Addictive behaviors最新文献

Introduction

Co-use of tobacco and cannabis has long been an issue for prevention and intervention efforts targeting these substances. Blunt use—cannabis inside a cigar wrapper—has been a consistent mode of cannabis consumption since the 1990s. Since then, both tobacco control and cannabis policies have changed considerably. This paper examines the influence of tobacco taxes and smoke-free policies as well as medical and recreational cannabis policies on blunt use among young people.

Methods

Combining state-level tobacco control and cannabis policy data with the restricted-access youth cohort of the Population Assessment of Tobacco and Health (PATH) study, we use multilevel logistic regression models to examine the impact of these policies on past-year blunt use.

Results

While we found a main effect whereby both legal medical and recreational cannabis policies are associated with higher odds of blunt use among youth, interaction effects demonstrate that this association only emerges in states lacking a comprehensive tobacco smoke-free policy. In states with smoke-free policies, we found no significant associations between cannabis policy and odds of blunt use.

Conclusions

Denormalization through smoke-free policies may mitigate the effects of recreational and medical cannabis policies on blunt use. Smoke-free policies represent a possible cost-effective mechanism to curb the co-use of tobacco and cannabis in the form of blunts. States with medical and recreational cannabis policies may benefit from greater prevention efforts for young people specifically focused on blunt use, especially in states that do not have strong tobacco control.

Background

Electronic nicotine delivery systems (ENDS) are the most used tobacco product among adolescents and young adults (AYAs) and are increasingly used to vape cannabis. It is unclear what vaping devices and ENDS modifications are used most frequently by AYAs who vape both nicotine and cannabis.

Methods

AYAs (aged 14–29) reporting ENDS use in the past 30 days were recruited via Qualtrics (N = 1,011). We conducted three multivariable logistic regression models examining differences in likelihood of: 1) vaping cannabis in the past 30 days; 2) mixing cannabis and nicotine liquids; and 3) using nicotine devices to vape cannabis; based on type of vaping device used most often, controlling for age, socio-economic status, gender, race, frequency of ENDS use, and other cannabis use.

Results

40 % (n = 405) of AYAs reported vaping both nicotine and cannabis in the past 30 days. AYAs who used vape pens most often were more likely to have vaped cannabis concentrates in the past 30 days compared to individuals using disposable vapes (aOR = 2.72, 95 %CI = 1.75–4.21, p < 0.001). AYAs who used open systems most often (i.e., vape pens, mods, or e-hookah) were more likely than individuals using closed systems (i.e., disposable vapes, rechargeable pods or cigalikes) to combine nicotine and cannabis e-liquids (aOR = 2.03, 95 %CI = 1.43–2.89, p < 0.001) or use a nicotine device to vape cannabis (aOR = 1.66, 95 %CI = 1.17–2.34, p = 0.005).

Implications

Co-use of cannabis and nicotine via similar devices, particularly vape pens and other open-systems, warrants collaborative regulatory efforts to mitigate co-use of both substances, with a particular need for increased regulation of cannabis vaping products.

Background

Alcohol Use Disorder (AUD) is linked to an attentional bias towards alcohol-related cues (e.g. images, smells), which acquire incentive properties and promote continued consumption.

Method

We investigated how the general and alcohol attentional bias evolved longitudinally in AUD patients along two periods of abstinence: t = 0 (baseline, 1–3 months of abstinence) and t = 1 (follow-up; 6 months of abstinence), as well as their relationship with alcohol-related variables. General and alcohol-specific attentional bias were evaluated by the Classic and the Alcohol Stroop tests (neutral and alcohol conditions) in abstinent AUD patients and controls.

Results

At t = 0, the AUD group exhibited both general and alcohol-specific attentional biases, with greater effect in the general bias. At t = 1, alcohol-specific attentional bias decreased specifically in the AUD group and reached control levels (with interference index levels increasing from 1-3 months to 6 months). However, general attentional bias showed a trend toward improvement but it did not significantly change through abstinence process (linear mixed models, controlling for age, BMI, sex and education).

Conclusions

In AUD patients, general and alcohol attentional biases exhibit different trajectories during abstinence, with the attentional bias toward alcohol improving significantly throughout this process whereas general attentional bias is maintained.

Background

A subpopulation of adults who smoke cigarettes use electronic nicotine device systems (ENDS) for cigarette cessation. This study examined the relationship between ENDS flavors, device types, and nicotine concentration with past month cigarette abstinence among adults using ENDS for cigarette cessation.

Methods

We used the Population Assessment of Tobacco and Health (PATH) Study (waves 5 and 6) to identify adults who self-reported using ENDS to quit cigarettes at baseline (wave 5) and investigated their cigarette abstinence at follow-up (wave 6) [n = 1252]. Measures assessed include ENDS features (flavors, device types, nicotine concentration) at baseline and past-month abstinence from cigarette smoking at follow-up. Weighted descriptive analysis was used, and multivariable logistic regression models examined ENDS features associated with past-month cigarette abstinence, adjusting for demographic factors and tobacco dependence at baseline.

Results

Most participants used disposable devices (37.2 %; 95 % CI:33.2–41.5), followed by refillable tanks (30.2 %; 95 % CI:26.2–34.5). Additionally, fruit (41.3 %; 95 % CI:37.3–45.5), followed by menthol (19.1 %; 95 % CI:16.2–22.4), and tobacco (18.5 %; 95 % CI:15.5–22.1) were the most common flavors. The most common nicotine concentration used was 1–6 mg/ml (38.8 %; 95 % CI:34.6–43.2). Furthermore, in the adjusted model, daily ENDS users at baseline had 86 % (95 % CI:1.08–3.18) higher odds of past month cigarette abstinence at follow-up, than individuals who indicated ‘not at all’ to the current use of ENDS at baseline. There were no significant differences by preferred flavors, device type and nicotine concentrations (p-values > 0.05).

Conclusions

Daily ENDS users had higher odds of quitting cigarettes compared to those who stopped using ENDS. However, the type of device, flavoring, and nicotine concentration used by ENDS users were not associated with past-month cigarette abstinence at follow-up two years later.

Background

Given that cannabis and e-cigarettes are among the most commonly used substances among young people, there is a need to identify risk factors for concurrent cannabis consumption and nicotine vaping among youth and young adults.

Methods

Data were obtained from the Truth Longitudinal Cohort, collected from September 2020 to March 2021, among a cohort aged 15–24 years (N = 6379). Chi-square tests were conducted to detect differences in sample characteristics by dual use status (never e-cigarette and never cannabis users, never cannabis and former/noncurrent e-cigarette users, never e-cigarette and former/noncurrent cannabis users, former/noncurrent e-cigarette and cannabis users, current e-cigarette only users, current cannabis only users, and concurrent cannabis and e-cigarette dual users). Multinomial logistic regression was used to determine key demographic variables predicting dual use status.

Results

Household tobacco use (Relative Risk Ratio, RRR = 4.93), higher sensation seeking (RRR = 3.98), and mental health score (RRR = 2.58) were associated with higher risk of dual use. Being 15–17 years (RRR = 0.22), being female (RRR = 0.59) and having parents with an education level of some college or more (RRR = 0.64) were associated with lower risk of dual use.

Conclusion

Findings suggest the need to carefully monitor cannabis and vaping nicotine among young people. The identification of risk factors provides additional guidance for prevention and treatment efforts, suggesting the need to address use of both substances and target those most at risk.

Background

Cannabis use is on the rise, but it is unclear how use is changing among individuals with serious psychological distress (SPD) compared to the general population as well as what associations this may have with mental health service use.

Methods

Retrospective cohort study using the National Survey on Drug Use and Health (NSDUH) 2009–19 public use files of 447,228 adults aged ≥ 18 years. Multivariable logistic regression and predictive margin methods were used to estimate linear time trends in any and greater-than-weekly levels of cannabis use by year and SPD status and rates of psychiatric hospitalization and outpatient mental health care.

Findings: Rates of any and weekly-plus cannabis use increased similarly among individuals with SPD compared to those without from 200 to 2014 but more rapidly in SPD every year from 2015 to 2019 (p < 0.001). Among individuals with SPD, no use was associated with a 4.2 % probability of psychiatric hospitalization, significantly less than less-than-weekly (5.0 %, p = 0.037) and weekly-plus cannabis use (5.1 %, p = 0.028). For outpatient mental health care, no use was associated with a 27.4 % probability (95 % CI 26.7–28.1 %) of any outpatient care, significantly less than less than weekly use (32.6 % probability, p < 0.001) and weekly-plus use (29.9 % probability, p = 0.01).

Conclusions

Cannabis use is increasing more rapidly among individuals with SPD than the general population, and is associated with increased rates of psychiatric hospitalization and outpatient service use. These findings can inform policy makers looking to tailor regulations on advertising for cannabis and develop public health messaging on cannabis use by people with mental illness.

Background

Young adults are more vulnerable than older adults to engagement with online tobacco marketing and to the use of electronic nicotine delivery systems (ENDS) products. Our study examined the longitudinal associations between engagement with pro- and anti-tobacco information on social media (SM) and young adults’ subsequent onset of symptoms of dependence on ENDS products one year later, which remain unclear.

Methods

Participants were college students in the Marketing and Promotions Across Colleges in Texas study. We analyzed data collected in spring 2018 (wave 8, baseline) and spring 2019 (wave 9), which involves 1,764 college students (Mean age = 24.48, 34.8% White) who reported having ever used any ENDS products but no ENDS dependence symptoms at baseline. Logistic regression analyses were conducted to examine the associations between pro- and anti-engagement with tobacco information at baseline and onset of ENDS dependence symptoms at one-year follow-up, controlling for baseline sociodemographic characteristics and tobacco smoking status. We also examined participant sex and depressive symptoms as moderators of the aforementioned associations.

Results

Engagement with both pro- (Odds Ratio = 1.73, p < 0.05) and anti- (Odds Ratio = 1.36, p < 0.05) tobacco information at baseline predicted the subsequent onset of symptoms of dependence on ENDS products one year later. The association between pro-engagement and subsequent onset of ENDS dependence symptoms was stronger among females than males ($\mathrm{Exp}\left(\beta \right)$ = 3.21, p < 0.05). Depressive symptomology did not moderate any of the associations.

Conclusions

Findings suggest that engaging with tobacco information on SM, regardless of its valence, serves as a risk factor for the development of subsequent dependence symptoms among young adult ever ENDS users. Considering the uncertainty of ENDS products’ health effects, regulation of SM is encouraged to reduce young adults’ (re)posting thoughts or comments about the advantages of ENDS products.

Problematic gaming is particularly prevalent in adolescent and young adult populations. While numerous studies have investigated the psychiatric comorbidities of Internet Gaming Disorder in young adults, few have focused specifically on adolescents who might be especially at risk because developmental particularities related to this developmental period.

Here, we conducted a review of the literature, in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, in order to highlight the types of psychiatric comorbidities found in adolescents with problematic gaming.. We selected and analyzed 30 cross-sectional and longitudinal studies which correspond to 3683 adolescents (63,27% of boys) worldwide with problematic gaming.

Our results highlight the high prevalence of Attention Deficit Hyperactivity Disorder (ADHD) in adolescents with problematic gaming and the links between this addiction and inattention, anxiety, depression, behavioural and emotional problems. These psychiatric comorbidities interact with problematic gaming and predict it throughout the adolescent’s development. Moreover, this interaction involves personality profile and environment, including parental education. The complexity of this interaction argues in favor of the multi-level assessment that we are promoting.

Background

Self-efficacy is a key concept in various behavioral theories. Refusal self-efficacy is important in understanding issues related to psychoactive substance use. To facilitate related research, this study translated and validated the Chinese version of the 14-item Psychoactive Substance Refusal Self-efficacy Questionnaire (PSRSEQ) among adolescents. There is a debate about whether such a refusal self-efficacy scale should be unidimensional or multidimensional.

Methods

A survey was conducted among 601 adolescent case-clients of social workers in Hong Kong from July 2021 to June 2022. Various psychometric properties were examined.

Results

The confirmatory factor analysis (CFA) supported the original 3-factor structure of the PSRSEQ (emotional relief, opportunistic, and social facilitation refusal self-efficacy), which showed satisfactory psychometric properties (internal consistency, convergent validity in terms of significant negative correlations with the intention of psychoactive substance use in the next year and psychoactive substance use behavior in the past six months, and the absence of floor effect) but ceiling effect was obvious. Notably, unacceptable discriminant validity of one subscale and strong correlations among the three subscales were observed. In another set of analyses using two split-half subsamples, the exploratory factor analysis identified a 1-factor 14-item structure, which was confirmed by CFA and showed satisfactory psychometric properties.

Conclusions

The 1-factor PSRSEQ, instead of the one having a 3-factor structure, was preferred and recommended to assess psychoactive substance refusal self-efficacy among Chinese adolescents. It is warranted to validate the scale in other adolescent and age groups in future studies.

Background and aims

The extent to which heavy smoking and retirement risk are causally related remains to be determined. To overcome the endogeneity of heavy smoking behaviour, we employed a novel approach by exploiting the genetic predisposition to heavy smoking, as measured with a polygenic risk score (PGS), in a Mendelian Randomisation approach.

Methods

8164 participants (mean age 68.86 years) from the English Longitudinal Study of Ageing had complete data on smoking behaviour, employment and a heavy smoking PGS. Heavy smoking was indexed as smoking at least 20 cigarettes a day. A time-to-event Mendelian Randomization (MR) analysis, using a complementary log–log (cloglog) link function, was employed to model the retirement risk.

Results

Our results show that being a heavy smoker significantly increases the risk of retirement (β = 1.324, standard error = 0.622, p < 0.05). Results were robust to a battery of checks and a placebo analysis considering the never-smokers.

Conclusions

Overall, our findings support a causal pathway from heavy smoking to earlier retirement.