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Importance: Social media use may be a risk factor for mental health problems in adolescents. However, few longitudinal studies have investigated this association, and none have quantified the proportion of mental health problems among adolescents attributable to social media use.Objective: To assess whether time spent using social media per day is prospectively associated with internalizing and externalizing problems among adolescents.Design, Setting, and Participants: This longitudinal cohort study of 6595 participants from waves 1 (September 12, 2013, to December 14, 2014), 2 (October 23, 2014, to October 30, 2015), and 3 (October 18, 2015, to October 23, 2016) of the Population Assessment of Tobacco and Health study, a nationally representative cohort study of US adolescents, assessed US adolescents via household interviews using audio computer-assisted self-interviewing. Data analysis was performed from January 14, 2019, to May 22, 2019.Exposures: Self-reported time spent on social media during a typical day (none, ≤30 minutes, >30 minutes to ≤3 hours, >3 hours to ≤6 hours, and >6 hours) during wave 2.Main Outcomes and Measure: Self-reported past-year internalizing problems alone, externalizing problems alone, and comorbid internalizing and externalizing problems during wave 3 using the Global Appraisal of Individual Needs-Short Screener.Results: A total of 6595 adolescents (aged 12-15 years during wave 1; 3400 [51.3%] male) were studied. In unadjusted analyses, spending more than 30 minutes of time on social media, compared with no use, was associated with increased risk of internalizing problems alone (≤30 minutes: relative risk ratio [RRR], 1.30; 95% CI, 0.94-1.78; >30 minutes to ≤3 hours: RRR, 1.89; 95% CI, 1.36-2.64; >3 to ≤6 hours: RRR, 2.47; 95% CI, 1.74-3.49; >6 hours: RRR, 2.83; 95% CI, 1.88-4.26) and comorbid internalizing and externalizing problems (≤30 minutes: RRR, 1.39; 95% CI, 1.06-1.82; >30 minutes to ≤3 hours: RRR, 2.34; 95% CI, 1.83-3.00; >3 to ≤6 hours: RRR, 3.15; 95% CI, 2.43-4.09; >6 hours: RRR, 4.29; 95% CI, 3.22-5.73); associations with externalizing problems were inconsistent. In adjusted analyses, use of social media for more than 3 hours per day compared with no use remained significantly associated with internalizing problems alone (>3 to ≤6 hours: RRR, 1.60; 95% CI, 1.11-2.31; >6 hours: RRR, 1.78; 95% CI, 1.15-2.77) and comorbid internalizing and externalizing problems (>3 to ≤6 hours: RRR, 2.01; 95% CI, 1.51-2.66; >6 hours: RRR, 2.44; 95% CI, 1.73-3.43) but not externalizing problems alone.Conclusions and Relevance: Adolescents who spend more than 3 hours per day using social media may be at heightened risk for mental health problems, particularly internalizing problems. Future research should determine whether setting limits on daily social media use, increasing media literacy, and redesigning social media platforms are effective means of reducing the burden of mental health problems in this population. [ABSTRACT FROM AUTHOR]

Background: Although in recent years, an increased number of young adult smokers have used flavored e-cigarettes, little research has been conducted to explore young adult smokers' perceptions about e-cigarette flavors. Methods: This study used qualitative methods to examine young adult smokers' perceptions towards e-cigarette flavors, their intentions of using e-cigarettes given a flavor ban, and their perceived role of e-cigarette flavors in their smoking behaviors. We conducted in-depth, semi-structured interviews to explore these themes among a purposive sample of 25 young adult smokers in the U.S. (aged 18–34) who had used e-cigarettes to reduce cigarette smoking. Thematic content analysis was employed to assess the qualitative data. Results: Most participants reported enjoying e-cigarettes with fruit, candy, dessert or menthol/mint flavors and valued having a wide selection of flavors. Most participants reported that they would likely quit or significantly reduce e-cigarette use if e-cigarette flavors were banned. Participants had little knowledge of the nicotine concentration in their e-cigarettes or the harm associated with the use of e-cigarette flavorings. Additionally, participants perceived e-cigarette flavorings as helpful in cutting down smoking by allowing for increased e-cigarette use frequency and duration. Conclusion: Participants indicated positive perceptions towards e-cigarette flavors and considered the role of e-cigarette flavors to be important in cutting down on cigarettes. Banning or restricting flavored e-cigarettes may discourage participants from using e-cigarettes for smoking cessation. The lack of knowledge about flavored e-cigarettes' harm and risks, together with the escalated consumption of flavored e-cigarettes, are causes for concern and warrant further attention. [ABSTRACT FROM AUTHOR]

The interrelationship between victimization, violence, and substance use/abuse has been well established, yet those who experience victimization do not necessarily respond with violence or substance use or escalate to experiencing substance abuse symptoms. Drawing on literature from both the syndemic research from medical anthropology and the resilience research from psychology, this study examines the interaction between early childhood adversity and young adult violent victimization on later substance use/abuse and violent offending to provide insight into conditional effects. Data are derived from the Woodlawn Study, an African American cohort of men and women from a socioeconomically heterogeneous community in the South Side of Chicago, who were followed from first grade through age 42. Results indicate that those with lower levels of childhood adversity are more likely to suffer the negative consequences of violent victimization than those with higher childhood adversity, providing support for a "steeling" effect. [ABSTRACT FROM AUTHOR]

Background: In the United States, perceptions of marijuana's acceptability are at an all-time high, risk perceptions among youth are low, and rates are rising among Black youth. Thus, it is imperative to increase the understanding of long-term effects of adolescent marijuana use and ways to mitigate adverse consequences.Objectives: To identify the midlife consequences of heavy adolescent marijuana use and the mechanisms driving effects among a Black, urban population.Methods: This study analyzed the propensity score-matched prospective data from the Woodlawn Study, a community cohort study of urban Black youth followed from ages 6-42. After matching the 165 adolescents who used marijuana heavily to 165 non-heavy/nonusers on background confounders to reduce selection effects (64.5% male), we tested the association of heavy marijuana use by age 16 with social, economic, and physical and psychological health outcomes in midlife and the ability of adult drug trajectories (marijuana, cocaine, and heroin use from ages 17-42) and school dropout to mediate effects.Results: Heavy adolescent marijuana use was associated with an increased risk of being poor and of being unmarried in midlife. Marijuana use also predicted lower income and greater anxious mood in midlife. Both adult drug use trajectories and school dropout significantly mediated socioeconomic effects but not marital or anxious mood outcomes.Conclusion: Heavy adolescent marijuana use seems to set Black, urban youth on a long-term trajectory of disadvantage that persists into midlife. It is critical to interrupt this long-term disadvantage through the prevention of heavy adolescent marijuana use, long-term marijuana and other drug use, and school dropout. [ABSTRACT FROM AUTHOR]

Depression among African Americans residing in urban communities is a complex, major public health problem; however, few studies identify early life risk factors for depression among urban African American men and women. To better inform prevention programming, this study uses data from the Woodlawn Study, a well-defined community cohort of urban African Americans followed from age 6 to 42 years, to determine depression prevalence through midlife and identify childhood and adolescent risk factors for adult depression separately by gender. Results indicate that lifetime depression rates do not differ significantly by gender (16.2 % of men, 18.8 % of women) in contrast to findings of a higher prevalence for women in national studies. Furthermore, rates of depression in this urban African American population are higher than those found in national samples of African Americans and more comparable to the higher rates found nationally among Whites. Regarding early predictors, for both men and women, family conflict in adolescence is a risk factor for adult depression in multivariate regression models. For women, vulnerability to depression has roots in early life, specifically, low maternal aspirations for school attainment. Females displaying more aggressive and delinquent behavior and those growing up in a female-headed household and a household with low maternal education have elevated rates of depression. Males growing up in persistent poverty, those engaging in greater delinquent behavior, and those with low parental supervision in adolescence also have elevated rates of depression. Effective prevention programming for urban African Americans must consider both individual characteristics and the family dynamic. [ABSTRACT FROM AUTHOR]

Aims This paper examines the association between social integration in young adulthood and the later onset of substance use and disorders through mid-adulthood. Design Data come from a community cohort of African Americans followed longitudinally from age 6–42 years with four assessment periods. Setting The cohort all lived in the Woodlawn neighborhood of Chicago in 1966, an urban disadvantaged setting. Participants All Woodlawn first graders in 1966 were asked to participate; 13 families declined ( n = 1242). Measurement Substance use was measured via interview at age 42 and includes the onset of alcohol and drug use disorders and the onset of cocaine/heroin use between ages 32 and 42 years. Social integration measures were assessed via interview at age 32 and include social roles (employee, spouse, parent), participation in religious and social organizations and a measure of overall social integration. Control variables were measured in childhood and later in the life course. Findings Multivariate regression analyses suggest that unemployment, being unmarried, infrequent religious service attendance and lower overall social integration in young adulthood predict later adult-onset drug use disorders, but not alcohol use disorders once confounders are taken into consideration. Unemployment and lower overall social integration predict onset of cocaine/heroin use later in adulthood. Conclusions Results show meaningful onset of drug use and substance use disorders during mid-adulthood and that social integration in young adulthood seems to play a role in later onset of drug use and drug disorders, but not alcohol disorders. [ABSTRACT FROM AUTHOR]

Although there has been much discussion about the persistence of poverty and welfare receipt among child-rearing women in the US, little is known about long-term patterns of poverty and welfare receipt or what differentiates those who remain on welfare from those who do not. Furthermore, are there distinctions between child-rearing women who are poor but not on welfare from those who do receive welfare? This study examined trajectories of welfare receipt and poverty among African-American women ( n = 680) followed from 1966 to 1997. A semiparametric group-based approach revealed four trajectories of welfare receipt: no welfare (64.2%), early leavers (12.7%), late leavers (10.1%), and persistent welfare recipients (10.1%). The “no welfare” group was further divided into a poverty group and a not poverty group to distinguish predictors of welfare from predictors of poverty. Multivariate analyses revealed differences in predictors of trajectory groups in terms of education, physical and psychological health, and social integration. In addition, earlier chronic illness and social integration were important predictors to differentiate between long-term users (i.e., late leavers, persistent recipients) and short-term users (i.e., early leavers). Trajectories did not differ in teenage motherhood, substance use, or family history of welfare receipt. Implications for public policy are discussed. [ABSTRACT FROM AUTHOR]

Using longitudinal data from the Woodlawn Project (N= 680), this study examined how patterns of living arrangements among a community cohort of African American mothers were associated with later physical and emotional health. We identified eight patterns of stability and transition in living arrangements during the childrearing years. Health outcomes include SF-36 Physical Functioning, SF-36 Bodily Pain, depressed mood, and anxious mood. Specific patterns of living arrangements were related to later health, controlling for age, earlier health, education, and poverty. Poverty explained many, but not all, of the relationships between living arrangements and health. Findings underscored the benefits of social support and social integration and highlighted the negative effects of marital dissolution on health. [ABSTRACT FROM AUTHOR]

The article focuses on the spread of computer-assisted reporting (CAR) source from cyberspace and its applications to journalism. It says that the level of the spread of CAR can be viewed in U.S. newspapers using on-line databases and journalists employment who are comfortable with the use of database software. It mentions that computer-assisted reporting will become a large part of the work of journalists.

A review of the article "Young Adult Longitudinal Patterns of Marijuana Use Among US National Samples of 12th Grade Frequent Marijuana Users: A Repeated-measures Latent Class Analysis" by Y.M. Terry-McElrath and others, which appears in the same issue of the journal, is presented.

Abstract: Drug use trends are typically monitored by surveys of retrospective self-reports of drug use; yet we know little about the consistency of reports made across the life course. This study examines the consistency of marijuana self-reports from adolescence and adulthood and what characterizes inconsistent reporting among a cohort of African American first graders followed longitudinally from age 6 to 32 (N =599, 51% female). Self-reported lifetime adolescent marijuana use (ages 16–17) and retrospective reports at age 32 were combined to categorize respondents as consistent reporters of nonuse (22%), consistent reporters of use (42%), adult recanters (19%), adolescent underreporters (8%), and inconsistent reporters of age of initiation (9%). Overall, about 64% of the population were consistent in their reports of adolescent marijuana use from adolescence to age 32. Multivariate logistic regression analyses found that recanters reported less marijuana use as adolescents, lower parental supervision during adolescence, lower deviant behavior as an adult, and stronger anti-drug values as adults than did consistent reporters. Adolescent underreporters reported less assault behaviors and less alcohol use as adolescents and had lower first grade math achievement than consistent reporters. Family background, depression, criminal arrests, and the field conditions of the interview were not related to inconsistent reporting. [Copyright &y& Elsevier]

Introduction: Although prior clinical and population-based studies have demonstrated comorbidity between mood and alcohol use disorders (AUD), there is a paucity of research assessing whether mood disorders predict transition across stages of alcohol involvement.Method: Hypothesizing that mood disorders predict transition across sex-specific alcohol involvement stages, we used prospective data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey of US adults, which included male (n = 14,564) and female (n = 20,089) participants surveyed in 2001-2 and re-interviewed in 2004-5. Latent class (LCA) and latent transition analyses (LTA) were used to assess patterns of alcohol involvement in the US and the association of lifetime mood disorders at baseline with transition across stages of alcohol involvement during follow-up.Results: A three-class model of AUD criteria was identified (No problems, Moderate problems and Severe problems) for both sexes. Positive cross-sectional associations between mood disorder and problem classes of alcohol involvement were found among both sexes, as were positive longitudinal associations. Propensity score adjustment mitigated the associations of baseline mood disorder with progressive transition for both sexes. However, among females, baseline mood disorder was consistently associated with reduction in remission from Severe to Moderate alcohol problems (aOR = 0.30, CI = 0.09-0.99, p = .048) over time.Discussion: Our study provides evidence that mood disorders impact transition through stages of alcohol involvement and are most strongly associated with hindering remission among females. Findings advance our understanding of these comorbid relationships and have clinical implications for ongoing assessment of drinking patterns among individuals with mood disorders. [ABSTRACT FROM AUTHOR]

Background: Electronic cigarette (e-cigarette) use is rapidly increasing among adults in the U.S. The purpose of this qualitative study was to explore consumer perceptions about e-cigarettes, including knowledge, attitudes, beliefs and perceived social norms.Methods: A total of 14 focus groups (N=116) were conducted with current adult e-cigarette users in five U.S. cities from March through May, 2014. Focus groups were segmented by age (young adults aged 18-29 and older adults aged 30 and older) as well as by e-cigarette use status (exclusive e-cigarette users and non-exclusive e-cigarette users). Focus group discussions lasted approximately 60-min and were audio-recorded and transcribed; data were analyzed using a phenomenological approach.Results: Participants expressed many positive attitudes towards e-cigarettes and simultaneously reported a lack of information and knowledge about the products. Focus group participants overwhelmingly felt as though the ingredients of e-cigarettes were likely less harmful than conventional cigarettes. Additionally, many described positive reactions from family and friends, especially when e-cigarettes were used in place of conventional cigarettes.Conclusions: Findings from this qualitative study provide insight into consumer knowledge, attitudes and beliefs about e-cigarettes increasing our understanding of why and how they are being used. Such information will help provide insight into the potential public health impact of these emerging products. [ABSTRACT FROM AUTHOR]

Abstract: Background: Age of onset of substance use disorders in adolescence and early adulthood could be associated with higher rates of adult criminal incarceration in the U.S., but evidence of these associations is scarce. Methods: Propensity score matching was used to estimate the association between adolescent-onset substance use disorders and the rate of incarceration, as well as incarceration costs and self-reported criminal arrests and convictions, of young men predominantly from African American, lower income, urban households. Age of onset was differentiated by whether onset of the first disorder occurred by age 16. Results: Onset of a substance use disorder by age 16, but not later onset, was associated with a fourfold greater risk of adult incarceration for substance related offenses as compared to no disorder (0.35 vs. 0.09, P =0.044). Onset by age 16 and later onset were both positively associated with incarceration costs and risk of arrest and conviction, though associations with crime outcomes were more consistent with respect to onset by age 16. Results were robust to propensity score adjustment for observable predictors of substance use in adolescence and involvement in crime as an adult. Conclusion: Among young men in this high risk minority sample, having a substance use disorder by age 16 was associated with higher risk of incarceration for substance related offenses in early adulthood and with more extensive criminal justice system involvement as compared to having no disorder or having a disorder beginning at a later age. [Copyright &y& Elsevier]

Background: Alcohol use has profound public health impact on women; however, modifiable factors that may influence alcohol use progression/recovery, including health service utilization, are understudied in women., Objective: To investigate the association between mental health (MH) and substance use (SU) treatment with alcohol use progression and recovery among women who currently use alcohol or have in the past., Methods: This study is a secondary data analysis of prospective data from waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; a US-nationally representative sample of adults). The analytic sample was limited to women who reported past or current alcohol use at wave 1 (N = 15,515). Latent transition analysis (LTA) examined whether receiving SU/MH treatment in the year prior to wave 1 was associated with transitioning between three empirically-derived stages of alcohol involvement (no, moderate, and severe problems classes), between Waves 1 and 2 adjusting for possible confounders using propensity score weight., Results: Compared to White female drinkers, female drinkers who were from Black, Hispanic, or other races were less likely to receive SU/MH treatment (p-values ≤. 001). SU/MH treatment in the year prior to wave 1 was associated with transitioning from the moderate problems class to the no problems class between Waves 1 and 2 (p-value = .04)., Conclusion: Receipt of SU or MH treatment among women, was associated with a higher likelihood of remission from moderate alcohol use problems to no problems over time. Future research, including investigation into treatment characteristics (e.g., frequency, duration, type) should further explore why women initially experiencing severe alcohol use problems did not experience similar remission., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: ASY has received research support from the Brain and Behavior Research Foundation, Supernus Pharmaceuticals, and Psychnostics, LLC; has served as a consultant to NIH, PCORI, and the University of Montana’s American Indian/Alaska Native Clinical & Translational Research Program, and is on the Board of Directors of Helping Give Away Psychological Science (HGAPS; a nonprofit 501c3). This does not alter our adherence to PLOS ONE policies on sharing data and materials, (Copyright: © 2024 Young et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Structural racism is how society maintains and promotes racial hierarchy and discrimination through established and interconnected systems. Structural racism is theorized to promote alcohol and tobacco use, which are risk factors for adverse health and cancer-health outcomes. The current study assesses the association between measures of state-level structural racism and alcohol and tobacco use among a national sample of 1,946 Black Americans., Methods: An existing composite index of state-level structural racism including five dimensions (subscales; i.e., residential segregation and employment, economic, incarceration, and educational inequities) was merged with individual-level data from a national sample dataset. Hierarchical linear and logistic regression models, accounting for participant clustering at the state level, assessed associations between structural racism and frequency of alcohol use, frequency of binge drinking, smoking status, and smoking frequency. Two models were estimated for each behavioral outcome, one using the composite structural racism index and one modeling dimensions of structural racism in lieu of the composite measure, each controlling for individual-level covariates., Results: Results indicated positive associations between the incarceration dimension of the structural racism index and binge drinking frequency, smoking status, and smoking frequency. An inverse association was detected between the education dimension and smoking status., Conclusions: Results suggest that state-level structural racism expressed in incarceration disparities, is positively associated with alcohol and tobacco use among Black Americans., Impact: Addressing structural racism, particularly in incarceration practices, through multilevel policy and intervention may help to reduce population-wide alcohol and tobacco use behaviors and improve the health outcomes of Black populations., (©2023 American Association for Cancer Research.)

Health equity research has identified fundamental social causes of health, many of which disproportionately affect Black Americans, such as early life socioeconomic conditions, neighborhood disadvantage, and racial discrimination. However, the role of life course factors in premature mortality among Black Americans has not been tested extensively in prospective samples into later adulthood. To better understand how social factors at various life stages impact mortality, this study examines the effect of life course poverty, neighborhood disadvantage, and discrimination on mortality and factors that may buffer their effect (i.e., education, social integration) among the Woodlawn cohort (N = 1242), a community cohort of urban Black Americans followed since 1966. Taking a life course perspective, we analyze mortality data for deaths through age 58 years old, as well as data collected at ages 6, 16, 32, and 42. At age 58, 204 (16.4%) of the original cohort have died, with ages of death ranging from 9 to 58.98 (mean = 42.9). Cox proportional hazard models adjusting for confounders show statistically significant differences in mortality risk based on timing and persistence of poverty; those who were never poor or poor only in early life had lower mortality risk at ages 43-58 than those who were persistently poor from childhood to adulthood. Education beyond high school and high social integration were shown to reduce the risk of mortality more for those who did not experience poverty early in their life course. Findings have implications for the timing and content of mortality prevention efforts that span the full life course., (© 2022. Society for Prevention Research.)

Objective: Opioid misuse has become an epidemic in the United States. In the present study, we examine potential malleable early childhood predictors of opioid misuse including whether childhood achievement, aggressive behavior, attention problems, and peer social preference/likability in first grade predicted opioid misuse and whether these relationships differed depending on participant sex., Method: Data are drawn from three cohorts of participants ( N = 1,585; 46.7% male) recruited in first grade as part of a series of elementary school-based, universal preventive interventions conducted in a Mid-Atlantic region of the US. In first grade, participants completed standardized achievement tests, teachers reported on attention problems, and peers nominated their classmates with respect to their aggressive behavior and social preference/likability. At approximately age 20, participants reported on their misuse of opioids defined as lifetime use of heroin or misuse of prescription opioids., Results: Higher levels of peer nominations for aggressive behavior in first grade predicted a greater likelihood of opioid misuse. An interaction between participant sex and attention problems was observed such that females higher in attention problems were more likely to misuse opioids, particularly prescription opioids, than females lower in attention problems. An interaction was also found between participant sex and peer likability such that males lower in peer-nominated likability were more likely to misuse opioids relative to males higher in likability., Conclusion: Given the malleable nature of attention problems, aggression, and social skills in early childhood, prevention programs that target these behaviors during this developmental period may attenuate risk for opioid misuse.

Background: Adverse childhood experiences (ACEs) are associated with a number of medical comorbidities. However, there is a paucity of data on the role ACEs play in transitions in stages of alcohol involvement., Objective: To examine the association between ACEs and transitions in alcohol problems progression and regression between No Problems, Moderate Problems and Severe Problems stages., Participants and Setting: Data from 14,363 male and 19,774 female participants in Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)., Methods: We used latent transition analysis (LTA) with propensity score adjustment to estimate the odds of transitioning across stages of alcohol involvement, between waves, based on the number of types of ACEs experienced. We hypothesized that ACEs would be associated with increased risk of progression and decreased risk of regression., Results: ACEs were associated with progression to higher alcohol involvement stages, with greatest likelihood of progression from No Problems to Severe Problems for those reporting ≥3 ACEs (males: aOR = 4.78 [CI (1.84-12.44)]; females: aOR = 3.81 [CI (1.69-8.57)]). ACEs were also associated with decreased odds of regression to less problematic alcohol involvement stages, with some distinctive patterns of associations in males and in females., Conclusions: This study suggests that ACEs impact transitions in alcohol involvement in both males and females, affecting both progression and regression. The association is magnified for those with multiple types of ACE exposures. These results highlight the need for prevention, early identification and intervention to mitigate the risks associated with childhood maltreatment., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Prior research has documented a strong association between cigarette and marijuana use among young adults; it is critical to study patterns and risk factors for co-use., Methods: Appended, cross-sectional National Health and Nutrition Examination Survey (NHANES) data were used to assess prevalence and correlates of cigarette and marijuana co-use among young adults (ages 21-30) over a 10-year period (2005-2014). Respondents (unweighted sample = 4,948) were classified into four categories regarding past-month behavior: neither use, cigarette-only use, marijuana-only use, and co-use of both. Regression models were computed to predict these categories using three waves of NHANES (unweighted sample = 3,073)., Results: Prevalence of past-month cigarette use decreased from 30.9% in 2005-2006 to 23.7% in 2013-2014 (p = 0.024) while past-month marijuana use (average 18.0%) and past-month co-use (average 9.8%) remained stable during this time. Co-use differed significantly by gender (p < 0.001; average 12.9% men, 6.8% women). Co-users were less likely to be married, more likely to endorse non-Hispanic black racial identity, more likely to have engaged in non-marijuana drug use in their lifetime and more likely to drink alcohol monthly than cigarette-only users. Co-users were more likely to have depressive symptoms, ever use non-marijuana drugs, live with a smoker, and initiate marijuana at a younger age than marijuana-only users., Conclusions: Co-use of cigarettes and marijuana remained stable but high over a ten-year period; understanding the unique characteristics, living situations, experiences, and substance use behaviors of co-users can contribute to more effective, tailored prevention and education strategies to reduce the burden of comorbid cigarette and marijuana use., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objectives: This study aims to examine the (a) probability of transition between stages of alcohol involvement and (b) influence of tobacco use and nicotine dependence on transitions., Methods: Data came from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Latent transition analysis estimated the probability of transitioning between stages of alcohol involvement across waves and the impact of tobacco use and nicotine dependence at Wave 1 on transitions., Results: Males reporting current tobacco use but no dependence at Wave 1 were more likely to progress from No Problems to Moderate Problems (adjusted odds ratio [aOR] = 1.79; 95% confidence interval [CI] [1.44, 2.22]) and from No Problems to Severe Problems (aOR = 2.44; 95% CI [1.25, 4.77]) than nontobacco users. Females reporting current tobacco use but no dependence were more likely to progress from No Problems to Moderate Problems (aOR = 2.00; 95% CI [1.37, 2.94]) and from No Problems to Severe Problems (aOR = 2.87; 95% CI [1.34, 6.13]). Females reporting current tobacco use and dependence were more likely than females not using tobacco to transition from Moderate to No Problems (aOR = 2.10; 95% CI [1.04, 4.22])., Conclusions: Results suggest that tobacco use is a preceding correlate of progression in alcohol involvement among males and females. Among females, tobacco use and nicotine dependence are also related to alcohol involvement recovery., (© 2019 John Wiley & Sons, Ltd.)

The Affordable Care Act (ACA) provides financial incentives to prevent substance use disorders (SUDs). Local health departments (LHDs) can receive funds to establish care teams that partner with primary care providers and health systems. This study estimates the potential effect of LHDs on emergency visits for SUDs, using linked data sets from the Healthcare Cost and Utilization Project Emergency Department (ED) sample for the State of Maryland-2012, the National Association of County and City Health Officials Profiles Survey 2013, and Area Health Resource File 2013 to estimate potential effect of LHDs' provision of SUD preventive care and SUD-related policy implementation. Local health department involvement in SUD-related policy during the past 2 years and provision of preventive care for behavioral health in the past year significantly reduced the probability of having a SUD-related ED visit by 11% and 6%, respectively, after controlling for individual characteristics (odds ratio [OR] = 0.89, p < .001; OR = 0.93, p < .001). After adjusting for the individual and contextual factors, LHD involvement in policy was still associated with 14% reduction in SUD-related ED visits (OR = 0.86, p < .001). Results offer insights on the extent to which the LHD activities can possibly affect SUD-related ED visits and provide a foundation for future work to identify effective LHD interventions.

Background: Prior studies on treatment for alcohol-related problems have yielded mixed results with respect to gender and race/ethnicity disparities. Additionally, little is known about gender and racial differences in time to first alcohol-related service contact amongst persons with alcohol dependence. This study explored gender and race/ethnicity differences for first alcohol-related service utilization in a population-based sample., Methods: Primary analyses were restricted to Blacks, Whites and Hispanics, ages 18-44, with lifetime alcohol dependence (n=3311) in Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions. We compared time to service use among men and women within and across race/ethnicity strata using multivariable Cox proportional hazard methods., Results: In the sample of individuals age <45 with alcohol dependence, only 19.5% reported alcohol-related service use. Overall, women were less likely than men to receive alcohol-related services in their lifetime. However, women who did receive treatment were younger at first service utilization and had a shorter interval between drinking onset and service use than men. Gender differences were consistent across racial/ethnic groups but only statistically significant for Whites. There were no appreciable race/ethnicity differences in hazard ratios for alcohol-related service use or time from drinking initiation to first service contact. Results of sensitivity analyses for persons ≥45 years old are discussed., Conclusions: There are important gender differences in receipt of and time from drinking initiation to service utilization among persons with alcohol dependence. Increased recognition of these differences may promote investigation of factors underlying differences and identification of barriers to services., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Background: Although prior studies have documented the co-occurrence of generalized anxiety disorder (GAD) and alcohol use disorder (AUD) disorder, there is a paucity of research assessing the patterns of alcohol involvement among individuals with GAD symptoms. This study investigated subtypes, or classes, of comorbid AUD and GAD symptoms, and assessed the association of class membership with health-related quality of life., Methods: Using data from the Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions, a latent class analysis was performed on the subset of individuals who were current drinkers and had reported ever experiencing a 6-month episode of feeling tense, nervous, or worried most of the time. We examined the association of these latent classes with physical and mental health-related quality of life measured by the Short Form-12, version 2., Results: Latent class analysis identified a 5-class model of AUD and GAD symptoms. A significant graded relationship was observed between the ordered classes and severity of impairment on the mental health scale of the Short Form-12, version 2, but no significant relationship was found with the physical health scale., Conclusions: Mental, but not physical, health-related quality of life in this population is associated with both the number and pattern of comorbid GAD and AUD symptoms.

Importance: Mood disorders and alcohol dependence frequently co-occur. Etiologic theories concerning the comorbidity often focus on drinking to self-medicate or cope with affective symptoms. However, there have been few, if any, prospective studies in population-based samples of alcohol self-medication of mood symptoms with the occurrence of alcohol dependence. Furthermore, it is not known whether these associations are affected by treatment or symptom severity., Objective: To evaluate the hypothesis that alcohol self-medication of mood symptoms increases the probability of subsequent onset and the persistence or chronicity of alcohol dependence., Design: Prospective study using face-to-face interviews-the National Epidemiologic Survey on Alcohol and Related Conditions., Setting: Nationally representative survey of the US population., Participants: Drinkers at risk for alcohol dependence among the 43 093 adults surveyed in 2001 and 2002 (wave 1); 34 653 of whom were reinterviewed in 2004 and 2005 (wave 2)., Main Outcomes and Measures: Association of alcohol self-medication of mood symptoms with incident and persistent DSM-IV alcohol dependence using logistic regression and the propensity score method of inverse probability of treatment weighting., Results: The report of alcohol self-medication of mood symptoms was associated with an increased odds of incident alcohol dependence at follow-up (adjusted odds ratio [AOR], 3.10; 95% CI, 1.55-6.19; P = .002) and persistence of dependence (AOR, 3.45; 95% CI, 2.35-5.08; P < .001). The population-attributable fraction was 11.9% (95% CI, 6.7%-16.9%) for incident dependence and 30.6% (95% CI, 24.8%-36.0%) for persistent dependence. Stratified analyses were conducted by age, sex, race/ethnicity, mood symptom severity, and treatment history for mood symptoms., Conclusions and Relevance: Drinking to alleviate mood symptoms is associated with the development of alcohol dependence and its persistence once dependence develops. These associations occur among individuals with subthreshold mood symptoms, with DSM-IV affective disorders, and for those who have received treatment. Drinking to self-medicate mood symptoms may be a potential target for prevention and early intervention efforts aimed at reducing the occurrence of alcohol dependence.

Background: Substance use and psychological problems are major public health issues because of their high prevalence, co-occurrence, clustering in socio-economically disadvantaged groups, and serious consequences. However, their interrelationship over time is not well understood., Methods: This study identifies and compares the developmental epidemiology from age 6 to 42 of substance use and psychological distress in a population of African American men and women. Data come from the Woodlawn study, a longitudinal study of an urban community cohort followed since 1966. We use structural equation modeling to examine pathways between substance use (i.e., alcohol, marijuana, and cocaine) and psychological distress over time by gender., Results: We find significant continuity from adolescence to midlife for substance use and for psychological distress, as well as significant correlations within time periods between substance use and psychological distress, particularly among women. We also find greater adolescent substance use predicts psychological distress in young adulthood for men, but no cross-lag associations for women. Women's adolescent psychological distress and substance use are linked uniquely to that of their mothers. Findings show additional gender differences in the developmental etiology of substance use and psychological distress., Conclusions: Findings demonstrate the continuity of substance use and psychological distress over time; the contemporaneous relationships between psychological distress and substance use within time periods, and minimal cross-lagged relationships. Findings also show that adolescent substance use may set boys on a pathway of long-term psychological distress, thus adding to evidence of negative consequences of frequent use., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Objective: Intimate partner violence (IPV) is a major public health issue, yet little is known about the association between IPV victimization and problem drinking among women. Study objectives were to (a) identify subtypes of problem drinking among women according to abuse and dependence criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV); (b) examine the association between recent IPV and the problem drinking classes; and (c) evaluate major depressive disorder (MDD) as a mediator of the IPV-alcohol relationship., Method: Data come from a cohort of 11,782 female current drinkers participating in Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Latent class analysis was used to group participants into problem drinking classes according to 11 DSM-IV abuse and dependence criteria. The IPV measure was derived from six questions regarding abusive behaviors perpetrated by a romantic partner in the past year. Past-year MDD was assessed according to DSM-IV criteria. Latent class regression was used to test the association between drinking class and IPV., Results: Three classes of problem drinkers were identified: Severe (Class 1: 1.9%; n = 224), moderate (Class 2: 14.2%; n = 1,676), and nonsymptomatic (Class 3: 83.9%; n = 9,882). Past-year IPV was associated with severe and moderate classes (severe: adjusted odds ratio [aOR] = 5.70, 95% CI [3.70, 8.77]; moderate: aOR = 1.92, 95% CI [1.43, 2.57]). Past-year MDD was a possible mediator of the IPV-drinking class relationship., Conclusions: Results indicate a strong association between recent IPV and problem drinking class membership. This study offers preliminary evidence that programs aimed at preventing problem drinking among women should take IPV and MDD into consideration.