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In recent years, studies have highlighted the upward trend in electronic cigarette use among adolescents, as well as the potential of e-cigarette use to lead to subsequent conventional cigarette use. The study's aims were two-fold: 1) to examine the progression from e-cigarette use to conventional cigarette use; and 2) to analyze the differences in the severity of smoking pattern among dual users (i.e., e-cigarette and conventional cigarette use), cigarette-only smokers, and e-cigarette-only users in a Spanish adolescent population. Data were obtained from the ESTUDES, a representative survey of addictive behaviors of Spanish adolescents aged 14-18, which was comprised of 38,010 adolescents (Mage = 15.69; SD = 1.19; 51.35% females). Results indicate that lifetime e-cigarette use increased the prevalence of subsequent conventional cigarette use by 1.86 times (95% CI 1.74, 1.99), and the prevalence of conventional cigarette use in the last month by 2.38 times (95% CI 2.19, 2.58), independently of whether the e-cigarette contains nicotine or not. Dual users showed a higher percentage of daily smokers, and a greater number of cigarettes per day, a higher use of e-cigarettes with nicotine, and an earlier age of smoking onset. Regarding risk perception, e-cigarette-only users perceived both conventional tobacco and e-cigarettes as less harmful (all p-values < .001). These findings document the strength of association between e-cigarette and conventional cigarettes, and underscore the importance of developing legal restrictions and prevention strategies aimed at reducing e-cigarette use, which in turn would reduce tobacco use.

Microelimination strategies for the hepatitis C virus (HCV) in vulnerable populations, such as users of Addiction Centres (AC), are key for the elimination of hepatitis C. The aim of the HepCelentes project was to design a certification program for AC from the generation of a guide with the criteria to favour the prevention, diagnosis, control, and treatment of HCV in Spain. The project was structured in 4 phases: normalisation, implementation, certification, and communication. In the first phase, developed between July and December 2020, a Steering Committee was created (formed by representatives of scientific societies, healthcare professionals from AC, primary care centres and hospital units, and patient associations) that, from of an exhaustive bibliographic review, generated by consensus an accreditation guide for AC. The guide consists of 22 criteria (15 mandatory and 7 recommended) structured based on the requirements to be met by AC, justification for the selection, level of action (management, prevention, diagnosis and treatment/follow-up), measurement of the indicator, objective level to be achieved, evidence of compliance, clarifications to improve understanding, and mandatory / recommendation (depending on their relevance to achieve HCV elimination and its feasibility for implementation in real practice). The development of a certification system for the AC, based on consensus and coordination of multidisciplinary teams, is intended to favour the management of hepatitis C and its elimination in AC users, supporting the international, national, and regional elimination strategies.

Problematic Gambling or Gambling Disorder (GD) can act by initiating and maintaining the problem of substance addiction. Despite this, there are no rapid screening tools validated in Spanish. The Brief Problem Gambling Screen (BPGS) has proven to be one of the most sensitive tools for detecting GD and populations at risk. This study aims to validate the Spanish version of the original five-item BPGS. A sample of 100 Spanish-speaking adults with substance use disorder were recruited from an addiction treatment center. The participants were administered the Spanish version of BPGS. It showed strong item reliability properties (Ω = 0.93). Sensitivity and specificity values were excellent (0.93 each), also positive (0.7) and negative (0.99) predictive values suggest high discriminant power when compared to non-GD subjects. Statistically significant strong correlation with a gold-standard measure (Problem Gambling Severity Index) was found (r = 0.8, p < 0.01). Similar psychometric properties were found in at-risk gambler patients. In conclusion, the BPGS seems to be an adequate screening instrument in Spanish-speaking clinical population, and also identifies at-risk of GD subjects.

The maintenance of premature mortality among opioid users is a highly significant public health issue. The main objective is to study the causes and age of mortality recorded in the population of opiate addicts (n = 1,998) treated at the Cangas Drug Addiction Assistance Unit (Pontevedra) over more than 30 years. The causes of mortality are classified into 4 groups: overdose, disease, suicide and trauma. The average age of mortality of the patients is compared with that of the general population residing in the same health area. Throughout the study, the premature mortality of these patients remained high, although with a tendency to decrease over time: up to 1998, the mean age of death was 31.8 years compared to 47.7 years since 1998. The mean age of death was always lower than that of the general population. Disease is the most prevalent cause of mortality (84% of the deceased) with a great difference compared to the other 3 groups. Despite the reduction in infections associated with parenteral use, there are still factors associated with an unhealthy lifestyle that, together with the aging of this population, explain to a large extent why the average age of death of these patients is not equal to that of the general population, which seems to force us to review the objectives of health and social intervention.

The goal of this study is to understand the relationship between the problematic use of WhatsApp among young adolescents and parental mediation. The rise of mobile phone use among young people is a cause for concern, especially among parents themselves. The literature suggests that parents have a certain amount of room for maneuver through different parental strategies (parental mediation) to maximize the benefits of technology and reduce its possible risks, although this has not been sufficiently analyzed in the case of problematic use of the mobile phone and its applications. This study therefore examined three different parental mediation strategies (restrictive, modeling and stimulation) and their possible impact on the problematic use of WhatsApp. The sample comprised 1,144 13- and 14-year-old students during three academic years (2015-2018) in 17 schools in 7 Spanish provinces. One of the novelties of the study was the use of adolescent voices to understand the parental mediation of their parents. The results showed a direct relationship between the level of restrictive mediation and a problematic use of WhatsApp. In addition, the number of mobile phones that students have enjoyed, as well as whether parents use their mobile phone during dinner, also has a positive relationship with the problematic use of WhatsApp. These results are useful for understanding a responsible use of the mobile phone, as well as to guide parents about the problematic use of WhatsApp among adolescents.

Chemsex is defined as use of psychoactive drugs with the aim of having sexual relations between gay men, bisexuals and men who have sex with men for a long period of time. To study this phenomenon, this qualitative descriptive study was proposed with the objective of describing the practice of chemsex from the perspective of users, to determine the main factors associated with its practice, the perception of the impact on their health and to establish prevention needs. Data were obtained using conversational techniques: 12 semi-structured interviews and 3 focus groups. The purposive sample was made up of GBMSM with a mean age of 40.1 years, 78% born in Spain, and 68% with completed university studies. The qualitative analysis focused on three thematic areas: factors associated with the practice of chemsex, the impact of chemsex on health, and prevention and risk reduction needs. It is concluded that the practice of chemsex should be understood as multifactorial and multicausal, associated with the sociocultural context. Sexual satisfaction, increased libido and the search for more intense pleasure are identified as key factors among people who practice it. These men are still scared of being judged, even by specialists who may lack knowledge or training. A reanalysis and rethinking of the interventions and policies directed towards this population is necessary, putting the focus of action on shared decision-making, self-care, cultural competence and the humanization of care.

The objective was to estimate the prevalence of polydrug use of tobacco and cannabis and to see its relationship with self-perceived health and mood state in adolescents from Central Catalonia in the 2019-2020 academic year. A cross-sectional study was carried out with a sample of 7,319 students, who answered a self-administered questionnaire. The dependent variables were the polydrug use of tobacco and cannabis and polydrug use of tobacco and high-risk cannabis. The main independent variables were self-perceived health status and mood state. Frequencies and percentages were analyzed for the prevalence analysis, and the Chi-square test was used. Poisson regression models were adjusted with robust variance, obtaining Prevalence Ratios. The prevalence of polydrug use of tobacco and cannabis was 3.5% and polydrug use of tobacco and high-risk cannabis was 2.5%. In boys, attending higher academic courses (4th of ESO (aPR: 3.88; 95% CI: 2.14-7.05) vs. CFGM (aPR: 8.67; CI95%: 4.51-16.67), having worse self-perceived health (aPR: 4.79; CI95%: 3.24-7.08) and worse mood state (aPR: 1.47; CI95%: 1.05-2.08) act as factors associated with polydrug use of tobacco and cannabis. The results for girls, and risky use of cannabis follow a similar pattern. Among the main conclusions we observe is that there are no differences in self-perceived health and mood state when comparing polydrug use of tobacco and cannabis and polydrug use of tobacco and high-risk cannabis, so risk reduction strategies must be applied whether the use of cannabis is occasional or problematic.

Detailed knowledge of the epidemiology of alcohol consumption at the population level is essential to the design of effective public health programs. The objectives of this study were to estimate the prevalence of daily, sporadic, occasional, binge and hazardous alcohol consumption among the Galician population aged 16 years and over, and to characterize hazardous drinkers, taking into account the gender perspective. A cross-sectional study was conducted in 2017 among people aged over 15 years residing in Galicia in the framework of the Risk Behavior Information System (SICRI). In 2017, 7,841 adults were interviewed by stratified random sampling. Questions related to alcohol consumption in the last month were included and the prevalence of hazardous consumption was estimated using the AUDIT test. A multivariate logistic regression model was fitted to characterize hazardous drinkers. A total of 18.8% of the Galician population consumed alcohol daily and 3.4% had hazardous consumption. The prevalence of daily, occasional, sporadic, binge and hazardous drinking was higher among men and varied by age. The prevalence of daily-occasional and sporadic drinking was highest at middle age (45-64 years) and binge and hazardous drinking among those aged 16 to 24 years. The characteristics associated with hazardous drinking varied by gender, and are identified by common characteristics to both genders such as age or being a tobacco or cannabis smoker, and differential characteristics such as educational level. Typologies of consumption changed according to age and gender. Surveillance systems should regularly monitor alcohol consumption in order to adapt prevention measures to changes in drinking patterns.

The Covid19 pandemic has led to many publications about its influence on the treatment and evolution of individuals with a substance use disorder, leading to contradictory results. In this study, the adherence and abstinence rates of patients who started treatment in an Addictive Behavior Unit during the pandemic are analyzed, compared with others who attended the previous year and comparing those who were attended in person or by phone. The results indicate that during the Covid19 period, patients had greater adherence to treatment after one month of follow up and when attended to by phone. At 3 and 12 months, greater adherence was maintained, although it was not statistically significant. Regarding abstinence, the small sample size made it difficult to obtain significant differences. The conclusion is that, despite a quantitative decrease in the number of patients beginning drug treatment, in qualitative terms the pandemic led to greater adherence in the short and medium term. Telephone attention can play an important and positive role at this point, complementary to other resources and interventions.