Substance Use & Misuse最新文献

Objectives: This study investigates the prevalence of exposure to pro- and anti-tobacco advertisements across different sociodemographic groups and sources of exposure in the United States.

Methods: The study included 6252 participants from the Health Information National Trends Survey. Binary logistic regression was used to examine associations between exposure to pro and anti-tobacco advertisements, the sources of exposure, and demographic factors.

Results: 10% of our sample were current smokers. A rate of 48.14% reported exposure to pro-tobacco ads, and 61.28% reported exposure to anti-tobacco ads. Findings reveal notable disparities in exposure to both pro and anti-tobacco advertisements. Exposure to pro-tobacco ads was more common among current smokers (OR = 0.53 (95% CI 0.44-0.64), p < 0.001), male participants (female: OR = 0.85 (95% CI 0.77-0.95), p = 0.003), and younger adults. Reported exposure to anti-tobacco ads was more common among younger adults, individuals with lower levels of education and income, and current smokers. Radio, TV, and billboards were among the most common sources of ad exposure for both types. Stores were among the most common sources of exposure to pro-tobacco ads (stores: 35.58% (18-34), 39.58% (35-49), and online sources (21.71%) were among the sources where people encountered anti-tobacco messages most frequently.

Conclusions: The findings underscore the importance of understanding the changing media consumption patterns and advertising awareness across various demographic groups. They also highlight the urgent need for targeted tobacco prevention interventions, especially via Radio, TV, billboards, and stores, particularly among younger adults, racial minorities, and current smokers who show higher exposure to pro-tobacco ads.

Background: Drinking prototypes (i.e., images of the type of individual who engages in specific alcohol use behaviors) are associated with alcohol use, with self-identified similarity to the prototype possibly driving this connection more than one's favorability of the prototype. Alcohol-related content (ARC; posts featuring alcohol or drinking) posting prototype favorability is also associated with ARC posting and drinking. However, the effects of ARC posting prototype similarity on posting or drinking behavior are unexamined. Prior research suggests specificity of antecedents (e.g., attitudes, prototypes) matters in predicting subsequent behavior. The current study examined which types of prototype similarity (e.g., drinking, ARC posting) are most strongly associated with later ARC posting and drinking behavior, respectively. Methods: Adolescents and young adults who reported alcohol use (N = 274) were recruited to complete two online surveys at baseline and 1-month later. Results: Controlling for abstaining, heavy episodic drinking (HED), and ARC posting prototype similarity, only greater baseline ARC posting prototype similarity was associated with posting ARC 1-month later. Zero-inflated negative binomial regressions revealed greater abstaining prototype similarity was associated with lower drinking frequency 1-month later. Higher HED prototype similarity was associated with likely drinking on at least one day in the past month (i.e., drinking frequency). Higher ARC posting prototype similarity was associated with likely reporting no negative alcohol consequences. Conclusions: Findings suggest that interventions targeting reductions in ARC posting should aim to change ARC posting prototype similarity whereas drinking prototype similarity should be highlighted in alcohol interventions.

Introduction: Waterpipe tobacco (WT) is unique compared to other tobacco products. Retailers and manufacturers may promote WT products using different marketing appeals and sales propositions on popular digital marketing media. This study examined WT digital marketing content in the United States (U.S.).

Methods: In 2020, a census of WT manufacturers that sold WT products in the U.S. was created and 33 WT manufacturers and 30 WT retailers across the U.S. were identified. Business websites and the 20 most recent Facebook and Instagram posts from identified manufacturers and retailers were recorded. Marketing appeals were coded for themes including sexuality and romance, U.S. patriotism, Middle Eastern culture, WT smoking cues, health or safety, and enjoyable experiences. Sale proposition content was also coded and included price promotions, scarcity, and free products.

Results: Digital marketing content posts (n = 1,520) were recorded, including 70 webpages (primary and secondary pages), 770 Instagram posts, and 680 Facebook posts. Most content (91.0%) included at least one examined marketing appeal, including smoking cues (54.3% of all marketing content), Middle Eastern culture (29.1%), enjoyable experiences (22.4%), and sexuality and romance (19.7%). At least one sales proposition was used in 28.6% of all marketing content. The most commonly used sales proposition was a financial incentive, which was included in 11.8% marketing content.

Conclusions: Manufacturers and retailers in the U.S. use a variety of digital marketing strategies to promote WT products. Research is needed examine the impact of WT digital marketing on consumer perceptions, particularly among youth and young adults who are at greatest risk for WT smoking.

Background: It has been seven years since Poland legalized medical cannabis. Doctors in Poland are allowed to prescribe medical cannabis, which can be then obtained via pharmacies. However, no evaluation has been produced to explore what this policy has achieved.

Method: This article uses online surveys (N = 571) and qualitative interviews to explore what Polish cannabis users think of the current system.

Results: Most users - medical and recreational - think that it is currently easy to obtain a prescription for medical cannabis in Poland, and medical cannabis from a pharmacy. The users seem to have a clear preference for cannabis clinics as a source of prescriptions for medical cannabis over traditional doctors. Doctors in cannabis clinics seem much more inclined to prescribe medical cannabis. Many respondents, however, agree that the current system remains too expensive, and many users also raise concerns about the quality of cannabis available from pharmacies and strain variation.

Conclusion: This article shows the emergence of a unique drug policy/model. The access to medical cannabis has improved significantly since the early stages of the policy. Notably - contrary to the wishes of the policymakers who wanted to create a "strict" medical model with the use of pharmacies, both - medical and recreational users seem to be benefiting from the current system.

Background: Sleep disturbances (SDs) in childhood can negatively impact behavioral and emotional control, which can lead to an increase in risky behaviors, such as substance use, including alcohol.

Methods: Data from 2,132 subjects who participated in the French TEMPO cohort from 1991 to 2018 were used. Sleep disturbances observed from ages 3 to 16 years defined our exposure. Alcohol use in adulthood was measured by alcohol consumption trajectories ascertained by using Group-Based Trajectory Modeling (GBTM) and constitutes our outcomes. The association between sleep disturbances in childhood and alcohol consumption trajectories was studied using multinomial logistic regression.

Results: Sleep disturbances at ≤ 16 years were observed in 26.7% of participants. Three alcohol use trajectories were defined: "light-drinkers", "moderate-drinkers", and "heavy-drinkers". Accounting for many confounders, we found statistically significant associations between sleep disturbances and alcohol use trajectories. Using "light-drinkers" trajectory as reference, we found that compared to children with no sleep disturbances, those with sleep disturbances had a higher likelihood to be in the "moderate-drinkers" (ORa = 1.51; 95% CI = 1.09-2.10) and "heavy-drinkers" trajectory (ORa = 2.34; 95% CI = 1.27-4.34).

Conclusion: This study suggests that sleep disturbances in childhood are associated with an increased risk of higher alcohol consumption in adulthood and highlights the importance of healthy sleep, particularly in children and adolescents, to prevent the onset of certain risky behaviors.

Background: PTSD rates are higher among lesbian, gay, bisexual, and other sexual minority individuals (LGB+), compared to heterosexual individuals. PTSD also frequently co-occurs with substance use disorders (SUDs). However, little is known about comorbid PTSD-SUD among LGB+ individuals. Further research is important given elevated rates of PTSD and SUD among LGB+ individuals and to inform culturally responsive practice.

Objectives: This cross-sectional study examined trauma exposure, PTSD severity, and emotion regulation (ER) difficulties among LGB+ and heterosexual individuals in residential SUD treatment. We hypothesized that LGB+ individuals would report more trauma exposure and more severe PTSD and ER difficulties compared to heterosexual peers. We also hypothesized that adding ER difficulties to the hierarchical regression model would attenuate the contribution of sexual minority status to PTSD symptom severity.

Results: Cross-sectional data were collected via questionnaires from 132 adults receiving residential SUD treatment (M age = 39.79 [SD = 12.26] years; 35% women, 65% men; 49% White, 40% Black, 11% multiracial/another race). Eighteen percent of the sample identified as LGB+ (29% gay or lesbian, 63% bisexual, and 8% other), and 82% identified as heterosexual. Consistent with hypotheses, LGB+ participants reported larger numbers of traumatic events (p < 0.01) and more severe PTSD symptoms (p < 0.01) and ER difficulties (p < 0.05). Controlling for trauma exposure, the association between sexual minority status and PTSD symptom severity became non-significant after adding ER difficulties to the model.

Conclusion: This suggests that ER may play an important role in the relationship between sexual minority status and PTSD severity in individuals with SUD.

Background: Alcohol and pain frequently co-occur and interact in a positive feedback loop that maintains and exacerbates both conditions. The Expectancies for Alcohol Analgesia (EAA) is a recently developed, single-factor measure that assesses the extent to which individuals expect alcohol will reduce their pain. Alcohol-related outcome expectancies motivate drinking and predict drinking trajectories among emerging adults (18-24). The EAA was initially validated among adults with chronic pain who drink alcohol and has been associated with several indices of pain and alcohol. We are unaware of prior work that examined the psychometric properties of the EAA among emerging adults, who are at high-risk for developing positive expectancies regarding the utility of alcohol for pain management.

Objectives: The goal of this study was to examine the factor structure, reliability, and validity of the EAA among emerging adult college students.

Methods: Emerging adult college students who endorsed lifetime alcohol use and varying pain levels (N = 555, 74.4% Female, 75.2% White) completed an online survey of pain and alcohol use.

Results: Confirmatory factor analysis indicated the single-factor structure was a good fit (CFI = 0.99, TLI = 0.99, SRMR = 0.01, RMSEA = 0.04). Internal consistency was excellent (α = .95), and EAA scores were positively associated with alcohol consumption, alcohol-related consequences, drinking motives, and pain intensity and disability (ps < .01).

Conclusion: These findings suggest the EAA is a valid and reliable measure for assessing expectancies for alcohol analgesia among emerging adult college students, which may also be a promising intervention target to include in expectancy challenge interventions.

Objectives: To examine prevalence trends in the use of smoked tobacco products in 11 South American (SA) countries (i.e., Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Suriname, Uruguay, and Venezuela) and their association with country-specific socio-demographic index (SDI) over 30 years.

Data and methods: The estimates of SDI and smoked tobacco prevalence stratified by age, sex, and country were extracted from the Global Burden of Disease Study (1990-2019) on individuals aged 15+. The annual percentage changes (APCs) of trends in country-specific prevalence of smoked tobacco were evaluated using Joinpoint regression. Correlation analysis was also used to explore the association between country-specific prevalence of smoked tobacco and their SDIs, a measure of developmental status considering income per capita, educational attainment, and total fertility rate.

Results: While all SA countries showed an overall decline in smoked tobacco use prevalence between 1990 and 2019 (APCs between -0.52%-and -4.73%; p < 0.05), Bolivia and Ecuador showed a significant increasing trend (APCs of 0.34% and 0.20%). Country-specific SDI was strongly and significantly correlated (rs = -0.99 to -0.85) with smoking prevalence in SA countries, except for Ecuador and Bolivia (rs = 0.16 and 0.36, respectively).

Conclusion: In recent decades, most SA countries have experienced a significant reduction in the prevalence of smoked tobacco use, except Ecuador and Bolivia, where smoking rates have risen, showing a direct correlation with SDI. These findings can contribute to the design and implementation of strategies and policies for tobacco prevention and control in the SA region especially within the two affected countries - Ecuador and Bolivia.

Background: Xylazine is in 99% of the fentanyl supply in Philadelphia, PA and is on the rise throughout the United States. Perspectives about this emerging crisis among people who use opioids (PWUO) and harm reduction workers are lacking.

Methods: We conducted focus groups with PWUO and harm reduction workers in Philadelphia, PA. Discussions focused on xylazine's impact on PWUO. Transcripts were coded for thematic analysis.

Results: Themes across focus groups included xylazine withdrawal, wounds, safety concerns, and overdose response implications. Participants emphasized extreme xylazine withdrawal and the difficulty of withdrawal management. Groups explored potential roles of first responders in addressing xylazine-related wounds. PWUO were receptive to receiving help, but many harm reduction workers expressed reservations about partnering with police.

Discussion: Results underscore the impact of xylazine withdrawal on PWUO. Emerging information on withdrawal management should be shared among care providers to identify optimal protocols. Safety-planning with PWUO should be explored, but structural interventions are imperative. While there may be a role for first responders in delivering harm reduction interventions, it is important to recognize historical harms by first responders against PWUO.

Objective: Understanding factors associated with early onset of substance use is critical as using alcohol or drugs at a young age is a strong predictor of later substance dependency. Experiencing stressful life events is associated with increased risk for early substance use in youth. Hair cortisol concentration (HCC) is considered a biomarker of psychological stress experienced over longer periods of time. We examined whether HCC could predict early substance use engagement in youth followed over 5 years.

Methods: Participants were 395 young adolescents (50% female, age range 10-15 years, M_age = 12.3, SD = 1.1 at baseline). Demographic data, socioeconomic factors, and substance use habits were collected at four waves between 2015 and 2021. HCC was assayed from hair collected at a home visit between Wave 1 and Wave 2. Analytic models tested a) HCC in relation to latent class membership of substance use and b) whether HCC moderated the relation between self-reports of stress and substance use.

Results: HCC did not add to the prediction of early substance use engagement in any of the models, while self-reports of stressful life events and everyday discrimination predicted early substance use engagement in the models comparing 'Early' vs 'Late/No' substance use class membership.

Conclusion: We found no evidence of HCC to be associated with early substance use engagement in youth. Nevertheless, our results do confirm that self-reports of stressful everyday life experiences predict earlier substance use engagement, underscoring the role of psychosocial stressors as significant predictors of substance use engagement in youth.