Journal of studies on alcohol and drugs最新文献

Objective: Little is known about the consequences of substance-related advertising on driving under the influence of alcohol (DUIA) or cannabis (DUIC). This study seeks to estimate associations between substance-related digital advertising exposures and DUIA and DUIC in a sample of young adults.

Method: The Rhode Island Young Adult Survey 2022 was a cross-sectional web-based survey of 1,022 adults ages 18-25 years. Analyses were conducted among lifetime alcohol users (n = 824) and lifetime cannabis users (n = 471). Prevalence of past-30-day digital ad exposure to alcohol and cannabis was assessed, as well as the prevalence of past-month DUIA and DUIC. Multivariable logistic regressions examined the association between digital ad exposure and substance use among lifetime users, and ad exposure and DUI among current users.

Results: In all, 54.4% of participants reported past-30-day exposure to digital alcohol advertising, and 33.5% reported exposure to digital cannabis advertising. Exposure to social media alcohol advertising was associated with higher odds of DUIA after adjustment for sociodemographic variables (odds ratio [95% CI] = 2.14 [1.07, 4.28]) but not after accounting for frequency of use. Odds of DUIC remained significantly higher for those exposed to app-based cannabis advertising after adjusting for sociodemographic variables (odds ratio [95% CI] = 4.36 [1.76, 10.8]) and frequency of use (odds ratio [95% CI] = 3.96 [1.53, 10.2]).

Conclusions: Since social media alcohol ad exposure may be indirectly linked with DUIA, and app-based cannabis ad exposure may be directly linked to frequency of use and DUIC, legislators should consider comprehensive substance-related ad regulations and bans.

Objective: Most research on alcohol control policies in the United States has focused on the state level. In this study, we assessed both local and state policy prevalence and restrictiveness in a nationwide sample of cities.

Method: We conducted original legal research to assess prevalence of local-level policies across 374 cities (48 states) in 2019 for the following seven policy areas: (a) drink specials; (b) beverage service training; (c) minimum age for on-premise servers and bartenders; (d) minimum age for off-premise sellers; (e) prohibitions against hosting underage drinking parties (i.e., social host provisions); (f) bans on off-premise Sunday sales; and (g) keg registration. We obtained parallel state-level policies from the Alcohol Policy Information System. We assessed the restrictiveness of existing policies and how these compared across local and state levels.

Results: We found that for six of the seven policy areas, the majority of cities (53% to 83%) had only a state-level policy. Few cities (0% to 8% across policy areas) had only a local-level policy. The percentage of cities that had an alcohol policy at both the local and state levels ranged from less than 1% to 19% across policy areas, and the policies were mostly equally restrictive at both levels.

Conclusions: The lack of local policies may point to areas where these localities could strengthen their alcohol policy environments. Additional research is needed to understand how the prevalence and restrictiveness of local and state policies are associated with public health harms such as traffic crashes.

Objective: Many young adults report frequent cannabis use and are at risk for cannabis harms. Knowledge of the tetrahydrocannabinol (THC) and cannabidiol (CBD) concentrations of cannabis products may promote harm reduction, but few studies have characterized cannabinoid concentration knowledge in this population. This study used day-level data to examine predictors of cannabinoid concentration knowledge and associations of cannabinoid concentration knowledge with substance-related consequences among young adults.

Method: Participants (n = 131; mean age = 22.11 years; 64.12% female) from a larger study of cannabis and alcohol co-use completed daily surveys over 21 days assessing knowledge of the cannabinoid concentrations of cannabis used, forms of cannabis used, motives for cannabis use (medicinal, nonmedicinal, both), and substance-related consequences.

Results: On average, participants reported at least some knowledge of the THC and CBD concentrations of their cannabis on 48% and 32% of their cannabis use days, respectively. Generalized linear mixed models revealed that participants with a greater propensity to use nonflower (relative to flower) cannabis products and to report medicinal (relative to exclusively nonmedicinal) motives for cannabis use reported greater cannabinoid concentration knowledge overall across days, controlling for sociodemographic factors and level of cannabis involvement. Participants with greater overall cannabinoid concentration knowledge reported positive substance-related consequences more often. In addition, participants were more likely to report negative substance-related consequences on days during which cannabinoid concentrations were known versus unknown.

Conclusions: Findings suggest that cannabinoid concentration knowledge may be higher among young adults who report primarily nonflower and medicinally motivated cannabis use, although cannabinoid concentration knowledge, alone, may not protect against negative substance-related consequences at the day level.

Objective: Victims of sexual violence experience detrimental physical and mental health consequences. Therefore, developing programs to prevent sexual violence is of utmost importance. Our previous work provided preliminary support for the efficacy of brief mindfulness and cognitive restructuring (CR) interventions in reducing sexual violence intentions. Because alcohol use and alcohol expectancies (AE) have been identified as risk factors for sexual violence, this secondary data analysis aimed to examine whether alcohol use and men's expectations that alcohol may affect women's vulnerability of being sexually coerced moderate the usefulness of these two interventions on nonconsensual sex intentions.

Method: Single, young, heterosexual, heavy episodic drinking men with sexual violence histories were randomly assigned to receive mindfulness or CR skills training, or attention control. Half of the participants in each intervention condition were then randomized to alcohol or sober conditions. All participants read a hypothetical sexual scenario and rated their intention to engage in nonconsensual sex with their hypothetical sexual partner.

Results: Mindfulness was effective in lowering nonconsensual sex intentions among sober men with high AE for women's vulnerability and intoxicated men with low AE for women's vulnerability to sexual coercion. CR was effective in lowering nonconsensual sex intentions among intoxicated men with low and moderate AE for women's vulnerability to sexual coercion.

Conclusions: Our results provide preliminary evidence for the efficacy of mindfulness and CR in lowering nonconsensual sex intentions under certain circumstances and highlight men's AE about women's vulnerability to sexual coercion as a critical factor that interacts with alcohol use to influence the efficacy of mindfulness and CR.

Objective: The relationship between mental health and substance use among military populations is well established, and evidence suggests that these risks may be greater for those who have left the military. However, it is less clear what independent effects leaving the military may have on substance use behaviors. This study examined the longitudinal relationship between leaving the military and substance use outcomes (hazardous drinking, frequent heavy drinking, nonmedical use of prescription drugs, illicit drug use) in a cohort of Reserve and National Guard (R/NG) soldiers. Further, we examined whether mental health symptoms moderate the relationship between leaving the military and substance use.

Method: Analyses used data (N = 485 soldiers) from the first four annual waves of Operation: SAFETY, an ongoing prospective cohort study of U.S. Army R/NG soldiers and their spouses. We used generalized estimating equations (GEEs) to examine the relationships between military status (former vs. current soldier) and substance use outcomes over 4 years. Last, we examined interactions between military status and mental health indicators (anxiety, anger, depression, and posttraumatic stress disorder) on substance use over time.

Results: After we controlled for sex, age, race, years of military service, sleep problems, bodily pain, and substance use norms, being a former soldier, compared with being a current soldier, was associated with greater odds of current illicit drug use (adjusted odds ratio = 2.86, 95% CI [1.47, 5.57]; p < .01). Mental health symptomatology did not moderate the relationship between leaving the military and current drug use.

Conclusions: Leaving the military in and of itself may result in increased drug use for some individuals, regardless of mental health symptomatology.

Objective: Assumptions about alcohol's health benefits profoundly influence global disease burden estimates and drinking guidelines. Using theory and evidence, we identify and test study characteristics that may bias estimates of all-cause mortality risk associated with low-volume drinking.

Method: We identified 107 longitudinal studies by systematic review with 724 estimates of the association between alcohol consumption and all-cause mortality for 4,838,825 participants with 425,564 recorded deaths. "Higher-quality" studies had a mean cohort age of 55 years or younger, followed up beyond 55 years, and excluded former and occasional drinkers from abstainer reference groups. "Low-volume" alcohol use was defined as between one drink per week (>1.30 g ethanol/day) and two drinks per day (<25 g ethanol/ day). Mixed linear regression was used to model relative risks (RRs) of mortality for subgroups of higher- versus lower-quality studies.

Results: As predicted, studies with younger cohorts and separating former and occasional drinkers from abstainers estimated similar mortality risk for low-volume drinkers (RR = 0.98, 95% CI [0.87, 1.11]) as abstainers. Studies not meeting these quality criteria estimated significantly lower risk for low-volume drinkers (RR = 0.84, [0.79, 0.89]). In exploratory analyses, studies controlling for smoking and/or socioeconomic status had significantly reduced mortality risks for low-volume drinkers. However, mean RR estimates for low-volume drinkers in nonsmoking cohorts were above 1.0 (RR = 1.16, [0.91, 1.41]).

Conclusions: Studies with lifetime selection biases may create misleading positive health associations. These biases pervade the field of alcohol epidemiology and can confuse communications about health risks. Future research should investigate whether smoking status mediates, moderates, or confounds alcohol-mortality risk relationships.

Objective: Neighborhood characteristics have been shown to influence lifestyle behaviors. Here we characterized alcohol outlet density in Los Angeles County, CA, and Hawaii and assessed the association of alcohol outlet density with self-reported alcohol intake in the Multiethnic Cohort.

Method: Participants (n = 178,977) had their addresses geocoded at cohort entry (1993-1996) and appended to block group-level alcohol outlet densities (on- and off-premises). Multinomial logistic regression was performed to assess the association between self-reported alcohol intake and on- and off-premise alcohol outlet densities by each state. Stratified analysis was conducted by sex, race, and ethnicity.

Results: Overall, we did not find associations between alcohol outlet density and self-reported alcohol intake in Los Angeles County, but we found that on-premise alcohol outlets were associated with 59% (odds ratio [OR] = 1.59, 95% CI [1.29, 1.96]) increased odds of consuming more than two drinks per day in Hawaii. Women living in neighborhoods with a high density of on-premise alcohol outlets (Los Angeles County: OR = 1.15, 95% CI [0.95, 1.40]; Hawaii: OR = 2.07, 95% CI [1.43, 3.01]) had an increased odds of more than two drinks per day.

Conclusions: This study suggests that neighborhood factors are associated with individual-level behaviors and that multilevel interventions may be needed.

Objective: The current study used U.S. national data to examine trends in cannabis use from 2013 to 2021, focusing on changes in cannabis prevalence during young and middle adulthood and whether trends differed by sociodemographic characteristics.

Method: Data from 2013 to 2021 from 21,182 respondents ages 19-30 and 29,871 ages 35-55 in the national Monitoring the Future panel study (followed since they were in 12th grade in 1976-2020) were used to model historical trends in cannabis prevalence (any 12-month use, any 30-day use, and near-daily use [≥20 occasions in the past 30 days]).

Results: Prevalence of 12-month, 30-day, and near-daily cannabis use significantly increased from 2013 to 2021 for both young and middle adults. Trends for all three behaviors indicated either consistent linear increases or two-slope increases in which the slope estimate was larger in more recent years. Historical increases in 12-month and 30-day use were similar for young and middle adulthood; the historical increase in near-daily use among middle adults had some evidence for a possible pandemic-related deviation. Historical trends did not differ by race/ethnicity or college degree. Trends for 12-month and 30-day use differed by sex, with women increasing more than men over time, especially during middle adulthood.

Conclusions: Significant increases in the prevalence of cannabis use have occurred over the past decade for young and middle adults across sociodemographic groups, with some indication that near-daily use increased among middle adults at the onset of the pandemic. Although men continue to have a higher prevalence than women, the gap has narrowed, with greater increases in cannabis use among women.