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To estimate the extent to which drinking to cope with the COVID-19 pandemic and experiencing pandemic-related life stressors are associated with alcohol use escalation among young adults. Respondents in Los Angeles, CA, USA (N = 2,130) completed prospective cohort study surveys before (baseline; October 2018–November 2019; mean age: 19.7[SD = 0.4]) and during (follow-up; May–August 2020) the COVID-19 outbreak. Past 30-day drinking days and number of drinks per drinking day were assessed from baseline to follow-up. At follow-up, participants reported drinking to cope with social isolation and pandemic-related stressors. Pandemic-related stressor prevalence ranged from 5.5% (evicted/lost home) to 72.6% (worried about education) and 27.1% drank to cope with social isolation during the pandemic. Respondents who did (vs. did not) report pandemic-related coping drinking were more likely to increase past 30-day drinking days and drinks per drinking day from baseline to follow-up after adjustment for possible confounders. Employment loss/reduction, financial problems, and perceived likelihood of contracting COVID-19 or handling the pandemic poorly were each associated with increases in drinking days or drinks per drinking day. Experiencing certain life stressors and drinking to cope with social isolation may be associated with drinking escalation among young adults during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Globally little is known regarding substance use service providers' perceptions of substitute behaviours and this significant gap could hinder service provision and recovery outcomes. Semi-structured focus group discussions (including 22 service providers across five sites) were conducted in residential treatment facilities in the Western Cape, South Africa. Service providers recognised substances (e.g. cigarettes and caffeine) and behaviours (e.g. gambling, eating, love, sex, shopping, exercise, and gaming) as potential substitutes. Identified substitute motives included managing cravings; self-medication; filling the experiential void of the primary substance, and time-spending. Concurrent behaviours and addictions were believed to be a key mechanism underlying substitution however, service providers did not uniformly screen for co-occurring behavioural addictions. Substitute behaviours were primarily considered a pathway to relapse and service providers emphasised prevention, detection and family education. To suitably intervene, screening for co-occurring behaviours should be an integral part of the assessment of those presenting for substance use treatment. [ABSTRACT FROM AUTHOR]

Lack of education and training on caring for patients with substance use disorder (SUD) is common among healthcare providers, often resulting in clinicians feeling unprepared to treat patients with SUD. This study explored resident physicians' experiences with SUD education throughout medical school and residency and qualitatively evaluated whether a SUD initiative improved resident's knowledge and efficacy of treating various SUDs. We implemented a brief (seven hours total) educational initiative focused on treating SUDs virtually over the course of an academic year for residents enrolled in the University of Southern California Internal Medicine Residency program. Semi-structured interviews were conducted with residents after completion of the initiative. A thematic analysis was conducted to identify common themes that emerged from the qualitative data. Every resident noted receiving insufficient training for the treatment of SUDs prior to the initiative. The initiative was viewed favorably, and participants particularly appreciated having an introduction to prescribing medication for the treatment of SUD such as buprenorphine. Despite the perceived success of the initiative in increasing awareness of treatment modalities for SUD, residents expressed a lack of comfort in handling SUD cases and desired additional practical lectures and application of knowledge through increased experiential training. SUD education and training appears to be a useful constituent of resident training and should be included in the standard curriculum and rotations. Residency programs should consider including formal education, hands-on practice, and providing adequate resources for residents to develop their capabilities to care for patients with SUD. [ABSTRACT FROM AUTHOR]

Background: We tested whether snus marketing with modified risk tobacco product (MRTP) claims: (a) promotes accurate knowledge about snus's health effects in young adults and (b) encourages use intentions in only those who use combustible tobacco without attracting other young adult populations., Methods: A randomised between-subjects experiment was embedded in a 2020 web survey of participants from Los Angeles (aged 19-23 years). Participants viewed mass-marketed snus advertising materials with (n=1212) vs without (n=1225) US Food and Drug Administration-authorised MRTP claims. After advertising exposure, snus use intention and perceptions of snus harms relative to cigarettes or e-cigarettes were measured., Results: Advertisements with versus without MRTP claims did not affect snus use intention (18.0% vs 19.4%) but produced a higher prevalence of perceptions that snus was less harmful than cigarettes (12.6% vs 9.1%; p=0.007) and e-cigarettes (8.0% vs 5.8%; p=0.04). MRTP claim exposure effects did not differ by past 30-day e-cigarette or combustible tobacco use. Snus use intentions after marketing exposure, collapsed across MRTP claim conditions, were higher in those who did versus did not report past 30-day use of e-cigarettes (38.4% vs 14.3%; adjusted OR (95% CI) 2.95 (2.28 to 3.81); p<0.001) or combustible tobacco (44.0% vs 16.2%; adjusted OR (95% CI) 2.26 (1.62 to 3.16); p<0.001)., Conclusion: Although some young adults who vape or smoke may have snus use intentions, snus MRTP claims might not affect young adults' snus use intentions, regardless of whether they vape/smoke. MRTP claims might modestly increase the accuracy of perceived harms of snus relative to cigarettes while also slightly causing unsubstantiated perceptions of lower harm than e-cigarettes., Competing Interests: Competing interests: No, there are no competing interests., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Objectives: Disposable electronic cigarettes (e-cigarettes) are widely used by adolescents and young adults (AYAs). Whether using disposable devices is associated with future e-cigarette use patterns is unknown but important for informing e-cigarette regulation., Methods: Prospective longitudinal study combining data from adolescent (14-17 years) and young adult (21-24 years) cohorts from Southern California surveyed at baseline and approximately 8-month follow-up during 2021 to 2022. The analyses included AYAs who used e-cigarettes in the past 30 days at baseline and had exposure and outcome data (N = 403; adolescent n = 124, young adult n = 279)., Results: In the pooled sample of AYAs who used e-cigarettes at baseline (57.2% cis-gender female, 56.2% Hispanic), 278 (69.0%) reported past 30-day disposable e-cigarette use, and 125 (31.0%) used only nondisposable e-cigarettes. Baseline use of disposable (versus only nondisposable) devices was associated with higher odds of continued e-cigarette use (adjusted odds ratio = 1.92; 95% confidence interval = 1.09-3.42) and a greater number of times used e-cigarettes per day at follow-up (adjusted incidence rate ratio = 1.29; 95% confidence interval = 1.02-1.63). In supplemental analyses, disposable e-cigarette use was associated with greater odds of no changes (versus reductions) in e-cigarette use frequency and puffs per episode from baseline to follow-up but was not associated with increases in use frequency and intensity. No differences in e-cigarette use outcomes were found between those with poly-device (disposable and nondisposable) versus only disposable device use., Conclusions: Use of disposable e-cigarette devices among AYAs may be associated with higher risks for persistent e-cigarette use patterns, which should be considered in tobacco product regulation designed to protect AYAs., (Copyright © 2024 by the American Academy of Pediatrics.)