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Background: Explanations for why social media users propagate misinformation include failure of classical reasoning (over-reliance on intuitive heuristics), motivated reasoning (conforming to group opinion), and personality traits (e.g., narcissism). However, there is a lack of consensus on which explanation is most predictive of misinformation spread. Previous work is also limited by not distinguishing between passive (i.e., "liking") and active (i.e., "retweeting") propagation behaviors. Methods: To examine this issue, 858 Twitter users were recruited to engage in a Twitter simulation task in which they were shown real tweets on public health topics (e.g., COVID-19 vaccines) and given the option to "like", "reply", "retweet", "quote", or select "no engagement". Survey assessments were then given tomeasure variables corresponding to explanations for: classical reasoning [cognitive reflective thinking (CRT)], motivated reasoning (religiosity, political conservatism, and trust in medical science), and personality traits (openness to new experiences, conscientiousness, empathy, narcissism). Results: Cognitive reflective thinking, conscientiousness, openness, and emotional concern empathy were all negatively associated with liking misinformation, but not significantly associated with retweeting it. Trust in medical scientists was negatively associated with retweeting misinformation, while grandiose narcissism and religiosity were positively associated. An exploratory analysis on engagement with misinformation corrections shows that conscientiousness, openness, and CRT were negatively associated with liking corrections while political liberalism, trust in medical scientists, religiosity, and grandiose narcissism were positively associated. Grandiose narcissism was the only factor positively associated with retweeting corrections. Discussion: Findings support an inhibitory role for classical reasoning in the passive spread of misinformation (e.g., "liking"), and a major role for narcissistic tendencies and motivated reasoning in active propagating behaviors ("retweeting"). Results further suggest differences in passive and active propagation, as multiple factors influence liking behavior while retweeting is primarily influenced by two factors. Implications for ecologically valid study designs are also discussed to account for greater nuance in social media behaviors in experimental research. [ABSTRACT FROM AUTHOR]

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Background E-cigarettes have emerged as popular products, especially for younger populations. However, concerns regarding health effects exist and there is a notable gap in understanding the prevalence and nature of adverse events. This study aims to examine the rate of adverse events in individuals who use e-cigarettes in a large sample. Methods A cross-sectional survey was conducted with a sample of 4695 current and former e-cigarette users with a median age of 34 years. The survey collected data on e-cigarette use, adverse events experienced, product characteristics, related behaviors, sociodemographic factors and presence of medical comorbidities. Statistical analyses were conducted using Pearson's chi-squared tests and logistic regression. Results A total of 78.9% of respondents reported experiencing an adverse event within 6 h of using a vaping device, with the most common events being headache, anxiety and coughing. Product characteristics and related behaviors significantly influenced the risk of adverse events. There were also sociodemographic disparities, with Hispanic respondents and those with at least college-level education reporting higher rates of adverse events. Conclusions Our study found a high rate of adverse events among e-cigarette users. We identified that certain e-cigarette product characteristics, behaviors and medical comorbidities significantly increased the risk of these events. [ABSTRACT FROM AUTHOR]

Introduction Unregulated and potentially illegal sales of tobacco, nicotine, and cannabis products have been detected on various social media platforms, e-commerce sites, online retailers, and the dark web. New end-to-end encrypted messaging services are popular among online users and present opportunities for marketing, trading, and selling of these products. The purpose of this study was to identify and characterize tobacco, nicotine, and cannabis selling activity on the messaging platform Telegram. Methods The study was conducted in three phases: (1) identifying keywords related to tobacco, nicotine, and cannabis products for purposes of detecting Telegram groups and channel messages; (2) automated data collection from public Telegram groups; and (3) manual annotation and classification of messages engaged in marketing and selling products to consumers. Results Four keywords were identified ("Nicotine," "Vape," "Cannabis," and "Smoke") that yielded 20 Telegram groups with 262 506 active subscribers. Total volume of channel messages was 43 963 unique messages that included 3094 (7.04%) marketing/selling messages. The most commonly sold products in these groups were cannabis-derived products (83.25%, n  = 2576), followed by tobacco/nicotine-derived products (6.46%, n  = 200), and other illicit drugs (0.77%, n  = 24). A variety of marketing tactics and a mix of seller accounts were observed, though most appeared to be individual suppliers. Conclusions Telegram is an online messaging application that allows for custom group creation and global connectivity, but also includes unregulated activities associated with the sale of cannabis and nicotine delivery products. Greater attention is needed to conduct monitoring and enforcement on these emerging platforms for unregulated and potentially illegal cannabis and nicotine product sales direct-to-consumer. Implications Based on study results, Telegram represents an emerging platform that enables a robust cannabis and nicotine-selling marketplace. As local, state, and national tobacco control regulations continue to advance sales restrictions and bans at the retail level, easily accessible and unregulated Internet-based channels must be further assessed to ensure that they do not act as conduits for exposure and access to unregulated or illegal cannabis and nicotine products. [ABSTRACT FROM AUTHOR]

Background: Illicit substance sales facilitated by social media platforms are a growing public health issue given recent increases in overdose deaths, including an alarming rise in cases of fentanyl poisoning. However, little is known about how online users evaluate what features of social media posts convey safety, which can influence their intent to source illicit substances. Objectives: This study adapts conjoint analysis which assessed how attributes of social media posts (i.e., features) influence safety evaluations of mock posts selling illicit substances. 440 participants were recruited online for self-reporting use or purchase of controlled substances or prescription medicines recreationally. The following attributes were tested: drug packaging, drug offerings, profile photo of seller, payment info provided, and use of emojis. Results: Packaging was ranked the most important attribute (Average Importance =43.68, Offering=14.94, Profile=13.86, Payment=14.11, Emoji=13.41), with posts that displayed drugs in pill bottles assessed as the most safe. Attribute levels for advertising multiple drugs, having a blank profile photo, including payment information, and including emojis also ranked higher in perceived safety. Rankings were consistent across tested demographic factors (i.e., gender, age, and income). Survey results show that online pharmacies were most likely to be perceived as safe for purchasing drugs and medications. Additionally, those who were younger in age, had higher income, and identified as female were more likely to purchase from a greater number of platforms. Conclusions: These findings can assist in developing more precise content moderation for platforms seeking to address this ongoing threat to public safety. [ABSTRACT FROM AUTHOR]

Introduction There has been a rapid proliferation of synthetic nicotine products in recent years, despite newly established regulatory authority and limited research into its health risks. Previous research has implicated social media platforms as an avenue for nicotine product unregulated sales. Yet, little is known about synthetic nicotine product content on social media. We utilized natural language processing to characterize the sales of synthetic nicotine products on Instagram. Methods We collected Instagram posts by querying Instagram hashtags (eg, "#tobaccofreenicotine) related to synthetic nicotine. Using Bidirectional Encoder Representations from Transformers, collected posts were categorized into thematically related topic clusters. Posts within topic clusters relevant to study aims were then manually annotated for variables related to promotion and selling (eg, cost discussion, contact information for offline sales). Results A total of 7425 unique posts were collected with 2219 posts identified as related to promotion and selling of synthetic nicotine products. Nicotine pouches (52.9%, n = 1174), electronic nicotine delivery systems (30.6%, n = 679), and flavored e-liquids (14.1%, n = 313) were most commonly promoted. About 16.1% (n = 345) of posts contained embedded hyperlinks and 5.8% (n = 129) provided contact information for purported offline transactions. Only 17.6% (n = 391) of posts contained synthetic nicotine-specific health warnings. Conclusions In the United States, synthetic nicotine products can only be legally marketed if they have received premarket authorization from the Food and Drug Administration (FDA). Despite these prohibitions, Instagram appears to be a hub for potentially unregulated sales of synthetic and "tobacco-free" products. Efforts are needed by platforms and regulators to enhance content moderation and prevent unregulated online sales of existing and emerging synthetic nicotine products. Implications There is limited clinical understanding of synthetic nicotine's unique health risks and how these novel products are changing over time due to regulatory oversight. Despite synthetic nicotine-specific regulatory measures, such as the requirement for premarket authorization and FDA warning letters issued to unauthorized sellers, access to and promotion of synthetic nicotine is widely occurring on Instagram, a platform with over 2 billion users and one that is popular among youth and young adults. Activities include direct-to-consumer sales from questionable sources, inadequate health warning disclosure, and exposure with limited age restrictions, all conditions necessary for the sale of various tobacco products. Notably, the number of these Instagram posts increased in response to the announcement of new FDA regulations. In response, more robust online monitoring, content moderation, and proactive enforcement are needed from platforms who should work collaboratively with regulators to identify, report, and remove content in clear violation of platform policies and federal laws. Regulatory implementation and enforcement should prioritize digital platforms as conduits for unregulated access to synthetic nicotine products and other future novel and emerging tobacco products. [ABSTRACT FROM AUTHOR]

The spread of misinformation and conspiracies has been an ongoing issue since the early stages of the internet era, resulting in the emergence of the field of infodemiology (i.e., information epidemiology), which investigates the transmission of health-related information. Due to the high volume of online misinformation in recent years, there is a need to continue advancing methodologies in order to effectively identify narratives and themes. While machine learning models can be used to detect misinformation and conspiracies, these models are limited in their generalizability to other datasets and misinformation phenomenon, and are often unable to detect implicit meanings in text that require contextual knowledge. To rapidly detect evolving conspiracist narratives within high volume online discourse while identifying nuanced themes requiring the comprehension of subtext, this study describes a hybrid methodology that combines natural language processing (i.e., topic modeling and sentiment analysis) with qualitative content coding approaches to characterize conspiracy discourse related to 5G wireless technology and COVID-19 on Twitter (currently known as 'X'). Discourse that focused on correcting 5G conspiracies was also analyzed for comparison. Sentiment analysis shows that conspiracy-related discourse was more likely to use language that was analytic, combative, past-oriented, referenced social status, and expressed negative emotions. Corrections discourse was more likely to use words reflecting cognitive processes, prosocial relations, health-related consequences, and future-oriented language. Inductive coding characterized conspiracist narratives related to global elites, anti-vax sentiment, medical authorities, religious figures, and false correlations between technology advancements and disease outbreaks. Further, the corrections discourse did not address many of the narratives prevalent in conspiracy conversations. This paper aims to further bridge the gap between computational and qualitative methodologies by demonstrating how both approaches can be used in tandem to emphasize the positive aspects of each methodology while minimizing their respective drawbacks. [ABSTRACT FROM AUTHOR]

Corruption is diverse in its forms and embedded in health systems worldwide. Health-sector corruption directly impedes progress towards universal health coverage by inhibiting people's access to quality health services and to safe and effective medicines, and undermining systems for financial risk protection. Corruption is also a cross-cutting theme in the United Nations'sustainable development goals (SDGs) which aim to improve population health, promote justice and strong institutions and advance sustainable human development. To address health-sector corruption, we need to identify how it happens, collect evidence on its impact and develop frameworks to assess the potential risks and put in place protective measures. We propose that the SDGs can be leveraged to develop a new approach to anti-corruption governance in the health sector. The aim will be to address coordination across the jurisdictions of different countries and foster partnerships among stakeholders to adopt coherent policies and anti-corruption best practices at all levels. Combating corruption requires a focused and invigorated political will, better advocacy and stronger institutions. There is no single solution to the problem. Nevertheless, a commitment to controlling corruption via the SDGs will better ensure the integrity of global health and human development now and beyond 2030. La corruption revet diverses formes et mine les systemes de sante du monde entier. La corruption dans le secteur de sante entrave directement les progres en faveur de la couverture sanitaire universelle en empechant l'acces de la population a des services de sante de qualite et a des medicaments surs et efficaces, et en ebranlant les systemes de protection contre le risque financier. La corruption est egalement une thematique transversale des objectifs de developpement durable (ODD) des Nations Unies, qui visent a ameliorer la sante de la population, a promouvoir la justice et des institutions efficaces, et a favoriser le developpement humain durable. Pour combattre la corruption dans le secteur de la sante, il est necessaire de determiner comment elle se produit, de collecter des donnees sur son impact et d'elaborer des cadres pour evaluer les risques potentiels et mettre en place des mesures de protection. Nous suggerons de tirer parti des ODD pour developper un nouveau systeme de gouvernance anticorruption dans le secteur de la sante. L'objectif sera d'assurer la coordination entre les systemes juridiques des differents pays et d'encourager les partenariats entre les parties prenantes en vue de l'adoption de politiques coherentes et de pratiques anticorruption exemplaires a tous les niveaux. La lutte contre la corruption exige une volonte politique ciblee et dynamisee, une prise de position renforcee et des institutions plus efficaces. Il n'existe pas de solution unique a ce probleme. Neanmoins, un engagement en faveur de la lutte contre la corruption par le biais des ODD permettra de mieux assurer l'integrite de la sante mondiale et du developpement humain jusqu'a 2030 et au-dela. La corrupcion es diversa en sus formas y esta incrustada en los sistemas de salud de todo el mundo. La corrupcion en el sector de la salud impide directamente el progreso hacia la cobertura universal de la salud al cohibir el acceso de las personas a servicios de salud de calidad y a medicamentos seguros y eficaces, y debilitar los sistemas de proteccion contra los riesgos financieros. La corrupcion es tambien un tema transversal en los objetivos de desarrollo sostenible (ODS) de las Naciones Unidas, cuyo objetivo es mejorar la salud de la poblacion, promover la justicia y el fortalecimiento de las instituciones y promover el desarrollo humano sostenible. Para hacer frente a la corrupcion en el sector de la salud, es necesario identificar como se produce, recopilar pruebas de su impacto y desarrollar marcos para evaluar los riesgos potenciales y establecer medidas de proteccion. Se propone aprovechar los ODS para desarrollar un nuevo enfoque dela gobernanza anticorrupcion en el sector de la salud. El objetivo sera coordinar las distintas jurisdicciones de los distintos paises y fomentar las asociaciones entre las partes interesadas para adoptar politicas coherentes y practicas optimas de lucha contra la corrupcion a todos los niveles. La lucha contra la corrupcion requiere una voluntad politica centrada y fortalecida, una mejor promocion y el fortalecimiento de las instituciones. No existe una unica solucion al problema. Sin embargo, el compromiso de controlar la corrupcion a traves de los ODS garantizara mejor la integridad de la salud mundial y el desarrollo humano actual y despues de 2030., Introduction Corruption is the abuse of entrusted power for private gain. (1) The concept of corruption in relation to global health has been defined as: 'misappropriation of authority, resources, trust [...]

Introduction: Increased awareness of the importance of mental health for global health has led to a number of new initiatives, including influential policy instruments issued by the World Health Organization (WHO) and the United Nations (UN). Method: This policy brief describes two WHO instruments, the Mental Health Action Plan for 2013-2020 (World Health Organization, 2013) and the Mental Health Atlas (World Health Organization, 2015), and presents a comparative analysis with the Sustainable Development Goals (SDGs) of the UN's 2030 Agenda for Sustainable Development (United Nations, 2015). Results: The WHO's Action Plan calls for several specific objectives and targets, with a focus on improving global mental health governance and service coverage. In contrast, the UN's Sustainable Development Goals include only one goal specific to mental health, with a single indicator tracking suicide mortality rates. Discussion: The discrepancy between the WHO and UN frameworks suggests a need for increased policy coherence. Improved global health governance can provide the basis for ensuring and accelerating progress in global mental health. Keywords: global mental health, health policy, United Nations, World Health Organization, Sustainable Development Goals, There is increased awareness of the importance of mental health for global health, largely driven by new data describing the substantial global burden of disease and economic costs associated with [...]

Background: Cancer patients often face multiple comorbidities and are at risk for various mental health conditions and substance use disorders. Tobacco/nicotine dependence (TND) is a known risk factor for poor health outcomes and has been associated with psychiatric disorders including substance use disorder. However, the specific relationship between TND and the risk of substance use disorder and mental health conditions among cancer patients remains underexplored. This study aimed to assess the association between TND and the risk of comorbid conditions among cancer patients. Methods: Data were obtained from a database of electronic health records for patients from the University of California health system. The odds for every condition among cancer patients with TND were calculated and compared with those for cancer patients without TND. ORs were adjusted for gender, ethnicity, and race. Results: Three thousand seven hundred and ninety‐one cancer patients with TND had 252,619 total conditions, and 51,711 cancer patients without TND had 2,310,880 conditions. After adjusting for confounders, the condition for which TND most exacerbated risk was psychoactive substance‐induced organic anxiety disorder (OR = 16.3, p < 0.001). This appeared consistent with the second, third, and fifth most‐exacerbated conditions: stimulant use disorder (OR = 12.8, p < 0.001), cocaine induced mental disorder (OR = 11.0, p < 0.001), and cocaine use disorder (OR = 11.0, p < 0.001). Different conditions exacerbated by TND include acute alcoholic intoxication (OR = 11.4, p < 0.001), opioid use disorder (OR = 7.6, p < 0.001), schizoaffective disorder (OR = 7.4, p < 0.001), and cannabis use disorder (OR = 6.3, p < 0.001). Conclusions: Our findings reveal a strong association between TND and an increased risk of substance use disorder and mental health conditions among cancer patients. Specifically, cancer patients with TND were at an elevated risk for psychoactive substance‐induced organic anxiety disorder, stimulant use disorder, and cocaine‐related disorders. Additionally, TND was associated with an increased risk of acute alcoholic intoxication, opioid use disorder, schizoaffective disorder, and cannabis use disorder. These findings underscore the need for comprehensive screening and interventions to address TND and comorbid conditions among cancer patients. [ABSTRACT FROM AUTHOR]

Introduction: In 2019, the state of Massachusetts signed into law the first statewide sales restrictions of flavored ENDS/tobacco products for both physical and online shops in response to a previous executive order to curb E-Cigarette, or Vaping Product, Use Associated Lung Injury (EVALI) cases that were surging throughout the nation. Methodology: This study obtained licensure data from the Massachusetts Department of Revenue, to observe the changes in retail licensure comparing the pre ban (October 2018-August 2019) and post ban periods (October 2020- August 2021). A series of linear regression tests were conducted on both periods using census tract data to explore potential associations with sociodemographic covariates, including median age, median household income, and population proportion by gender, age, and race/ethnicity groups. Results: Analysis of the Massachusetts post-ban period (October 2020-August 2021) found that new tobacco retail licenses issued decreased by 52.9% (n = 968) when compared to the pre-ban period (October 2018-August 2019) of 1831. A significant positive association was discovered between change in new retailer count and proportion male population (2.48 ± 1.05, P =.018) as well as proportion Hispanic population (1.19 ±.25, P <.001) at the census tract level. Conclusion/Discussion: Our analysis indicates that, following the temporary MA flavor sales ban, the total number of licenses decreased, though decreases were more pronounced for new licenses when compared to continuing licenses. Higher increases in new tobacco retailer density were significantly associated with concentration of male and Hispanic populations. [ABSTRACT FROM AUTHOR]

INTRODUCTION The state of California has enacted progressive anti-tobacco policies, including Proposition 56 in 2016. In response, the alternative and emerging tobacco product (ATP) industry has increased its political activity. This study explores the association between the proportion of people voting against Proposition 56 and tobacco/ATP retail density. METHODS We conducted a retrospective analysis using data on licensed California tobacco retailers, which were then cross-referenced for categorization using Yelp. Proportion voting against Proposition 56 was obtained from the Secretary of State's website. A series of linear regression tests were performed between populationnormalized retailer density and voting proportion at the county level before and after adjusting for covariates such as age, gender, race/ethnicity and median household income. RESULTS The total number of licensed tobacco retailers increased by 29.31% from 2015 to 2019. Association between proportion voting against Proposition 56 and retail density was significant during voting and during periods of policy implementation and post-implementation (2016-2018) for non-specialized tobacco retailers. For specialized/ATP retailers, significance was only detected during the post-implementation period (2018-2019) after normalization. Proportion voting against Proposition 56 was also a significant predictor of increase in total number of non-specific (ß=0.48, p=0.008) as well as specialized tobacco and/or ATP retail storefronts (ß=0.21, p=0.001) from 2016 to 2018. CONCLUSIONS This study provides initial evidence of the association between tobacco retail density and voting patterns for anti-tobacco policy. Future research should examine the role of tobacco retail density on variation in local support for state tobacco control initiatives, including tailoring outreach to specific voting census blocks in communities with heavy retail presence. [ABSTRACT FROM AUTHOR]

A case-control study was conducted between 1 December 2021 and 31 January 2022 to identify factors, which increase risk for coronavirus disease 2019 (COVID-19) among athletes in the National Basketball Association (NBA). Behavioral factors and stadium attendance significantly decreased time to COVID-19 infection, but local COVID-19 rates were not associated in a multivariable model. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tobacco retailer density may be associated with greater youth initiation and reduced success during quit attempts; however, the extent to which tobacco retailer density has changed overtime across multiple categories of retailers has not been reported. METHODS Data on licensed tobacco retailers within California from 2015-2019 were obtained from the California Department of Tax and Fee Administration. Store type was categorized by automated cross-referencing with Yelp. Geolocations were aggregated at county level for analyzing longitudinal trends in changes in tobacco retail density including demographic characteristics. RESULTS The number of active CA tobacco retailer licenses increased from 19825 in 2015 to 25635 in 2019. The highest percent increase in tobacco retailer licenses (9.1%) was observed in 2017. The number of specialized tobacco stores was highest in Los Angeles, San Diego, and Riverside counties. We observed a significant increase in the number of active licenses for non-specialized and specialized tobacco stores, both overall and after controlling for the size of populations within each region. Time was a statistically significant predictor for the number of active licenses for only non-specialized stores, after adjusting for covariates. Regional volume of retailers was positively associated with higher proportion of women, lower median household income, and higher proportion of Hispanic residents. CONCLUSIONS Monitoring the changes in tobacco retail density and associated sociodemographic factors over time can help to identify communities at higher risk for tobacco and nicotine product exposure and access, and its associated health disparities. [ABSTRACT FROM AUTHOR]

The tragic death of 18-year-old Ryan Haight highlighted the ethical, public health, and youth patient safety concerns posed by illicit online nonmedical use of prescription drugs (NUPM) sourcing, leading to a federal law in an effort to address this concern. Yet despite the tragedy and resulting law, the NUPM epidemic in the United States has continued to escalate and represents a dangerous and growing trend among youth and adolescents. A critical point of access associated with youth NUPM is the Internet. Internet use among this vulnerable patient group is ubiquitous and includes new, emerging, and rapidly developing technologies—particularly social media networking (eg, Facebook and Twitter). These unregulated technologies may pose a potential risk for enabling youth NUPM behavior. In order to address limitations of current regulations and promote online safety, we advocate for legislative reform to specifically address NUPM promotion via social media and other new online platforms. Using more comprehensive and modernized federal legislation that anticipates future online developments is critical in substantively addressing youth NUPM behavior occurring through the Internet.

Technological advances have enabled the rapid generation of health and genomic data, though rarely do these technologies account for the values and priorities of marginalized communities. In this commentary, we conceptualize a blockchain genomics data framework built out of the concept of Indigenous Data Sovereignty. [ABSTRACT FROM AUTHOR]