Pub Date : 2026-01-06DOI: 10.1016/j.addbeh.2026.108603
Laura C. Chambers , Benjamin D. Hallowell , Andrew R. Zullo , McClaren Rodriguez , Marzan A. Khan , Justin Berk , Rachel Gaither , Macy Daly , Rachel S. Wightman , Francesca L. Beaudoin
Background
For patients who use fentanyl, higher than currently recommended maintenance doses of buprenorphine treatment for opioid use disorder (OUD) may be needed to prevent cravings and withdrawal, but some clinicians and regulators are concerned that higher doses may increase overdose risk. We evaluated buprenorphine effectiveness for overdose prevention in the fentanyl era.
Methods
We conducted a retrospective cohort study of Rhode Island residents initiating buprenorphine for OUD (October 2016‒September 2022) using statewide administrative data. On each of 365 follow-up days, patients were classified as having an active buprenorphine prescription (yes/no) and a non-fatal or fatal opioid overdose (yes/no). Follow-up was discontinued if patients died or initiated methadone or naltrexone. Generalized estimating equations compared opioid overdose risk for days with versus without an active buprenorphine prescription, controlling for potential confounders and clustering by patient.
Results
Among 8,676 patients initiating buprenorphine, most were aged 25–44 years (56.0 %) and male (61.3 %). In the 365 days following initiation, 52.6 % of person-days were covered by an active buprenorphine prescription, 1,069 patients (12.3 %) had follow-up discontinued due to methadone initiation, and 411 patients (4.7 %) experienced 545 opioid overdoses. Opioid overdose risk was 61 % lower for days with versus without an active buprenorphine prescription (adjusted risk ratio = 0.39, 95 % confidence interval = 0.31–0.49). Daily doses prescribed on days with and without an opioid overdose event were similar (P = 0.261).
Conclusions
Buprenorphine remains effective for overdose prevention in the fentanyl era among patients who remain in treatment. There was no evidence that higher doses were associated with greater overdose risk.
{"title":"Risk of opioid overdose during buprenorphine treatment for opioid use disorder in the fentanyl era","authors":"Laura C. Chambers , Benjamin D. Hallowell , Andrew R. Zullo , McClaren Rodriguez , Marzan A. Khan , Justin Berk , Rachel Gaither , Macy Daly , Rachel S. Wightman , Francesca L. Beaudoin","doi":"10.1016/j.addbeh.2026.108603","DOIUrl":"10.1016/j.addbeh.2026.108603","url":null,"abstract":"<div><h3>Background</h3><div>For patients who use fentanyl, higher than currently recommended maintenance doses of buprenorphine treatment for opioid use disorder (OUD) may be needed to prevent cravings and withdrawal, but some clinicians and regulators are concerned that higher doses may increase overdose risk. We evaluated buprenorphine effectiveness for overdose prevention in the fentanyl era.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of Rhode Island residents initiating buprenorphine for OUD (October 2016‒September 2022) using statewide administrative data. On each of 365 follow-up days, patients were classified as having an active buprenorphine prescription (yes/no) and a non-fatal or fatal opioid overdose (yes/no). Follow-up was discontinued if patients died or initiated methadone or naltrexone. Generalized estimating equations compared opioid overdose risk for days with versus without an active buprenorphine prescription, controlling for potential confounders and clustering by patient.</div></div><div><h3>Results</h3><div>Among 8,676 patients initiating buprenorphine, most were aged 25–44 years (56.0 %) and male (61.3 %). In the 365 days following initiation, 52.6 % of person-days were covered by an active buprenorphine prescription, 1,069 patients (12.3 %) had follow-up discontinued due to methadone initiation, and 411 patients (4.7 %) experienced 545 opioid overdoses. Opioid overdose risk was 61 % lower for days with versus without an active buprenorphine prescription (adjusted risk ratio = 0.39, 95 % confidence interval = 0.31–0.49). Daily doses prescribed on days with and without an opioid overdose event were similar (P = 0.261).</div></div><div><h3>Conclusions</h3><div>Buprenorphine remains effective for overdose prevention in the fentanyl era among patients who remain in treatment. There was no evidence that higher doses were associated with greater overdose risk.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108603"},"PeriodicalIF":3.6,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-06DOI: 10.1016/j.addbeh.2026.108594
Simon D’Aquino , Benjamin Riordan , Megan Cook , Sarah Callinan
Objective
Alcohol consumption patterns have been associated with long-term anxiety, but evidence on how these associations vary across population subgroups remains limited. This study examines longitudinal associations between alcohol consumption frequency and quantity and subsequent anxiety, and tests whether these relationships were moderated by sex, age, and income level.
Methods
Participants were from a nationally representative sample of Australian adults (N = 21,405) from the Household, Income, and Labour Dynamics in Australia (HILDA) survey between 2006 and 2021. Linear mixed-effects models predicted anxiety based on alcohol consumption one-year prior up to eight times per participant. Moderation by sex (male, female), age-group (18–25, 26–37, 38–50, 51 + years), and income quartile were examined. Anxiety was measured using the Kessler-10 anxiety subscale and alcohol consumption was measured using self-reported alcohol consumption frequency (alcohol consumption occasions per week) and alcohol consumption quantity (standard drinks consumed on alcohol consumption occasions).
Results
An adjusted model demonstrated a small effect of frequency (IRR[95 % CI] = 0.98[0.98, 0.99]) and quantity (IRR[95 % CI] = 1.02[1.01, 1.03]) on anxiety one-year later. Age, but not sex nor income, moderated the relationship between alcohol consumption and anxiety. Specifically, frequency was associated with slightly lower longitudinal anxiety for 51 + year-olds (β[95 % CI] = -0.04[-0.05, −0.03]), but showed no association for 18–50-year-olds. Conversely, quantity was associated with slightly greater longitudinal anxiety for 51 + year-olds (β[95 % CI] = 0.03[.02, 0.05]) and 26–50-year-olds (β[95 % CI] = 0.02[.01, 0.03]), but not 18–25-year-olds.
Conclusions
While the impact of alcohol consumption on anxiety appears very small, divergent relationships of drinking frequency versus quantity on long-term anxiety seem to emerge across the lifespan. Drinking larger amounts per occasion appears associated with slight increases in anxiety from early adulthood, while drinking more frequently but in smaller amounts appears associated with slight decreases in anxiety in older adulthood.
{"title":"Alcohol consumption patterns and Long-Term Anxiety: The influence of Sex, Age, and income","authors":"Simon D’Aquino , Benjamin Riordan , Megan Cook , Sarah Callinan","doi":"10.1016/j.addbeh.2026.108594","DOIUrl":"10.1016/j.addbeh.2026.108594","url":null,"abstract":"<div><h3>Objective</h3><div>Alcohol consumption patterns have been associated with long-term anxiety, but evidence on how these associations vary across population subgroups remains limited. This study examines longitudinal associations between alcohol consumption frequency and quantity and subsequent anxiety, and tests whether these relationships were moderated by sex, age, and income level.</div></div><div><h3>Methods</h3><div>Participants were from a nationally representative sample of Australian adults (<em>N</em> = 21,405) from the Household, Income, and Labour Dynamics in Australia (HILDA) survey between 2006 and 2021. Linear mixed-effects models predicted anxiety based on alcohol consumption one-year prior up to eight times per participant. Moderation by sex (male, female), age-group (18–25, 26–37, 38–50, 51 + years), and income quartile were examined. Anxiety was measured using the Kessler-10 anxiety subscale and alcohol consumption was measured using self-reported alcohol consumption frequency (alcohol consumption occasions per week) and alcohol consumption quantity (standard drinks consumed on alcohol consumption occasions).</div></div><div><h3>Results</h3><div>An adjusted model demonstrated a small effect of frequency (IRR[95 % CI] = 0.98[0.98, 0.99]) and quantity (IRR[95 % CI] = 1.02[1.01, 1.03]) on anxiety one-year later. Age, but not sex nor income, moderated the relationship between alcohol consumption and anxiety. Specifically, frequency was associated with slightly lower longitudinal anxiety for 51 + year-olds (β[95 % CI] = -0.04[-0.05, −0.03]), but showed no association for 18–50-year-olds. Conversely, quantity was associated with slightly greater longitudinal anxiety for 51 + year-olds (β[95 % CI] = 0.03[.02, 0.05]) and 26–50-year-olds (β[95 % CI] = 0.02[.01, 0.03]), but not 18–25-year-olds.</div></div><div><h3>Conclusions</h3><div>While the impact of alcohol consumption on anxiety appears very small, divergent relationships of drinking frequency versus quantity on long-term anxiety seem to emerge across the lifespan. Drinking larger amounts per occasion appears associated with slight increases in anxiety from early adulthood, while drinking more frequently but in smaller amounts appears associated with slight decreases in anxiety in older adulthood.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108594"},"PeriodicalIF":3.6,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-03DOI: 10.1016/j.addbeh.2026.108595
Laurel P. Gibson , Michael J. Parks , Heather L. Kimmel , Carlos Blanco , Joseph T. Ciccolo , MeLisa R. Creamer , Colm Everard , Neal D. Freedman , Melissa Garcia , John H. Kingsbury , Youn Ok Lee , Daniela Marshall , Wilson M. Compton , Annette Kaufman
Given recent increases in cannabis and tobacco co-use, alongside the rapidly evolving cannabis and tobacco use landscapes in the United States (US), updated national estimates of current co-use that account for route of administration are needed. Using data from Wave 7 (2022/2023) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study (N = 39,947), this study estimates the prevalence of current co-use among US youth and adults aged 12 years and older and examines the specific routes (e.g., combustible, vaping, oral) through which individuals co-use both substances. Data were weighted to produce representative estimates. An estimated 8.2 % of US youth and adults reported current (past 30-day) co-use between 2022 and 2023. Co-use of combustible tobacco and combustible cannabis products was the most common form of co-use, accounting for nearly one third of all co-using individuals. Co-use involving combustible tobacco and combustible cannabis was most common among co-using individuals aged 25–39 and 40+, while co-use involving nicotine vaping was most common among those aged 12–24. Use of multiple tobacco and/or cannabis administration routes was also common. These findings provide the first nationally representative estimates of co-use that account for specific administration routes for both tobacco and cannabis. Findings highlight the need for surveillance and intervention strategies that account for the full range of tobacco and cannabis administration routes available today.
{"title":"Tobacco and cannabis co-use by route of administration in the United States, 2022/2023","authors":"Laurel P. Gibson , Michael J. Parks , Heather L. Kimmel , Carlos Blanco , Joseph T. Ciccolo , MeLisa R. Creamer , Colm Everard , Neal D. Freedman , Melissa Garcia , John H. Kingsbury , Youn Ok Lee , Daniela Marshall , Wilson M. Compton , Annette Kaufman","doi":"10.1016/j.addbeh.2026.108595","DOIUrl":"10.1016/j.addbeh.2026.108595","url":null,"abstract":"<div><div>Given recent increases in cannabis and tobacco co-use, alongside the rapidly evolving cannabis and tobacco use landscapes in the United States (US), updated national estimates of current co-use that account for route of administration are needed. Using data from Wave 7 (2022/2023) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study (<em>N</em> = 39,947), this study estimates the prevalence of current co-use among US youth and adults aged 12 years and older and examines the specific routes (e.g., combustible, vaping, oral) through which individuals co-use both substances. Data were weighted to produce representative estimates. An estimated 8.2 % of US youth and adults reported current (past 30-day) co-use between 2022 and 2023. Co-use of combustible tobacco and combustible cannabis products was the most common form of co-use, accounting for nearly one third of all co-using individuals. Co-use involving combustible tobacco and combustible cannabis was most common among co-using individuals aged 25–39 and 40+, while co-use involving nicotine vaping was most common among those aged 12–24. Use of multiple tobacco and/or cannabis administration routes was also common. These findings provide the first nationally representative estimates of co-use that account for specific administration routes for both tobacco and cannabis. Findings highlight the need for surveillance and intervention strategies that account for the full range of tobacco and cannabis administration routes available today.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108595"},"PeriodicalIF":3.6,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.addbeh.2025.108591
Jennifer E. Merrill , Roselyn Peterson , Christian C. Garcia , Lindy K. Howe , Kate B. Carey , Nancy P. Barnett , Kristina M. Jackson , Mary Beth Miller
Background
Heavy episodic drinking (HED; 4 + [females]/5 + [males] drinks/occasion), high-intensity drinking (HID; 8 + [females]/10 + [males] drinks/occasion), and drinking events that are planned are all associated with negative consequences. Protective behavioral strategies (PBS) are techniques to minimize alcohol-related consequences. In this day-level study, we hypothesized (1) PBS use would be associated with safer same-day drinking (lower odds of HID and negative consequences), and (2) risks of HID and consequences associated with planned drinking would be reduced on days with higher PBS use. Additionally, (3) on HID days, having planned to engage in HID was hypothesized to relate to use of fewer PBS.
Method
Young adults (n = 203, 57 % female) completed a baseline assessment and 28-day ecological momentary assessment of drinking intentions, and number of drinks.
Results
In total, 2,467 drinking days were captured (52% planned, 27% HID). Using more PBS was associated with lower odds of HID (relative to HED but not moderate drinking), and fewer consequences, partially supporting our first hypothesis. PBS did not moderate effects of planned drinking on HID or negative consequence odds. On planned (vs unplanned) HID days, fewer PBS were used, supporting our third hypothesis.
Conclusion
Planning to drink is linked reliably to heavier drinking and negative consequences, but day-level associations between PBS and risky drinking are complex. PBS appear to have less impact on consequences when drinking is planned. When HID in particular is planned, fewer PBS are used. For days when HID is planned, real-time reminders of PBS may add value to intervention efforts.
{"title":"Protective behavioral strategies and planned drinking relate to high intensity drinking and consequences at the day level","authors":"Jennifer E. Merrill , Roselyn Peterson , Christian C. Garcia , Lindy K. Howe , Kate B. Carey , Nancy P. Barnett , Kristina M. Jackson , Mary Beth Miller","doi":"10.1016/j.addbeh.2025.108591","DOIUrl":"10.1016/j.addbeh.2025.108591","url":null,"abstract":"<div><h3>Background</h3><div>Heavy episodic drinking (HED; 4 + [females]/5 + [males] drinks/occasion), high-intensity drinking (HID; 8 + [females]/10 + [males] drinks/occasion), and drinking events that are planned are all associated with negative consequences. Protective behavioral strategies (PBS) are techniques to minimize alcohol-related consequences. In this day-level study, we hypothesized (1) PBS use would be associated with safer same-day drinking (lower odds of HID and negative consequences), and (2) risks of HID and consequences associated with planned drinking would be reduced on days with higher PBS use. Additionally, (3) on HID days, having planned to engage in HID was hypothesized to relate to use of fewer PBS.</div></div><div><h3>Method</h3><div>Young adults (<em>n</em> = 203, 57 % female) completed a baseline assessment and 28-day ecological momentary assessment of drinking intentions, and number of drinks.</div></div><div><h3>Results</h3><div>In total, 2,467 drinking days were captured (52% planned, 27% HID). Using more PBS was associated with lower odds of HID (relative to HED but not moderate drinking), and fewer consequences, partially supporting our first hypothesis. PBS did not moderate effects of planned drinking on HID or negative consequence odds. On planned (vs unplanned) HID days, fewer PBS were used, supporting our third hypothesis.</div></div><div><h3>Conclusion</h3><div>Planning to drink is linked reliably to heavier drinking and negative consequences, but day-level associations between PBS and risky drinking are complex. PBS appear to have less impact on consequences when drinking is planned. When HID in particular is planned, fewer PBS are used. For days when HID is planned, real-time reminders of PBS may add value to intervention efforts.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108591"},"PeriodicalIF":3.6,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-28DOI: 10.1016/j.addbeh.2025.108593
Jordan P. Davis , Shaddy K. Saba , Daniel Leightley , Eric R. Pedersen , John Prindle , Jonathan Cantor , Bistra Dilkina , Emily Dworkin , Angeles Sedano
Background and aims. Cannabis use is increasingly prevalent among U.S. veterans, with high rates of both recreational and problematic use. Veterans often use cannabis to manage symptoms associated with mental health problems such as depression and posttraumatic stress disorder (PTSD). Prior work has noted mixed results on the longitudinal associations between cannabis use and depression. Studying these associations at the daily level can lead to improved clarity. Design. The present study examined the daily associations between cannabis use and depression in veterans using dynamic structural equation modeling (DSEM). We also explored these associations for those veterans who screened positive for posttraumatic stress disorder (PTSD) compared to those who did not. Setting. All participants were recruited using advertisements from BuildClinical, an NIH approved recruitment vendor. Participants. The sample consisted of 74 veterans who provided daily data for 87 consecutive days. Measurement. Cannabis was assessed asking how many hours each individual spent high each day, depressed mood was assessed using a sliding scale from not depressed to very depressed each day, and PTSD was assessed using the PTSD checklist. Findings. Among the full veteran sample results revealed a bidirectional, negative, association. Specifically, on days when veterans reported greater depression, they reported fewer hours “high” the next day. Conversely, on days when veterans reported a greater number of hours high, they reported less depression the next day. Among veterans screening positive for PTSD, on days when they reported more depression, they reported fewer hours high the next day (no association was noted for cannabis use predicting depression). However, for those who did not screen positive for PTSD, on days when veterans reported greater number of hours high, they reported less depression the next day. Conclusions. These results highlight the need for further research on the effect of individual differences in cannabis use patterns among veterans with PTSD on health outcomes. Clinically, these results highlight the importance of targeting the pros and cons of cannabis use for depression symptom relief. Future research should incorporate daily objective measures of cannabis use to refine treatment strategies for veterans managing PTSD or depressive related distress.
{"title":"More high, less low? PTSD and the complex daily associations between cannabis use and depression in veterans","authors":"Jordan P. Davis , Shaddy K. Saba , Daniel Leightley , Eric R. Pedersen , John Prindle , Jonathan Cantor , Bistra Dilkina , Emily Dworkin , Angeles Sedano","doi":"10.1016/j.addbeh.2025.108593","DOIUrl":"10.1016/j.addbeh.2025.108593","url":null,"abstract":"<div><div><strong>Background and aims</strong>. Cannabis use is increasingly prevalent among U.S. veterans, with high rates of both recreational and problematic use. Veterans often use cannabis to manage symptoms associated with mental health problems such as depression and posttraumatic stress disorder (PTSD). Prior work has noted mixed results on the longitudinal associations between cannabis use and depression. Studying these associations at the daily level can lead to improved clarity. <strong>Design</strong>. The present study examined the daily associations between cannabis use and depression in veterans using dynamic structural equation modeling (DSEM). We also explored these associations for those veterans who screened positive for posttraumatic stress disorder (PTSD) compared to those who did not. Setting. All participants were recruited using advertisements from BuildClinical, an NIH approved recruitment vendor. <strong>Participants</strong>. The sample consisted of 74 veterans who provided daily data for 87 consecutive days. <strong>Measurement</strong>. Cannabis was assessed asking how many hours each individual spent high each day, depressed mood was assessed using a sliding scale from not depressed to very depressed each day, and PTSD was assessed using the PTSD checklist. <strong>Findings</strong>. Among the full veteran sample results revealed a bidirectional, negative, association. Specifically, on days when veterans reported greater depression, they reported fewer hours “high” the next day. Conversely, on days when veterans reported a greater number of hours high, they reported less depression the next day. Among veterans screening positive for PTSD, on days when they reported more depression, they reported fewer hours high the next day (no association was noted for cannabis use predicting depression). However, for those who did not screen positive for PTSD, on days when veterans reported greater number of hours high, they reported less depression the next day. <strong>Conclusions</strong>. These results highlight the need for further research on the effect of individual differences in cannabis use patterns among veterans with PTSD on health outcomes. Clinically, these results highlight the importance of targeting the pros and cons of cannabis use for depression symptom relief. Future research should incorporate daily objective measures of cannabis use to refine treatment strategies for veterans managing PTSD or depressive related distress.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108593"},"PeriodicalIF":3.6,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-22DOI: 10.1016/j.addbeh.2025.108592
Jaqueline C. Avila , Nirotma Tripathi , Caylin J. Marotta , Caitlin E. McCann , Michele Reyen , Jennifer S. Haas , Elyse R. Park , Nancy A. Rigotti
Introduction
Lung cancer screening (LCS) provides an opportunity to offer tobacco cessation treatment, but most people who smoke are unable to quit, even with support. They might benefit from switching to electronic cigarettes (EC), but their perceptions and interest in EC use are unknown.
Methods
Adults who participated in a smoking cessation clinical trial offered at LCS and still smoked at trial completion were surveyed about their interest in trying EC (primary outcome). Independent variables were EC use history and perceptions of health risks and benefits of EC vs combustible cigarettes (CC). Logistic regression models tested the association of EC use and perceptions with interest in trying EC, adjusting for covariates.
Results
204/359 eligible participants (56.8 %) completed the survey. 56.4 % had never tried EC, and 30.9 % were interested in trying EC in the future. 60.3 % believed EC to be as or more harmful than CC, but 60.8 % thought that EC were likely to help people cut down smoking. Interest in trying EC was positively associated with previous EC experience (OR: 2.08, 95 %CI:1.1–3.9), and the belief that EC were less harmful than CC (OR: 8.9, 95 %CI: 3.2–24.9), or that EC can help people cut down on smoking (OR: 8.6, 95 %CI: 3.5–21.2).
Conclusions
Adults undergoing LCS who smoke after cessation treatment ends believe that EC can help people cut down, but they overestimate EC health risks. A positive perception of EC is associated with greater interest in trying EC. Education to correct EC misperceptions might increase interest in trying EC as a harm reduction tool among those who smoke.
{"title":"Are older adults scheduled for lung cancer screening interested in trying electronic cigarettes when conventional smoking cessation treatment fails? A cross-sectional survey","authors":"Jaqueline C. Avila , Nirotma Tripathi , Caylin J. Marotta , Caitlin E. McCann , Michele Reyen , Jennifer S. Haas , Elyse R. Park , Nancy A. Rigotti","doi":"10.1016/j.addbeh.2025.108592","DOIUrl":"10.1016/j.addbeh.2025.108592","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer screening (LCS) provides an opportunity to offer tobacco cessation treatment, but most people who smoke are unable to quit, even with support. They might benefit from switching to electronic cigarettes (EC), but their perceptions and interest in EC use are unknown.</div></div><div><h3>Methods</h3><div>Adults who participated in a smoking cessation clinical trial offered at LCS and still smoked at trial completion were surveyed about their interest in trying EC (primary outcome). Independent variables were EC use history and perceptions of health risks and benefits of EC vs combustible cigarettes (CC). Logistic regression models tested the association of EC use and perceptions with interest in trying EC, adjusting for covariates.</div></div><div><h3>Results</h3><div>204/359 eligible participants (56.8 %) completed the survey. 56.4 % had never tried EC, and 30.9 % were interested in trying EC in the future. 60.3 % believed EC to be as or more harmful than CC, but 60.8 % thought that EC were likely to help people cut down smoking. Interest in trying EC was positively associated with previous EC experience (OR: 2.08, 95 %CI:1.1–3.9), and the belief that EC were less harmful than CC (OR: 8.9, 95 %CI: 3.2–24.9), or that EC can help people cut down on smoking (OR: 8.6, 95 %CI: 3.5–21.2).</div></div><div><h3>Conclusions</h3><div>Adults undergoing LCS who smoke after cessation treatment ends believe that EC can help people cut down, but they overestimate EC health risks. A positive perception of EC is associated with greater interest in trying EC. Education to correct EC misperceptions might increase interest in trying EC as a harm reduction tool among those who smoke.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108592"},"PeriodicalIF":3.6,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.addbeh.2025.108589
Yaniv Efrati , Dvora Shmulewitz , Vera Skvirsky , Merav Vider , Ariel Kor , Shaul Lev-Ran , Mario Mikulincer
Research has shown that compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU) are associated with mental disorders. However, less is known about how trajectories of probable CSBD and PPU prospectively contribute to the evolvement of psychopathology during a stressful period. In this study, we applied latent profile analysis (LPA) to identify distinct latent profiles of participants’ probable CSBD and PPU across 2018 and 2022, prior to the October 2023 attack in Israel (Iron Swords War), and to examine how these profiles prospectively predict the evolvement of psychopathology during wartime. A longitudinal study surveying the in a community sample of Jewish population in Israel, aged 18–70, was conducted before October 7th 2023 attack and during the subsequent war. Participants completed self-report measures of probable CSBD and PPU, psychopathology (global distress, emotional dysregulation, PTSD, anxiety, depression), and level and kind of exposure to the October 7th attack. LPA revealed four distinct probable CSBD/PPU profiles during the two pre-war waves: ‘no disorder’ (n = 952; 80.54 %),‘recovery’ (n = 138; 11.68 %),‘delayed onset’ (n = 50; 4.23 %), and ‘chronic’ (n = 42; 3.55 %). Using T3 and T4 for the trajectory results, the no-disorder group consistently demonstrated the lowest levels of psychopathology and out-of-control behaviors during wartime, while the chronic group reported significantly higher distress; differential impacts among probable CSBD/PPU trajectory groups showed that the no-disorder group reported decreasing anxiety and depression during wartime in contrast to the chronic group that experienced increased PTSD severity. This research offers a nuanced understanding of probable CSBD/PPU profiles, showing how these profiles impact the evolvement of psychopathology during wartime.
{"title":"Longitudinal study of probable compulsive sexual behavior disorder and problematic pornography use profiles: their prospective impact on psychopathology during wartime","authors":"Yaniv Efrati , Dvora Shmulewitz , Vera Skvirsky , Merav Vider , Ariel Kor , Shaul Lev-Ran , Mario Mikulincer","doi":"10.1016/j.addbeh.2025.108589","DOIUrl":"10.1016/j.addbeh.2025.108589","url":null,"abstract":"<div><div>Research has shown that compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU) are associated with mental disorders. However, less is known about how trajectories of probable CSBD and PPU prospectively contribute to the evolvement of psychopathology during a stressful period. In this study, we applied latent profile analysis (LPA) to identify distinct latent profiles of participants’ probable CSBD and PPU across 2018 and 2022, prior to the October 2023 attack in Israel (Iron Swords War), and to examine how these profiles prospectively predict the evolvement of psychopathology during wartime. A longitudinal study surveying the in a community sample of Jewish population in Israel, aged 18–70, was conducted before October 7th 2023 attack and during the subsequent war. Participants completed self-report measures of probable CSBD and PPU, psychopathology (global distress, emotional dysregulation, PTSD, anxiety, depression), and level and kind of exposure to the October 7th attack. LPA revealed four distinct probable CSBD/PPU profiles during the two pre-war waves: ‘no disorder’ (n = 952; 80.54 %),‘recovery’ (n = 138; 11.68 %),‘delayed onset’ (n = 50; 4.23 %), and ‘chronic’ (n = 42; 3.55 %). Using T3 and T4 for the trajectory results, the no-disorder group consistently demonstrated the lowest levels of psychopathology and out-of-control behaviors during wartime, while the chronic group reported significantly higher distress; differential impacts among probable CSBD/PPU trajectory groups showed that the no-disorder group reported decreasing anxiety and depression during wartime in contrast to the chronic group that experienced increased PTSD severity. This research offers a nuanced understanding of probable CSBD/PPU profiles, showing how these profiles impact the evolvement of psychopathology during wartime.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108589"},"PeriodicalIF":3.6,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-19DOI: 10.1016/j.addbeh.2025.108590
Andrea M. Wycoff , Timothy J. Trull
Negative reinforcement is a major component of etiologic models of addiction. Recent work using ecological momentary assessment (EMA) implicates subjective substance-contingent relief as a negative reinforcer of substance use rather than improvements in negative affect. This pre-registered secondary data analysis tested predictors of subjective alcohol- and cannabis-contingent relief to understand what factors contribute to perceived relief, if not actual improvements in negative affect. Adults (N = 87, mean age 25.2 years, 60.2% female, 85.2% white) who reported using alcohol and cannabis simultaneously at least twice per week completed 14 days of EMA. Morning surveys assessed hypothetical relief expectancies for that day. All surveys assessed affect, craving, alcohol and cannabis use, and subjective relief and pleasure from use. Multilevel models tested predictors of subjective relief. During alcohol use moments (n = 868), drinking-contingent pleasure (b = 0.25, SE = 0.06, p < .001) and relief expectancy reported that morning (b = 0.29, SE = 0.10, p = .005) predicted higher drinking-contingent relief. During cannabis use moments (n = 1519), cannabis-contingent pleasure (b = 0.29, SE = 0.06, p < .001) and relief expectancy reported that morning (b = 0.33, SE = 0.11, p = .004) predicted higher cannabis-contingent relief. Changes in affect and craving were not associated with relief. Results highlight subjective pleasure, which is more consistent with positive reinforcement, as a potential driver of perceived relief. Future work should disentangle the predictive direction of relief and pleasure to inform reinforcement mechanisms. Results also highlight the role of expectancies in subjective perceptions of use, above and beyond measurable changes in mood and craving. Collectively, findings add to a growing body of work seeking to articulate reinforcement processes in the natural environment.
负强化是成瘾病因学模型的主要组成部分。最近使用生态瞬时评估（EMA）的工作暗示主观物质-偶然缓解是物质使用的负强化物，而不是消极影响的改善。这项预先注册的二级数据分析测试了主观酒精和大麻缓解的预测因子，以了解哪些因素有助于感知缓解，如果不是负面影响的实际改善。每周至少两次同时使用酒精和大麻的成年人（N = 87，平均年龄25.2岁，60.2%女性，85.2%白人）完成了14天的EMA。上午的调查评估了当天的假设救济预期。所有调查都评估了情感、渴望、酒精和大麻的使用，以及使用后的主观缓解和愉悦。多水平模型测试了主观缓解的预测因子。在饮酒时刻（n = 868），饮酒附带快感(b = 0.25, SE = 0.06, p
{"title":"Perceptions of negative reinforcement in the natural environment: Characterizing subjective alcohol- and cannabis-contingent relief","authors":"Andrea M. Wycoff , Timothy J. Trull","doi":"10.1016/j.addbeh.2025.108590","DOIUrl":"10.1016/j.addbeh.2025.108590","url":null,"abstract":"<div><div>Negative reinforcement is a major component of etiologic models of addiction. Recent work using ecological momentary assessment (EMA) implicates subjective substance-contingent relief as a negative reinforcer of substance use rather than improvements in negative affect. This pre-registered secondary data analysis tested predictors of subjective alcohol- and cannabis-contingent relief to understand what factors contribute to perceived relief, if not actual improvements in negative affect. Adults (<em>N</em> = 87, mean age 25.2 years, 60.2% female, 85.2% white) who reported using alcohol and cannabis simultaneously at least twice per week completed 14 days of EMA. Morning surveys assessed hypothetical relief expectancies for that day. All surveys assessed affect, craving, alcohol and cannabis use, and subjective relief and pleasure from use. Multilevel models tested predictors of subjective relief. During alcohol use moments (<em>n</em> = 868), drinking-contingent pleasure (<em>b</em> = 0.25, <em>SE</em> = 0.06, <em>p</em> < .001) and relief expectancy reported that morning (<em>b</em> = 0.29, <em>SE</em> = 0.10, <em>p</em> = .005) predicted higher drinking-contingent relief. During cannabis use moments (<em>n</em> = 1519), cannabis-contingent pleasure (<em>b</em> = 0.29, <em>SE</em> = 0.06, <em>p</em> < .001) and relief expectancy reported that morning (<em>b</em> = 0.33, <em>SE</em> = 0.11, <em>p</em> = .004) predicted higher cannabis-contingent relief. Changes in affect and craving were not associated with relief. Results highlight subjective pleasure, which is more consistent with positive reinforcement, as a potential driver of perceived relief. Future work should disentangle the predictive direction of relief and pleasure to inform reinforcement mechanisms. Results also highlight the role of expectancies in subjective perceptions of use, above and beyond measurable changes in mood and craving. Collectively, findings add to a growing body of work seeking to articulate reinforcement processes in the natural environment.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108590"},"PeriodicalIF":3.6,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.1016/j.addbeh.2025.108588
Yusuff Adebayo Adebisi , Najim Z. Alshahrani
Background
Smoking initiation remains a major public health concern, yet little is known about whether functional disability independently increases the risk of becoming a smoker.
Methods
We conducted a prospective cohort analysis using data from Waves 10 (2018–2019, baseline) and 14 (2022–2023, follow-up) of the UK Household Longitudinal Study. The analytic sample included 20,529 adults who were non-smokers at baseline and were prospectively followed over four years to assess smoking initiation at Wave 14. Functional disability was assessed across twelve domains; mobility, lifting or carrying objects, manual dexterity, continence, hearing, sight, physical coordination, personal care, memory/concentration/learning/understanding, communication/speech, recognising physical danger, and other health problems or disabilities; and was operationalised based on its presence, number of affected domains, and specific type of limitation reported. Modified Poisson regression with robust standard errors was used to estimate adjusted relative risks (RRs) of smoking initiation, controlling for age, sex, education, ethnicity, and urban/rural residence.
Results
At baseline, 25.1 % of participants (n = 5161) reported at least one functional disability. By follow-up, 379 participants (1.9 %) had initiated smoking. Individuals with functional disabilities had a higher risk of smoking initiation (RR = 1.42, 95 % CI: 1.12–1.80, p = 0.004) after adjustment. A significant trend was observed across increasing numbers of functional disabilities (p-trend < 0.001), with elevated risks among individuals reporting two or more (RR = 1.80, 95 % CI: 1.33–2.42, p < 0.001). Among new smokers, individuals with functional disabilities were also more likely to smoke ≥ 10 cigarettes per day (RR = 1.40, 95 % CI: 1.04–1.64, p = 0.020). Domain-specific analyses showed that mobility limitations (RR = 1.83, 95 % CI: 1.33–2.50, p < 0.001), lifting or carrying impairments (RR = 1.90, 95 % CI: 1.40–2.57, p < 0.001), personal care limitations (RR = 1.95, 95 % CI: 1.19–3.18, p = 0.008), and difficulties recognising physical danger (RR = 2.59, 95 % CI: 1.15–5.81, p = 0.021) were most strongly associated with smoking initiation.
Conclusions
Functional disability is associated with an increased risk of smoking initiation. These findings highlight the need for inclusive tobacco prevention strategies that address the unique vulnerabilities and barriers faced by people with functional impairments.
背景：开始吸烟仍然是一个主要的公共卫生问题，但关于功能障碍是否会单独增加成为吸烟者的风险，我们知之甚少。方法：我们使用英国家庭纵向研究第10期（2018-2019年，基线）和第14期（2022-2023年，随访）的数据进行前瞻性队列分析。分析样本包括20,529名在基线时不吸烟的成年人，并对他们进行了为期四年的前瞻性随访，以评估第14期开始吸烟的情况。在12个领域评估功能性残疾；行动能力、举起或携带物品、手巧、自制、听力、视力、身体协调、个人护理、记忆/集中/学习/理解、沟通/言语、识别身体危险以及其他健康问题或残疾；并根据其存在，受影响领域的数量和报告的特定限制类型进行操作。在控制年龄、性别、教育程度、种族和城乡居住等因素的情况下，采用修正泊松回归稳健标准误差来估计开始吸烟的校正相对危险度（rr）。结果基线时，25.1%的参与者（n = 5161）报告了至少一种功能障碍。通过随访，379名参与者（1.9%）开始吸烟。调整后，功能障碍者开始吸烟的风险较高（RR = 1.42, 95% CI: 1.12-1.80, p = 0.004）。观察到功能性残疾人数增加的显著趋势（p趋势<； 0.001），报告两种或两种以上的个体风险升高（RR = 1.80, 95% CI: 1.33-2.42, p < 0.001）。在新吸烟者中，有功能障碍的个体每天吸烟≥10支的可能性也更大（RR = 1.40, 95% CI: 1.04-1.64, p = 0.020）。特定领域分析显示，活动受限（RR = 1.83, 95% CI: 1.33-2.50, p < 0.001）、举重或负重障碍（RR = 1.90, 95% CI: 1.40-2.57, p < 0.001）、个人护理受限（RR = 1.95, 95% CI: 1.19-3.18, p = 0.008）和难以识别身体危险（RR = 2.59, 95% CI: 1.15-5.81, p = 0.021）与开始吸烟最密切相关。结论：功能障碍与开始吸烟的风险增加有关。这些发现突出表明，需要制定包容性烟草预防战略，以解决功能障碍者面临的独特脆弱性和障碍。
{"title":"Functional disability and the risk of subsequent smoking initiation: A prospective cohort analysis","authors":"Yusuff Adebayo Adebisi , Najim Z. Alshahrani","doi":"10.1016/j.addbeh.2025.108588","DOIUrl":"10.1016/j.addbeh.2025.108588","url":null,"abstract":"<div><h3>Background</h3><div>Smoking initiation remains a major public health concern, yet little is known about whether functional disability independently increases the risk of becoming a smoker.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort analysis using data from Waves 10 (2018–2019, baseline) and 14 (2022–2023, follow-up) of the UK Household Longitudinal Study. The analytic sample included 20,529 adults who were non-smokers at baseline and were prospectively followed over four years to assess smoking initiation at Wave 14. Functional disability was assessed across twelve domains; mobility, lifting or carrying objects, manual dexterity, continence, hearing, sight, physical coordination, personal care, memory/concentration/learning/understanding, communication/speech, recognising physical danger, and other health problems or disabilities; and was operationalised based on its presence, number of affected domains, and specific type of limitation reported. Modified Poisson regression with robust standard errors was used to estimate adjusted relative risks (RRs) of smoking initiation, controlling for age, sex, education, ethnicity, and urban/rural residence.</div></div><div><h3>Results</h3><div>At baseline, 25.1 % of participants (n = 5161) reported at least one functional disability. By follow-up, 379 participants (1.9 %) had initiated smoking. Individuals with functional disabilities had a higher risk of smoking initiation (RR = 1.42, 95 % CI: 1.12–1.80, p = 0.004) after adjustment. A significant trend was observed across increasing numbers of functional disabilities (p-trend < 0.001), with elevated risks among individuals reporting two or more (RR = 1.80, 95 % CI: 1.33–2.42, p < 0.001). Among new smokers, individuals with functional disabilities were also more likely to smoke ≥ 10 cigarettes per day (RR = 1.40, 95 % CI: 1.04–1.64, p = 0.020). Domain-specific analyses showed that mobility limitations (RR = 1.83, 95 % CI: 1.33–2.50, p < 0.001), lifting or carrying impairments (RR = 1.90, 95 % CI: 1.40–2.57, p < 0.001), personal care limitations (RR = 1.95, 95 % CI: 1.19–3.18, p = 0.008), and difficulties recognising physical danger (RR = 2.59, 95 % CI: 1.15–5.81, p = 0.021) were most strongly associated with smoking initiation.</div></div><div><h3>Conclusions</h3><div>Functional disability is associated with an increased risk of smoking initiation. These findings highlight the need for inclusive tobacco prevention strategies that address the unique vulnerabilities and barriers faced by people with functional impairments.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108588"},"PeriodicalIF":3.6,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-14DOI: 10.1016/j.addbeh.2025.108586
Marissa G. Hall , Phoebe R. Ruggles , Carolyn Chelius , Cristina J.Y. Lee , Callie Whitesell , Allison J. Lazard , Noel T. Brewer , Thomas K. Greenfield , Anna H. Grummon
Background
The US has had the same health warning on alcohol containers since 1989. We sought to estimate consumer noticing, reading, and recall of the current US alcohol health warning.
Methods
We recruited a nationally representative sample of 1,036 US alcohol consumers ages 21 + years. Participants completed an online survey in 2024 that assessed whether they had noticed or read the current US alcohol health warning, as well as aided recall of the topics in the warning. Analyses used multivariable logistic regression to examine correlates of reading the warning.
Results
About half of participants (52 %) reported noticing the alcohol health warning the last time they saw an alcohol container and 27 % reported reading the warning in the past month. Reading the warning was more common among Black people (vs. white, 43 % vs. 23 %, p = 0.02). When prompted with a list of possible warning topics, only 4 % of participants correctly recalled all five topics in the warning. Most (60 %) recalled that the warning discussed pregnancy, but less than half recalled the remaining topics in the warning (46 % driving a car, 44 % operating machinery, 41 % birth defects, and 33 % health problems). Recall was modestly higher among those who read the warning in the past month (improvements of 5–16 percentage points) compared to those who did not. However, fewer than two-thirds of people who said they had read the warning recalled each topic.
Conclusions
The current US alcohol warning fails to actively engage many alcohol consumers. The US should require new, rotating alcohol warnings designed to heighten engagement and better inform consumers.
自1989年以来，美国在酒精容器上也有同样的健康警告。我们试图估计消费者对当前美国酒精健康警告的注意、阅读和召回情况。方法：我们招募了1036名年龄在21岁以上的美国酒精消费者的全国代表性样本。参与者在2024年完成了一项在线调查，评估他们是否注意到或阅读了当前的美国酒精健康警告，以及帮助回忆警告中的主题。分析使用多变量逻辑回归来检验阅读警告的相关性。大约一半的参与者（52%）报告说，他们最后一次看到酒精容器时注意到了酒精健康警告，27%的人报告说，在过去一个月里阅读了警告。阅读警告的黑人更常见（43% vs. 23%, p = 0.02）。当提示一个可能的警告主题列表时，只有4%的参与者正确地记住了警告中的所有五个主题。大多数（60%）的人回忆起警告讨论了怀孕，但只有不到一半的人回忆起警告中的其他话题（46%的人驾驶汽车，44%的人操作机器，41%的人出生缺陷，33%的人健康问题）。在过去的一个月里，那些读过警告的人的记忆力比没有读过警告的人略高（提高了5-16个百分点）。然而，只有不到三分之二的人说他们读过警告，记住了每个主题。目前的美国酒精警告未能积极吸引许多酒精消费者。美国应该要求新的、循环的酒精警告，旨在提高消费者的参与度，更好地告知消费者。
{"title":"Consumer engagement with the US alcohol health warning: A nationally representative study","authors":"Marissa G. Hall , Phoebe R. Ruggles , Carolyn Chelius , Cristina J.Y. Lee , Callie Whitesell , Allison J. Lazard , Noel T. Brewer , Thomas K. Greenfield , Anna H. Grummon","doi":"10.1016/j.addbeh.2025.108586","DOIUrl":"10.1016/j.addbeh.2025.108586","url":null,"abstract":"<div><h3>Background</h3><div>The US has had the same health warning on alcohol containers since 1989. We sought to estimate consumer noticing, reading, and recall of the current US alcohol health warning.</div></div><div><h3>Methods</h3><div>We recruited a nationally representative sample of 1,036 US alcohol consumers ages 21 + years. Participants completed an online survey in 2024 that assessed whether they had noticed or read the current US alcohol health warning, as well as aided recall of the topics in the warning. Analyses used multivariable logistic regression to examine correlates of reading the warning.</div></div><div><h3>Results</h3><div>About half of participants (52 %) reported noticing the alcohol health warning the last time they saw an alcohol container and 27 % reported reading the warning in the past month. Reading the warning was more common among Black people (vs. white, 43 % vs. 23 %, <em>p</em> = 0.02). When prompted with a list of possible warning topics, only 4 % of participants correctly recalled all five topics in the warning. Most (60 %) recalled that the warning discussed pregnancy, but less than half recalled the remaining topics in the warning (46 % driving a car, 44 % operating machinery, 41 % birth defects, and 33 % health problems). Recall was modestly higher among those who read the warning in the past month (improvements of 5–16 percentage points) compared to those who did not. However, fewer than two-thirds of people who said they had read the warning recalled each topic.</div></div><div><h3>Conclusions</h3><div>The current US alcohol warning fails to actively engage many alcohol consumers. The US should require new, rotating alcohol warnings designed to heighten engagement and better inform consumers.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"175 ","pages":"Article 108586"},"PeriodicalIF":3.6,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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