hispanic college students who consumed alcohol within the last 30 days. Participants completed demographics, the IGC scale, and drinking measures.

Results: A one-factor solution was the best fit (χ² = 53.92, df = 35, p = .02, CFI = .96, RMSEA = .06, SRMR = .05) for the data. IGC was not associated with binge drinking (β = .03, p = .87) but was positively associated with alcohol consequences (IRR = 1.43, β = .36, p = .001).

Conclusions: The IGC scale may be applicable to Hispanic college students. Moreover, IGC was only positively associated with alcohol consequences.

Objective: The COVID-19 pandemic likely heightened stress in smokers undergoing cessation treatment, while health care services faced challenges in maintaining interventions during the prevaccination phase. This study compares smoking cessation outcomes before and during the pandemic in individuals with and without mental health disorders and identifies variables associated with abstinence.

Method: A naturalistic longitudinal design with a 1-year follow-up was used. Smoking quit rates and time to relapse in participants who received a multicomponent cessation intervention before the lockdown (2019 group, n = 147) were compared with those during the pandemic (2020 group, n = 120).

Results: The sample was 53.6% female, with a mean age of 58.2, and 79.4% had a comorbid mental disorder. One-year quit rates and time to relapse were similar between the 2019 and 2020 groups (51% vs. 50.8%; 225.3 vs. 221.6 days, respectively). A mental health history did not affect outcomes. Smokers age 55 or older had higher quit rates during the pandemic than younger smokers (61% vs. 41%), and no differences were found between in-person and telematic interventions.

Conclusions: Smoking cessation rates were similar before and during the pandemic, regardless of mental health status, and the increased use of telematic visits could be considered after the pandemic era. Older age was only associated with abstinence during the pandemic, highlighting the need for research on improving outcomes in younger populations undergoing treatment during stressful times. Identifying modifiable variables associated with abstinence can help smoking cessation services implement strategies to prevent relapse.

Objective: The tobacco industry strives to keep product prices low by providing consumer-focused discounts (e.g., coupons) that can be applied at retail locations. Local communities have responded by prohibiting the distribution and/or redemption of coupons at retail locations, yet evidence that this policy diminishes product purchases and use intentions is lacking. The purpose of this experiment is to evaluate whether the elimination of price discounts from retail locations influences use intentions for smokeless tobacco, little cigars/cigarillos (LCCs), and electronic nicotine delivery devices (ENDS) in young adults.

Method: Participants were 298 college students recruited from the community. They participated in a simulated shopping task in the RAND StoreLab, a life-sized replica of a mid-sized convenience store. They were randomized into one of two conditions: price discounts present (store tobacco posters displayed price discount information) or price discounts absent (no price discount information displayed on posters). The dependent measure was postshopping intentions to use smokeless tobacco, LCCs, and ENDS.

Results: Exposure to the price-discounts-absent condition led to a lower susceptibility of using smokeless tobacco compared with exposure to the price-discounts-present condition (adjusted odds ratio [aOR] = 0.48, 95% CI [0.23, 0.98]). Experimental condition was not related to LCC use susceptibility (aOR = 1.46, 95% CI [0.70, 3.03]) or to ENDS use susceptibility (aOR = 0.89, 95% CI [0.40, 1.95]).

Conclusions: These results support eliminating tobacco discounts from retail locations, at least for reducing college students' desire to use some tobacco products.

Objective: Schools engaged in prevention efforts struggle to respond quickly and effectively to changing drug use trends due to insufficient investment in infrastructure at local, state, and national levels. This results in preventable morbidity and mortality among adolescents. This study estimated the costs associated with implementing Rapid Adaptation to Prevent Drug use (RAPD) infrastructure-building implementation strategies, using mixed methods to optimize data collection feasibility and quality and to support a comprehensive understanding of outcomes.

Method: We conducted semi-structured interviews in Step 1 (pre-pilot trial) to inform the initial cost data collection approach. In Step 2, we used activity-based costing, conducted a sensitivity analysis, and estimated the budget impacts of replication. Step 3 included interviews with pilot participants to contextualize the results and verify time reporting.

Results: Thirty-four school personnel participated in Step 1 interviews, and four health coordinators and six teachers participated in the pilot study. We identified cost drivers and pragmatic constraints related to effective time-cost data collection and developed an activity-based costing data collection plan. The estimated cost of deploying RAPD (Step 2) was $6,215/school. We estimated the budget impact of replication to be $5,551/school, with 52% of the cost incurred during the pre-implementation phase. In Step 3 interviews, participants identified financial and staffing resources as central challenges to infrastructure development.

Conclusions: This study used a mixed-methods approach, incorporating an exploratory sequential design, to proactively guide microcosting. By identifying potential barriers in advance, we enhanced the rigor and feasibility of the data collection process. This study provides preliminary cost estimates for deploying RAPD infrastructure-building strategies to address emerging drug trends and sustain prevention efforts.

Objective: Posters that advertise tobacco products in point-of-sale (POS) retail environments have a significant influence on youth smoking risk. This study experimentally examined how restricting poster coverage space in a retail POS setting affects young adults' future susceptibility to cigarette smoking.

Method: Young adult participants (N = 288) shopped in the RAND StoreLab (RSL), a life-sized replica of a convenience store, under one of two experimental conditions: (a) high-coverage poster space (the status quo, featuring 16 tobacco posters displayed as usual), and (b) low-coverage poster space, which halved the number of displayed posters. After shopping in the RSL, participants completed measures assessing their susceptibility to future smoking. Multivariable logistic regression was used to evaluate the effect of the experimental condition on the likelihood of future smoking susceptibility.

Results: Restricting poster coverage at POS was associated with a significant reduction in future susceptibility to cigarette smoking (adjusted odds ratio = 0.21, 95% confidence interval [0.05, 0.90], p = .035) among young adults with high breadth of exposure to cigarette advertising in the past month. Restricting poster coverage did not have an impact on young adults with low levels of past-month breadth of cigarette advertising exposure.

Conclusions: Reducing poster space at POS can effectively influence certain segments of the young adult population. These results suggest that policies aimed at decreasing smoking advertisements in retail environments may help reduce smoking intentions among young adults.

Objective: Young adults reporting high-intensity drinking (HID, 8+/10+ drinks for females/males) are more likely to experience negative alcohol consequences than those reporting heavy episodic drinking (HED; 4+/5+ drinks for females/males). Identifying for whom and when HID is associated with same-day negative (and positive) consequences may inform intervention approaches. We hypothesized that negative consequences would be more likely on HID vs HED days, and when HID levels were reached more quickly.

Methods: Young adults reporting prior HID (N=203, 57% female) completed a 28-day ecological momentary assessment of alcohol use and consequences. Generalized hierarchical linear modeling was used to test hypothesized effects. Analyses also explored the odds of each unique negative (e.g., hangover) and positive (e.g., improved mood) consequence.

Results: HID (vs HED) was related to more same-day negative consequences. In exploratory analyses, HID was associated with increased odds of being rude/obnoxious, hurting/injuring oneself, feeling too drunk, nausea, vomiting, sleeping worse, hangover, and memory loss. HID (vs HED) was also related to more same-day positive consequences. In exploratory analyses, HID was associated with increased odds of expressing feelings more easily, feeling more energetic, improved mood, being more sociable, desirable level of intoxication, laughing with others, and a fun/exciting time. Drinking duration was not significantly related to consequences on HID days.

Conclusion: Same-day positive consequences resulting from HID may help explain why this risky behavior recurs, despite negative consequences. From a prevention and intervention perspective, healthcare providers and clinicians are strongly encouraged to prioritize alcohol interventions for young adults reporting 8-10 drinks per occasion.