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BackgroundAlthough the DSM-5 was adopted in 2013, the validity of the new substance use disorder (SUD) diagnosis and craving criterion has not been investigated systematically across substances.MethodsAdults (N = 588) who engaged in binge drinking or illicit drug use and endorsed at least one DSM-5 SUD criterion were included. DSM-5 SUD criteria were assessed for alcohol, tobacco, cannabis, cocaine, heroin, and opioids. Craving was considered positive if “wanted to use so badly that could not think of anything else” (severe craving) or “felt a very strong desire or urge to use” (moderate craving) was endorsed. Baseline information on substance-related variables and psychopathology was collected, and electronic daily assessment queried substance use for the following 90 days. For each substance, logistic regression estimated the association between craving and validators, i.e. variables expected to be related to craving/SUD, and whether association with the validators differed for DSM-5 SUD diagnosed with craving as a criterion v. without.ResultsAcross substances, craving was associated with most baseline validators (p valuesp's ⩽ 0.0001], with stronger associations for moderate than severe craving (p's < 0.05). Baseline DSM-5 SUD showed stronger associations with subsequent use when diagnosed with craving than without (p's < 0.05).ConclusionThe DSM-5 craving criterion as operationalized in this study is valid. Including craving improves the validity of DSM-5 SUD diagnoses, and clinical relevance, since craving may cause impaired control over use and development and maintenance of SUD.

Background Exposure to alcohol, tobacco and high fat, sugar and salt (HFSS) food imagery is a significant risk factor for the uptake and regular use of these products in young people, and imagery are more frequently portrayed in video-on-demand (VOD) than in terrestrial television programmes. This study compared alcohol, tobacco and HFSS imagery in original films on Amazon Prime Instant Video and Netflix. Methods Content analysis of 11 original films released by Amazon Prime and Netflix in 2017 using 5-minute interval coding of alcohol, tobacco and HFSS content. Proportions of intervals containing alcohol, tobacco and HFSS imagery were compared between services using the chi-square test. Results Alcohol content appeared in 200 (41.7%) out of the total of 479 intervals coded, whereas tobacco and HFSS appeared in 129 (26.9%) and 169 (35.24%), respectively. Proportions were similar between Amazon Prime Instant Video and Netflix original films and were unrelated to film age classification. Conclusions Alcohol, tobacco and HFSS content likely to promote consumption among young people occurs frequently in original films shown by VOD services in the UK. Further studies are needed to investigate effective regulatory frameworks for VOD services to protect viewers from harmful or unwanted contents.

Background Substance use disorders (SUDs) are based on pathophysiological mechanisms common to all psychoactive substances. However, general practitioners (GPs) hold different views depending on the substance in question. Objectives To determine whether the perceptions that teaching GPs and final-year residents in general practice have of patients with a SUD vary according to the substance involved and explore their professional responsibility and management experiences. Methods A cross-sectional observational study was carried out by asking residents and teaching GPs from eight faculties of medicine about their perceptions, professional responsibility and management experience of patients with tobacco, alcohol and opioid use disorders, using an online questionnaire between June and September 2017. Results The responses of 238 teaching GPs (mean age 50 years SD 3.5; 58% men) and 327 residents (mean age 28 years SD 9.9; 67% women) were analysed (response rates: 9 and 15% respectively). Tobacco smokers were considered to be more responsible for their acts than the other users. Teaching GPs and residents considered that it was their responsibility to discuss substance use. They did not feel able to manage alcohol and opioid use disorders. Tobacco cessation was mainly managed alone (78%). The results were quite similar among teaching GPs and residents. Conclusion The majority of practitioners had no difficulty managing smoking cessation. During the management of alcohol and particularly opioid use disorders, practitioners did not feel competent. The gap between their perceived responsibility and competencies should be addressed by training and promoting collaborative care.

Background: In Benin, motorcycle taxi drivers make up a significant portion of road transport. The use of psychoactive substances, a behavior recognized as being at risk of road crashes, is frequent in this group. This study aimed to analyze the association between the consumption of psychoactive substances and the occurrence of road crashes among motorcycle taxi drivers. Methods: This was a cross-sectional study involving 430 motorcycle taxi drivers selected from motorcycle taxi stands in Cotonou (Benin) using a two-stage cluster sampling technique. An interview with a structured questionnaire was used to collect data, which took place in March and April 2019. Alcohol, tramadol, and tobacco were the psychoactive substances considered in this study and their daily use was investigated. A binary logistic regression was used for the analysis. Results: Among the motorcycle taxi drivers surveyed, 27.79% (95% CI = 23.71 - 32.25) were involved in a road crash. The prevalence of psychoactive substances daily use was: 30.41% (95% CI = 26.17 - 35.00) for alcohol, 28.50% (95% CI = 24.37 - 33.02) for tramadol and 4.03% (95% CI = 2.51 - 6.42) for tobacco. Alcohol daily consumption (AOR = 2.09, 95% CI = 1.27 - 3.45, p = 0.004) was associated with a significant risk of road crashes. Conclusion: Interventions aiming to reduce psychoactive substances use should, therefore, be included in road safety policies, especially for this group.

The authors examined psychiatric comorbidities associated with alcohol use disorders and tobacco use disorders among heterosexual, bisexual, and gay and lesbian men and women in the United States and whether stress-related factors were predictive of comorbidities.The authors used data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012-2013, N=36,309) to examine the co-occurrence of past-year alcohol or tobacco use disorder with past-year anxiety disorders, mood disorders, and posttraumatic stress disorder by sexual identity (heterosexual, bisexual, gay or lesbian) and sex. The authors also examined the association of stress-related factors and social support with the presence of comorbidities.Comorbidities were more prevalent among women and sexual minorities, particularly bisexual women. More than half of bisexual (55%) and gay or lesbian (51%) individuals who met criteria for a past-year alcohol use disorder had a psychiatric comorbidity, while only one-third of heterosexual individuals who met criteria for a past-year alcohol use disorder did. Similar differences were found among those who met criteria for a past-year tobacco use disorder. Among sexual minorities, the frequency of sexual orientation discrimination (adjusted odds ratio range=1.08-1.10), number of stressful life events (adjusted odds ratio range=1.25-1.43), and number of adverse childhood experiences (adjusted odds ratio range=1.04-1.18) were significantly associated with greater odds of comorbidities. Greater social support was significantly inversely associated with tobacco use disorder comorbidities (adjusted odds ratio range=0.96-0.97).This research suggests that integrated substance use and mental health prevention and treatment programs are needed, particularly for individuals who identify as sexual minorities. The increased stressors experienced by sexual minority individuals may be important drivers of these high levels of comorbidities.

Objective: To investigate the rate of attendance at Alcohol Tobacco and Other Drug Services (ATODS) for patients discharged from an acute mental health unit with a primary/secondary diagnosis of substance use disorder (SUD); and describe factors, demographics, diagnoses and service provision that relate to their attendance. Method: All inpatients between 1 November 2016 and 31 October 2017 with a diagnosis of SUD were compared for their attendance at ATODS within 30 days of discharge. Other measures included their admission data (e.g. demographics, diagnosis), and indices of their illness severity. Results: Of 1295 admissions for a total of 900 patients, 32.4% of patients had an SUD diagnosis. Only 10.3% of these patients attended ATODS. There were no significant differences by gender, age, indigenous status, illness severity or dual diagnosis intervention during their inpatient stay on attendance. Relative to the SUD-only group, individuals with any psychiatric comorbidity were three–four times less likely to attend ATODS. Conclusion: Despite the ongoing emphasis on dual diagnosis treatment, the rate of engagement with ATODS remains low. Further review is needed to determine whether enhanced information sharing or case management models may improve attendance rates.

OBJECTIVE: To estimate alcohol, tobacco, and recreational drug use during pregnancy among nulliparous women. METHODS: In a cohort of nulliparous women followed through pregnancy from the first-trimester Nulliparous Outcomes in Pregnancy: Monitoring Mothers to be (nuMoM2b) study, self-reported use of alcohol, tobacco, and drugs was chronicled longitudinally at 4 study visits in this secondary analysis. Rates of use before pregnancy, in each trimester (visit 1, visit 2, visit 3, approximating each trimester), and at the time of delivery (visit 4) were recorded. The amount of alcohol, tobacco, and drug exposure were recorded using validated measures, and trends across pregnancy were analyzed. RESULTS: Of the 10,038 study participants, 10,028 had information regarding alcohol, tobacco, and drug use at visit 1, 9,412 at visit 2, 9,217 at visit 3, and 7,167 at visit 4. The rates of drinking alcohol, which had been 64.6% in the 3 months before pregnancy, were lower in pregnancy (3.9% at visit 1, 5.6% at visit 2, 7.0% at visit 3, and 6.1% at visit 4, p

This study’s purpose was to determine whether specific youth assets (conceptualized as influencing health behavior at the individual, family, or community level) were prospectively associated with reduced alcohol, tobacco, and other drug use (ATD) in a sample of Hispanic youth. A longitudinal community-based study was conducted with five waves of data collected annually over 4 years. Participants were Hispanic youth (14.1 years old; 53% female) and their parents ( N = 306 youth/parent pairs). Generalized linear mixed models were used to determine the prospective influence of 17 youth assets on ATD over five waves of data. Results indicated that Hispanic youth with three of seven individual-level assets (e.g., educational aspirations), any of four family-level assets (e.g., family communication), or with one of six community-level assets (e.g., positive peer role models) were significantly less likely to engage in ATD. The results suggest that assets protect Hispanic youth from ATD and that family-level assets may be particularly important.

This study examined the association of social norms (i.e., descriptive and injunctive norms) and perceived risk with alcohol, tobacco, and marijuana use in a sample of 378 Argentinean adolescents (60.3% girls, mean age 15.26 [SD = 1.26]). We conducted descriptive, correlation, and multivariate (i.e., hierarchical regression) analyses to describe substance use and examine the association of social norms and perceived risk with the frequency of heavy episodic drinking, tobacco, and marijuana. Perceived risk, injunctive norms, and descriptive peer norms were associated with frequency of substance use. Parental, but not peer, injunctive norms were associated with heavy alcohol use while peer injunctive norms were associated with tobacco and marijuana use. Findings suggest that increasing parent’s disapproval of substance use, reducing biases on descriptive and injunctive social norms on substance use, or increasing the perceived risk associated with such use may be valuable potential targets in interventions to reduce/prevent underage substance use.

Background There is some evidence that paternal health behaviours during and around pregnancy could be associated with offspring health outcomes. However, the impact that paternal health behaviours during pregnancy can have on offspring mental health is understudied and remains unclear. Methods We conducted a systematic review and meta-analysis of articles in PubMed describing studies of potentially modifiable paternal health behaviours (tobacco smoking, alcohol consumption, caffeine consumption and physical activity) in the prenatal period in relation to offspring mental health. GRADE was used to measure risk of bias. Results Eight studies were included and categorized by paternal health behaviour and offspring mental health outcome investigated. The narrative synthesis provided evidence of association between paternal health behaviours around pregnancy and offspring mental health problems, with the strongest evidence shown for tobacco use. Grouped by analysis type, two separate meta-analyses showed evidence of paternal smoking during pregnancy being associated with greater odds of ADHD in offspring (OR 1.42, 95% CI 1.02–1.99; HR 1.28, 95% CI 1.19–1.39). Conclusions The small number of studies that have investigated paternal prenatal effects on offspring mental health, and the limited sample sizes of those studies, makes it challenging to draw firm conclusions. Although existing studies suggest that paternal tobacco smoking and alcohol consumption in the prenatal period are associated with poorer offspring mental health, (particularly hyperactivity/ADHD), further investigation of potential paternal effects is required, using methods that allow stronger inference to determine whether associations are causal. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01266-w., Plain language summary More research has focused on the impact mothers’ behaviours (such as smoking or alcohol use) during and around pregnancy may have on their children’s health, with less research investigating the role paternal health behaviours may play. This review captured what research was currently available that investigated the impact of paternal alcohol, tobacco, caffeine use, and physical activity during pregnancy on children’s mental health. We showed that this area is currently under researched, finding only eight studies. However, of the research that was already published we found evidence of paternal health behaviours having an impact on children’s mental health. The strongest evidence was shown for paternal smoking during pregnancy having a negative impact on children’s hyperactivity/ADHD. No studies measured paternal caffeine use or physical activity around pregnancy. This review highlights the lack of research that has investigated the association between paternal modifiable health behaviours around pregnancy and offspring mental health. Despite including four different types of paternal health behaviours and a broad definition of offspring mental health across any age, only eight studies were shown. This review suggests further research within this area is needed which may influence health warnings to potential fathers to be both before conception and during pregnancy. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01266-w.

Alcohol, tobacco, and other drug (ATOD) use by adolescents are major contributors to death and disability in sub-Saharan Africa (SSA). This paper reviews the extent of adolescents' ATOD use, risk and protective factors, and studies evaluating prevention interventions for adolescents in SSA. It also describes the harms associated with adolescents' ATOD use in SSA, which mainly include interpersonal violence, sexual risk behaviours, and negative academic outcomes. We use the socio-ecological model as our framework for understanding ATOD use risk and protective factors at individual, interpersonal, peer/school, and societal/structural levels. We used two strategies to find literature evaluating ATOD interventions for adolescents in SSA: (a) we sought systematic reviews of adolescent ATOD interventions in SSA covering the period 2000-2020; and (b) we used a comprehensive evidence review strategy and searched for studies that had evaluated ATOD interventions in all SSA countries between 2000 and 2020. Only two community interventions (a brief intervention and an HIV prevention intervention), out of four that were identified, were partially effective in reducing adolescent ATOD. Furthermore, only one school-based intervention (HealthWise), out of six that we uncovered, had any effect on ATOD use among adolescents. Possible reasons why many interventions were not effective include methodological limitations, involvement of non-evidence-based education-only approaches in some studies, and shortcomings in adaptations of evidence-based interventions. The scale of ATOD and related problems is disproportionate to the number of evaluated interventions to address them in SSA. More ATOD interventions need to be developed and evaluated in well-powered and well-designed studies.

Background Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis and is a public health problem worldwide. It is estimated that 90% of the patients diagnosed with TB live in vulnerable environments with limited health resources, such as individuals living in correctional facilities. This study aimed to identify the consumption of alcohol, tobacco, and other drugs among prisoners diagnosed with tuberculosis and the spatial determinants and time trends of the phenomenon in southern Brazil. Methods An ecological study using data from the Brazilian Notifiable Diseases Information System. Tuberculosis cases confirmed from 2014 to 2018 in prisons located in Paraná, Brazil, were selected. The Prais-Winsten procedure was performed to identify time trends by calculating monthly rates and the percentage of monthly variation. The Seasonal-Trend by Loess decomposition method was used to verify the time series and trends. The spatial association was verified with the Getis-Ord Gi* technique, and risk areas were identified using spatial scan statistics. Results A total of 1,099 TB cases were found in the studied population. The consumption of tobacco (n = 460; 41.9%), illegal drugs (n = 451; 41.0%), and alcohol (n = 179; 16.3%) stand out. An ascending trend was found for the consumption of alcohol [+ 19.4%/mo. (95%CI: 12.20-23.03)], tobacco [+ 20.2% (95%CI: 12.20-28.82)], and illegal drugs [+ 62.2%/mo. (95%CI: 44.54–81.97)]. Spatial analysis revealed clusters for the use of alcohol, tobacco, and illegal drugs. Conclusions This study advances knowledge presenting the burden of drug use and its typology among individuals diagnosed with tuberculosis in the prison system. There is a growing trend among patients to use drugs, especially illegal drugs. The clusters show differences between the places where the prisons are located. Tuberculosis within the prison system is already a complex disease, and it is even more challenging when drugs are consumed. The consumption of drugs increased threefold when tobacco and alcohol were considered.

Objective Alcohol, tobacco, and cannabis are the three most frequently used drugs in the United States and co-use is common. Alcohol, tobacco, and cannabis use has been separately associated with altered brain structure, and alcohol and tobacco co-use results in decreases in gray matter volume. Less is known about the effect of alcohol and cannabis co-use, and alcohol, tobacco, and cannabis tri-use. Therefore, this study examined the effect of co- and tri-use on gray matter volume, a measure of brain cell density, in heavy drinkers. Method Heavy drinkers (n = 237; 152m/85f; age = 32.52; white = 111; black = 28; Latino = 9; American Indian = 2; Pacific Islander = 4; Asian = 59; mixed = 15; other = 9) were classified into four groups based on their alcohol, tobacco, and cannabis use: alcohol only users (n = 70), alcohol and tobacco co-users (n = 90), alcohol and cannabis co-users (n = 35), and alcohol, tobacco, and cannabis tri-users (n = 42). All participants completed a structural MRI scan. Voxel-based morphometry was conducted to evaluate the effect of co-use on gray matter volume, with alcohol only users as the reference group. Age, sex, and scanner were included as covariates. Results Alcohol and tobacco co-users had significantly decreased left orbitofrontal gray matter volume relative to alcohol only users (Cohen's d = .79). There were no differences in gray matter volume between the alcohol only and alcohol and cannabis co-users, or between the alcohol only and tri-user groups. Conclusion The additive effect of tobacco co-use on gray matter volumes in heavy drinkers was limited and localized. The effect of tri-use of alcohol, tobacco, and cannabis may have interacted, such that overlapping cannabis and tobacco use masked volume differences present in separate co-using groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

In the past dozen years the regulatory systems surrounding the traditional vices of alcohol, tobacco, and gambling have been extensively overhauled in Russia, generally in the direction of tighter control. This paper surveys these reforms and assesses their impact. In the case of alcohol and tobacco, the reforms generally have been quite salutary, even as opportunities to engage legally in these vices remain plentiful; Russia’s extensive geographical ban on casino gambling might rein in compulsive wagering, but at the cost of putting legal casino gambling out of reach for most Russians. Informal markets continue to limit the effectiveness of formal vice market regulations, but do not preclude the maintenance of robust regimes that can protect (arguably) rational vice participation, while still raising meaningful barriers to less-than-fully considered vice decision-making.

NY State community health center sites were surveyed in 2012 to assess the availability of alcohol, tobacco, and other drug services for the underserved. Surveys were completed from 156 of 251 adult primary care clinical sites (62% response rate). Seventy-one percent of sites had guidelines requiring screening for mental health problems while less than half (46%) had guidelines for substance use disorders. In practice, 55% of clinics reported nearly all adults were screened for mental health disorders compared to 32% of adults for substance use disorders (SUD). Forty three percent of sites that screened patients for SUD did not use a standard screening instrument. More than three quarters of sites offered tobacco cessation services while 17% reported offering SUD treatment. Findings from multi-level analyses suggested that FQHC organizations influence sites’ SUD screening requirements but not the provision of on-site treatment. Analyses further suggested that neither geographic setting (urban/rura...

OBJECTIVES: This study aimed to better examine substance use among college students during the acute period of transition between high school and college. METHODS: One week before coming to campus, participants completed an online survey assessing their alcohol, tobacco, and marijuana use. Next, beginning on the first Friday of the semester, they completed a 10-day experience sampling (ES) protocol, receiving one app-based survey each morning assessing recent substance use. RESULTS: Among students who used any tobacco product prior to college, 70% or more reported alcohol use during ES. Among previous marijuana users, 85.7% reported alcohol use during ES. Baseline alcohol and tobacco use were not associated with subsequent marijuana use. CONCLUSIONS: Substance use prevention should target the transition to college.

Purpose To assess structural changes in the retina using optical coherence tomography (OCT) in children prenatally exposed to toxic substances. Methods The study included a total of 49 infants, aged between 5 and 18 years, exposed to toxic substances during pregnancy. Among the exposed children, 25 were exposed to tobacco, 20 were exposed to alcohol, and 4 children were exposed to other drugs of abuse. All children underwent a complete ophthalmology examination, including an OCT. The results were compared against a control group composed of 25 infants, age matched with controlled pregnancy, and not exposed to toxic substances. Results Children prenatally exposed to toxic substances showed significantly thinner average retinal nerve fibre layer (RNFL) compared with control children (81.5 vs. 99.7 μm; p Conclusion Toxic substances during pregnancy interfere in retinal development. These results strengthen the evidence about the avoidance of any toxic substance during pregnancy.

Background Substance use seems to be higher among populations with chronic pain. Aim The aim of this study is to examine the relationship between the quantity of alcohol, tobacco, and psychotropic drugs consumed and chronic pain among women and men. Method Linear and logistic regression analyses were carried out using data from the 2015-2016 adults’ version of the Andalusian Health Survey which is a representative cross-sectional population-based study (n = 6,569 adults aged >16 years; 50.8% women; 49.2% men). Results Disabling chronic pain was statistically associated with higher tobacco consumption among men (β = –30.0, 95% confidenct interval [CI] –59.5 to –0.60; t = –2.0; p < .05). Regarding alcohol, non-disabling chronic pain and a higher quantity of alcohol consumed are statistically associated for both sexes (women: β = 30.4, 95% CI 2.3-58.6; t = 2.12; p < .05 vs. men: β = 164.2, 95% CI 24.3-340.1); t = 2.30; p < .05). For women and men, both disabling chronic pain (women: odds ratio [OR] = 8.7, 95% CI 6.0-12.7); p < .05 vs. men: OR = 3.5, 95% CI 1.5-8.2); p < .05) and non-disabling chronic pain (women: OR = 3.7, 95% CI 2.0-7.0); p

The study examines the rate of alcohol, tobacco, and marijuana use among White, African American, and Latino adolescents and whether racial/ethnic bullying subtypes (victim-only, bullies-only, and bully/victim) are related to alcohol, tobacco, and marijuana use. We used data from the 2009–2010 Health Behaviour in School-aged Children study (n = 9863) to examine differences in alcohol, tobacco, and marijuana use among White, African American, and Latino adolescents in the USA, and assessed whether racial/ethnic bullying involvement was associated with alcohol, tobacco, and marijuana use among these adolescents. Adolescents were categorized into four groups based on whether they had experienced racial bullying perpetration, victimization, both perpetration, and victimization, or neither perpetration nor victimization. Descriptive statistics were conducted to examine the distributions of the study variables and describe the samples. Spearman’s rank-order correlation analyses were used to examine the relationships among the variables. Multinomial logistic regression was conducted to examine alcohol, tobacco, and marijuana use among the racial bully victimization, perpetration, and victimization-perpetration groups compared to the non-involved group by race/ethnicity. The White victim–only group was more likely to use alcohol but less likely to use tobacco. The African American victim–only group was more likely to use alcohol, and the bully/victim group was more likely to use marijuana. The Latino victim–only group was more likely to use alcohol, whereas the bully/victim group was more likely to use tobacco. Our findings have implications for the development and implementation of prevention and intervention programs across different racial/ethnic adolescent groups.

Objective: To estimate the prevalence of co-occurrence of alcohol, tobacco, and illicit drug use among students at a public university in a municipality in Southern Brazil, and to evaluate the factors associated with this practice. Methods: Cross-sectional study conducted with undergraduate students between November 2017 and July 2018, to whom a digital self-administered questionnaire was applied. The relationship between the dependent variables co-occurrence of alcohol, tobacco, and illicit drug use and co-occurrence of alcohol and illicit drug use was analyzed using binary logistic regression with a 95% confidence interval. Results: Of the 1,824 university students, 92.0% consumed alcohol in their lifetime, 11.0% smoked, 43.9% used at least one illicit drug in their lifetime, and 23.3% used at least one illicit drug in the last 30 days. The rate of co-occurrence of alcohol, tobacco, and illicit drug use was 5.2%, and it was associated with belonging to the highest economic class (p = 0.0003), experimenting with drugs before the age of 18 (p = 0.0013), and attending an exact sciences or land/agricultural sciences program (p = 0.0386). The prevalence of co-occurrence of alcohol and illicit drug use was 13.6%, and it was associated with belonging to the highest economic class (p = 0.0000), male gender (p = 0.0323), depression (p = 0.0001), experimentation with alcohol before the age of 18 (p = 0.0000), attending a linguistics or arts and literature program (p = 0.0314) and living alone/with friends (p = 0.0000). Conclusion: The co-occurrence of alcohol and drug use was higher than the co-occurrence of use of the three substances, and factors such as experimenting with drugs before the age of 18 and being of higher economic status were associated with these patterns. Objetivo: Estimar la prevalencia del uso concurrente de alcohol, tabaco y drogas ilícitas entre los estudiantes de una universidad pública de un municipio del Sur de Brasil así como evaluar los factores asociados con esa práctica. Métodos: Estudio transversal realizado con estudiantes de grado entre noviembre de 2017 y julio de 2018 a los cuales se les ha dado un cuestionario digital auto aplicado. La relación entre las variables dependientes uso concurrente de alcohol, tabaco y drogas ilícitas y uso concurrente de alcohol y drogas ilícitas ha sido analizada por la regresión logística binaria con intervalo de confianza del 95%. Resultados: De los 1.824 universitarios, el 92,0% ha consumido alcohol en la vida, el 11,0% fumaban, el 43,9% ha utilizado por lo menos una droga en la vida y el 23,3% por lo menos una en los últimos 30 días. El consumo concurrente de alcohol, tabaco y drogas ha sido del 5,2% y se ha asociado con la clase económica más alta (p=0,0003), la experiencia con la droga antes de los 18 años de edad (p=0,0013) y asistir a cursos de ciencias exactas y tierra/ciencias agrarias (p=0,0386). La prevalencia del uso concurrente de alcohol y drogas ha sido del 13,6% asociado con la clase económica más alta (p=0,0000), el género masculino (p=0,0323), la depresión (p=0,0001), la experiencia del alcohol antes de los 18 años de edad, asistir al curso de lingüística, letras y artes (p=0,0314) y vivir solo/con los amigos (p=0,0000). Conclusión: El consumo concurrente de alcohol y drogas ha sido más alto que el consumo concurrente de las tres sustancias; y factores como la experiencia con drogas antes de los 18 años de edad y ser de la clase económica más alta se han asociado.

Behavioral health conditions such as addiction are chronic diseases that require long-term treatment. In 2018, 20.3 million people had a substance use disorder in the United States. Additionally, 58.8 million people were current tobacco users, 67.1 million binge drank, and 16.6 million drank alcohol heavily. Important sex and gender differences exist in addiction from epidemiology to efficacy of treatment approaches. Generally, substance use disorders are more common among men than women, although women typically progress more quickly from substance use to addiction than men and present to treatment with more severe disease status and more medical and psychosocial co-morbidities. Although women typically face more barriers to treatment than men, their treatment outcomes are similar. A gender lens should be incorporated into both the clinical care of people with substance use disorder and public health approaches to addiction and recovery.

Objectives: to analyze, in the light of systemic thinking, the association between family dynamics and the use of alcohol, tobacco, and other drugs by adolescents throughout life. Methods: a cross-sectional descriptive study was conducted in nine public schools in the city of Recife. Three hundred and sixty-four adolescents aged 14 to 19 years participated. We used three questionnaires: The Alcohol, Smoking, and Substance Involvement Screening Test, a reduced version of the Drug Use Screening Inventory; and a sociodemographic questionnaire. Results: there was an association between parents/guardians ignoring what the child considers meaningful to him and the consumption of alcohol and tobacco by adolescents; we also verified an association between the occurrence of conflicting relationships and the consumption of illicit drugs by adolescents. Conclusions: it confirmed that disorganization in the family system, marked by impairments in emotional connections among members, and fragility in the sense of belonging are associated with the consumption of drugs in life by adolescents. RESUMEN Objetivos: analizar, a la luz del pensamiento sistémico, la asociación entre la dinámica familiar y el consumo de alcohol, tabaco y otras drogas en la vida por adolescentes. Métodos: estudio descriptivo transversal realizado en nueve escuelas públicas de Recife. Participaron 364 adolescentes con edad entre 14 a 19 años. Fueron utilizados tres encuestas: el Alcohol, Smoking and Substance Involvement Screening Test, una versión reducida del Drug Use Screening Inventory; y una encuesta sociodemográfica. Resultados: hubo asociación entre padres/responsables desconocieron lo que su hijo considera importante y el consumo de alcohol y tabaco por adolescentes; también se verificó asociación entre ocurrencia de relaciones conflictivas y el consumo de drogas ilícitas por adolescentes. Conclusiones: fue evidenciado que la desorganización en el sistema familiar, marcada por perjuicios en las conexiones emotivas entre los miembros, y la fragilidad en el sentimiento de pertenecer están relacionadas al consumo de drogas en vida por los adolescentes. RESUMO Objetivos: analisar, à luz do pensamento sistêmico, a associação entre a dinâmica familiar e o consumo de álcool, tabaco e outras drogas na vida por adolescentes. Métodos: estudo descritivo transversal realizado em nove escolas públicas do Recife. Participaram 364 adolescentes com idade entre 14 a 19 anos. Foram utilizados três questionários: o Alcohol, Smoking and Substance Involvement Screening Test, uma versão reduzida do Drug Use Screening Inventory; e um questionário sociodemográfico. Resultados: houve associação entre pais/responsáveis desconhecerem o que o filho considera importante para ele e o consumo de álcool e tabaco por adolescentes; também verificou-se associação entre ocorrência de relações conflituosas e o consumo de drogas ilícitas por adolescentes. Conclusões: foi evidenciado que a desorganização no sistema familiar, marcada por prejuízos nas ligações emotivas entre os membros, e a fragilidade no sentimento de pertença estão associadas ao consumo de drogas na vida pelos adolescentes.

Virtually no studies appraised the co-use of alcohol, tobacco, and other drug (ATOD) among Finn undergraduates. We assessed the associations between sociodemographic, health, academic, policy, and lifestyle characteristics (independent variables), and individual, multiple and increasing ATOD use (dependent variables) using regression analyses. Data were collected by online questionnaire at the University of Turku, Finland (1177 students). Roughly 22% of the sample smoked, 21% ever used illicit drug/s, 41% were high frequency drinkers, and 31.4%, 16.3%, and 6.7% reported 1, 2, or 3 ATOD behaviors respectively. Individual ATOD use was significantly positively associated with the use of the other two substances [adjusted odds ratio (Adj OR range 1.893–3.311)]. Multiple ATOD use was negatively associated with being single (p = 0.021) or agreeing with total smoking or alcohol ban policy on campus (p &lt, 0.0001 for each), but positively associated with not living with parents (p = 0.004). Increasing ATOD behaviors were significantly less likely among those agreeing with total smoking or alcohol ban policy on campus (p range 0.024 to &lt, 0.0001). Demographics significant to either individual, multiple, or increasing ATOD use included males, being single, not living with their parents during semesters, and to some extent, religiosity. Age, depressive symptoms, perceived stress, self-rated health, health awareness, income sufficiency, and academic variables were not associated with individual, multiple, or increasing ATOD use. Education and prevention efforts need to reinforce abstinence from ATOD, highlight their harmful outcomes, and target risk groups highlighted above. University strategies should be part of the wider country-wide successful ATOD control policies.

Objectives: to analyze the factors associated with the use of alcohol, tobacco and illicit drugs among Brazilian undergraduate students. Methods: observational, cross-sectional study, with convenience sampling, conducted in 2014/2015, involving institutional data and a self-completed online questionnaire, analyzed using measures of frequency, central tendency/dispersion and logistic regression. Results: among 126,326 students, 62.8% reported alcohol use; 11%, tobacco; and 7.5%, illicit drugs. Several academic factors-such as not residing with family (sororities [alcohol: aOR:2.38;95%CI:2.28-2.48; tobacco: AOR:2.20;95%CI:2.09-2.33; illicit drugs: AOR:2.53;95%CI:2.38-2.70]), acting in university movements (student [alcohol: AOR:1.74;95%CI:1.65-1.83; tobacco: AOR:1.97;95%CI:1.86-2.08; illicit drugs: AOR:2.43;95%CI:2.28-2.59] and religious [alcohol: AOR:0.28;95%CI:0.26-0.29; tobacco: AOR:0.23;95%CI:0.21-0.26; illicit drugs: AOR:0.18;95%CI:0.16-0.21]) and lack of discipline/study habit (alcohol: AOR:1.41;95%CI:1.37-1.45; tobacco: AOR:1.53;95%CI:1.46-1.59; illicit drugs: AOR:1.85;95%CI:1.76-1.94) - were associated with the use of the three categories of substances. Conclusions: we identified that a number of academic factors are associated with licit and illicit drug use. These findings may help in designing preventive strategies among college students. RESUMEN Objetivos: analizar factores relacionados al uso de alcohol, tabaco y drogas ilícitas en graduandos brasileños. Métodos: estudio observacional, transversal, con muestreo por conveniencia, realizado en 2014/2015, envolviendo datos institucionales y encuesta en línea autorellenado, analizados por medio de medidas de frecuencia, tendencia central/dispersión y regresión logística. Resultados: entre 126.326 estudiantes, 62,8% reportaron uso de alcohol; 11%, tabaco; y 7,5%, drogas ilícitas. Diversos factores académicos - como no residir con la familia (repúblicas [alcohol: Ora:2,38;IC95%:2,28-2,48; tabaco: Ora:2,20;IC95%:2,09-2,33; drogas ilícitas: Ora:2,53;IC95%:2,38-2,70]), actuar en movimientos universitarios (estudiantil [alcohol: Ora:1,74;IC95%:1,65-1,83; tabaco: Ora:1,97;IC95%:1,86-2,08; drogas ilícitas: Ora:2,43;IC95%:2,28-2,59] y religioso [alcohol: Ora:0,28;IC95%:0,26-0,29; tabaco: Ora:0,23;IC95%:0,21-0,26; drogas ilícitas: Ora:0,18;IC95%:0,16-0,21]) y falta de disciplina/hábito de estudio (alcohol: Ora:1,41;IC95%:1,37-1,45; tabaco: Ora:1,53;IC95%:1,46-1,59; drogas ilícitas: Ora:1,85;IC95%:1,76-1,94) - relacionados al uso de tres categorías de substancias. Conclusiones: identificamos que una serie de factores académicos están relacionados al consumo de drogas lícitas e ilícitas. Esos hallados pueden ayudar a elaborar estrategias preventivas entre universitarios. RESUMO Objetivos: analisar os fatores associados ao uso de álcool, tabaco e drogas ilícitas em estudantes de graduação brasileiros. Métodos: estudo observacional, transversal, com amostragem por conveniência, realizado em 2014/2015, envolvendo dados institucionais e questionário on-line autopreenchido, analisados por meio de medidas de frequência, tendência central/dispersão e regressão logística. Resultados: entre 126.326 estudantes, 62,8% reportaram uso de álcool; 11%, tabaco; e 7,5%, drogas ilícitas. Diversos fatores acadêmicos - como não residir com a família (repúblicas [álcool: ORa:2,38;IC95%:2,28-2,48; tabaco: ORa:2,20;IC95%:2,09-2,33; drogas ilícitas: ORa:2,53;IC95%:2,38-2,70]), atuar em movimentos universitários (estudantil [álcool: ORa:1,74;IC95%:1,65-1,83; tabaco: ORa:1,97;IC95%:1,86-2,08; drogas ilícitas: ORa:2,43;IC95%:2,28-2,59] e religioso [álcool: ORa:0,28;IC95%:0,26-0,29; tabaco: ORa:0,23;IC95%:0,21-0,26; drogas ilícitas: ORa:0,18;IC95%:0,16-0,21]) e falta de disciplina/hábito de estudo (álcool: ORa:1,41;IC95%:1,37-1,45; tabaco: ORa:1,53;IC95%:1,46-1,59; drogas ilícitas: ORa:1,85;IC95%:1,76-1,94) - foram associados ao uso das três categorias de substâncias. Conclusões: identificamos que uma série de fatores acadêmicos estão associados ao consumo de drogas lícitas e ilícitas. Esses achados podem ajudar a elaborar estratégias preventivas entre universitários.

OBJECTIVES: People under stress tend to use unhealthy coping mechanisms including using products like alcohol, tobacco and unhealthy snacks. The purpose of this study is to assess how measures of community socio-economic status, which may be proxies for community stress, are associated with the sales of unhealthy products (alcohol, tobacco, and unhealthy snacks) at a discount variety store chain. Specifically, we consider the following measures of community socio-economic status: population racial/ethnic composition, % of households on SNAP, % of households without a vehicle, walkability score and median community income. METHODS: Mixed effects linear regressions with random effects were used to examine the relationship between the weekly unit sales (per 1000 population) of three outcome variables (tobacco, alcohol, unhealthy snacks) and community socio-economic factors: % of households on SNAP, % of households without a vehicle, and median community income. RESULTS: The sales of alcohol, tobacco, and unhealthy snacks increased as the % of the population participating in SNAP increased. Other measures of community socio-economic status were not significantly (at 5% significance level) associated with tobacco or unhealthy snack sales. However, for alcohol sales, increases in: the median household income, walkability score and % of African American residents, were associated with a decrease in alcohol sales. CONCLUSIONS: Low income neighborhoods frequently experience greater health burden compared to higher income neighborhoods. Understanding and quantifying the relationship between financial stress and unhealthy product consumption can help public health professionals intervene before chronic diseases manifest. FUNDING SOURCES: Robert Woods Johnson Foundation.

The effects of psychoactive substance abuse are not limited to the user, but extend to the entire family system, with children of substance abusers being particularly at risk. This meta-analysis attempted to quantify the longitudinal relationship between parental alcohol, tobacco, and drug use and child well-being, investigating variation across a range of substance and well-being indices and other potential moderators. We performed a literature search of peer-reviewed, English language, longitudinal observational studies that reported outcomes for children aged 0 to 18 years. In total, 56 studies, yielding 220 dependent effect sizes, met inclusion criteria. A multilevel random-effects model revealed a statistically significant, small detriment to child well-being for parental substance abuse over time (r= .15). Moderator analyses demonstrated that the effect was more pronounced for parental drug use (r= .25), compared with alcohol use (r= .13), tobacco use (r= .13), and alcohol use disorder (r= .14). Results highlight a need for future studies that better capture the effect of parental psychoactive substance abuse on the full breadth of childhood well-being outcomes and to integrate substance abuse into models that specify the precise conditions under which parental behavior determines child well-being.Registration: PROSPERO CRD42017076088

The consumption of alcohol, tobacco and other drugs is considered a public health problem, being one of the main causes of academic failure of university students. The objective of this research was to identify psychosocial characteristics in clusters of alcohol, tobacco and other drug consumers. A sample of 3741 college students from Ecuador who complete a psychosocial questionnaire was used. Sparse K-means algorithm showed three clusters. Cluster CLNA1 represents students with low consume of tobacco and alcohol. Apparently, they do not have depression and are comfortable with their lives. CLNA2 presents low consume of tobacco and alcohol. This group shows signals of depression and they consider that there are aspects of their life to improve and small but significant problems of their life. CLNA3 presents the higher consume of tobacco and alcohol.

Labor force and school attachment may influence alcohol, tobacco, and marijuana use in the US and Canada. Differences in social welfare provision, which provide protections for individuals with ins...

Purpose Despite the prevalence of alcohol, tobacco, and other drug (ATOD) use screening as part of prenatal care, pregnant women's perspectives on screening are largely absent from research and clinical practice. This study examines pregnant women's acceptability of ATOD screening and willingness to disclose their ATOD use in prenatal care. Methods Pregnant women completed a self-administered survey and structured interview at four prenatal care facilities in Louisiana and Maryland (N = 589). Participants reported the acceptability of screening and their willingness to honestly disclose their ATOD use to their provider. Data were analyzed through descriptive statistics, tests of proportions, simple regression models, and coding of open-ended responses. Results Nearly all pregnant women found screening acceptable for alcohol (97%), tobacco (98%), and other drug use (97%) during prenatal care. The acceptability of alcohol use screening was higher among those who reported binge drinking (98% vs. 96%; p = .002) and risky alcohol consumption (99% vs. 96%; p = .018). The acceptability of screening for other drugs was higher among women reporting binge drinking (98% vs. 96%; p = .032) and other drug use (98% vs. 96%; p = .058). Almost all pregnant women indicated that they were willing to disclose their alcohol (99%), tobacco (99%), and other drug use (98%) to their provider. Conclusions Almost all women considered verbal screening for ATOD use during prenatal care acceptable and indicated that they were willing to honestly disclose their ATOD use. Verbal screening may allow for the opportunity to initiate safe, nonjudgmental conversations about women's substance use, risk, and goals for their ATOD use, pregnancy, and parenting.

Introduction Craving has been proposed as a major contributor to addiction relapse and the influence of mood on craving and substance use has been extensively documented. However, information is lacking concerning the extent to which the magnitude of these effects may vary according to different types of substances. The aim of the present study was to compare the prospective links between emotions, craving and substance use in four groups of patients beginning treatment for alcohol, tobacco, cannabis, or opiate addiction. Methods Ecological Momentary Assessment (EMA) was used over a two-week period. Data were analyzed using hierarchical linear modeling (HLM). Results 159 participants were recruited (67.3% male; M = 36.7 years). The average response rate to the EMA assessments was 83.1%. The findings confirmed the strong predictive role of craving intensity on substance use reported at the next assessment of the day among the alcohol (γ = 0.224; p = .018), tobacco (γ = 0.133; p = .013) and cannabis groups (γ = 0.266; p = .019), but not for opiates (γ = 0.098; p = .142). Craving intensity was itself predicted by greater anxious mood (γ = 0.108; p = 0,029) and event negativity (γ = 0.107; p = .003) among tobacco patients, lower sad mood among cannabis patients (γ = −0.248; p = 0,002), and lower event negativity among opiate patients (γ = −0.201; p = .002). Conclusion While these results support the benefit of targeting craving in addiction treatment regardless of substance type, the substance-specific emotional risk factors for craving identified in this study may provide important insights for the development of personalized treatment strategies.

Parental conversations with their teenage children about alcohol, tobacco and drugs, are associated with lower rates of use. Looked after young people are at greater risk of early initiation, higher rates of use and more problematic use. However, there is no evidence regarding whether these conversations occur in settings where the parental role is assumed by someone other than the biological parent. The aim of the study was to examine how carers communicate with looked after young people about alcohol, tobacco and drug use. In-depth interviews were conducted with 16 residential care staff and foster carers in Scotland. Data were analysed using a thematic analysis approach. Participants talked about ‘shared doing’ as a way of building relationships and communicating about substance use. Shared doing encompassed particular activities that carers and young people would do together, such as driving in the car, cooking, watching TV and going for a walk. Shared doing provided an opportunity to spend time together and to create an environment in which communication could be facilitated. These environments were shaped by space, time and context. Carers should be encouraged to take advantage of the time-limited occasions they are with young people to have conversations about substance use.

Contains fulltext : 193278.pdf (Publisher’s version ) (Closed access) BACKGROUND: Neuroimaging studies have demonstrated gray matter (GM) volume abnormalities in substance users. While the majority of substance users are polysubstance users, very little is known about the relation between GM volume abnormalities and polysubstance use. METHODS: In this study we assessed the relation between GM volume, and the use of alcohol, tobacco, cocaine and cannabis as well as the total number of substances used, in a sample of 169 males: 15 non-substance users, 89 moderate drinkers, 27 moderate drinkers who also smoke tobacco, 13 moderate drinkers who also smoke tobacco and use cocaine, 10 heavy drinkers who smoke tobacco and use cocaine and 15 heavy drinkers who smoke tobacco, cannabis and use cocaine. RESULTS: Regression analyses showed that there was a negative relation between the number of substances used and volume of the dorsal medial prefrontal cortex (mPFC) and the ventral mPFC. Without controlling for the use of other substances, the volume of the dorsal mPFC was negatively associated with the use of alcohol, tobacco, and cocaine. After controlling for the use of other substances, a negative relation was found between tobacco and cocaine and volume of the thalami and ventrolateral PFC, respectively. CONCLUSION: These findings indicate that mPFC alterations may not be substance-specific, but rather related to the number of substances used, whereas, thalamic and ventrolateral PFC pathology is specifically associated with tobacco and cocaine use, respectively. These findings are important, as the differential alterations in GM volume may underlie different cognitive deficits associated with substance use disorders.

OBJECTIVE: Research on effects of pregnancy termination on women’s alcohol, tobacco, and other drug (ATOD) use suffers from methodological and conceptual problems. Improving on prior methodologies, this study examines changes in ATOD use over 5 years among women seeking terminations. METHOD: Data are from the Turnaway Study, a longitudinal study of 956 women seeking terminations at 30 U.S. facilities. Participants presented just below a facility’s gestational limit and received terminations (Near-Limits) or just beyond the limit and were denied terminations (Turnaways). Using mixed-effects logistic regression, we assessed differences in ATOD use over 5 years among Near-Limits and Turnaways. RESULTS: There were no differences in ATOD use before pregnancy recognition; 1 week after termination seeking, Turnaways had lower odds than Near-Limits of any and heavy episodic alcohol use (p < .001), but not alcohol problem symptoms, tobacco use, or other drug use. Although both groups increased in any alcohol use over time, Turnaways increased more rapidly. Neither group increased any other ATOD measures over time. Turnaways’ lower odds of heavy episodic alcohol use at 1 week after termination seeking were maintained throughout the subsequent 5 years. There was no differential change in problem alcohol use or in tobacco or other drug use over time, yet fewer Turnaways than Near-Limits reported problem alcohol symptoms 6 months through 3.5 years. CONCLUSIONS: There is no indication that terminating a pregnancy led women to increase heavy episodic or problem alcohol use or to increase tobacco or other drug use. Women denied terminations had temporary or sustained reductions in all alcohol measures, but not tobacco or other drugs, suggesting that relationships between pregnancy/parenting and ATOD differ across substances.

Tobacco use, lack of physical activity and poor diet, and alcohol consumption are leading causes of death in the United States. We estimated screening and counseling rates by using a nationally representative sample of adults aged 35 years and older with a preventive care supplement to the 2014 Medical Expenditure Panel Survey. Receipt of the recommended level of services ranged from nearly two-thirds (64.2% for obesity, 61.9% for tobacco use) to less than one-half (41.0% for alcohol misuse). There is significant room for improving care delivery, but primary care practices probably also need additional resources to raise screening and counseling rates.

Introduccion: El consumo de drogas en jovenes es considerado un grave problema de salud publica. Objetivo: Conocer la prevalencia del consumo de alcohol, tabaco y otras drogas en jovenes universitarios. Metodologia. Estudio descriptivo y transversal, se encuestaron 434 alumnos del Centro Universitario de Ciencias Biologicas y Agropecuarias de la Universidad de Guadalajara, seleccionados al azar, de ambos sexos, se aplicaron cuestionarios acerca del consumo de alcohol tabaco y otras drogas, el analisis estadistico se realizo mediante la prueba t de student y la Prueba X 2 . Resultados: 49% fueron mujeres y 51% hombres, 84.6% consume alguna bebida alcoholica, siendo la cerveza la bebida preferida. El 26.7% son fumadores, los hombres fuman mas (33.5%) que las mujeres (19.7%) con diferencia estadistica significativa (p

The aim of this study was to estimate the prevalence of use of licit and illicit drugs and verify the behavioral profile among truck drivers. A total of 697 truck drivers were interviewed at a gas station on BR-153, between from February 2014 to February 2015. The questionnaire ASSIST was applied to screening the use of alcoholic beverages, tobacco and illicit drugs. Sociodemographic information and professional were also collected. Urine samples were screened for licit and illicit drugs. All of truckers were male, median age of 42 years, most of them married and low scholarity. 47% related moderate or high consumption of alcohol and tobacco and need a brief intervention. 21% use of cocaine, cannabinoids, amphetamine, hypnotics/sedatives, opioids, inhalants and need specialist treatment. From the 697 participants, 94% provided urine samples. 10,5% were positive for drugs. 5,2% were positive for cocaine, 2,6% for cannabinoids, 2,0% for amphetamine, 0,4% for benzodiazepines, 0,3% positive for methamphetamines and 1,4% for combined use of two drugs. Young and single truckers use tobacco, cannabis and amphetamines and need to receive brief intervention for these drugs. Truck drivers in the northern region of low education, require specialized treatment for tobacco. Truck drivers make high use of tobacco, alcohol, cocaine and other ilicit drugs. Measures are needed to improve quality of life to the drivers, as well as to prevent and treat individuals who use licit and illicit drugs in order to reduce engagement with traffic accidents. Se estimó la prevalencia del uso de drogas lícitas e ilícitas y verificar el perfil de comportamiento de los camioneros. Se entrevistó a 697 camioneros en una gasolinera de la BR-153, de febrero 2014 a febrero 2015. Se aplicó el cuestionario ASSIST para rastrear el consumo de bebidas alcohólicas, tabaco y drogas ilícitas. También se recogió información sociodemográfica y profesional. Se analizaron muestras de orina para detectar drogas lícitas e ilícitas. Los conductores de camiones eran hombres, con una edad media de 42 años, la mayoría de los cuales estaban casados y tenían un nivel educativo bajo. El 47% informó un consumo moderado o alto de alcohol y tabaco y necesitaría una breve intervención y 21% consumía cocaína, cannabinoides, anfetaminas, hipnóticos/sedantes, opioides, inhalantes y necesitan tratamiento especializado. De los 697 participantes, el 94% proporcionó muestras de orina. El 10,5% fueron positivos a fármacos; 5,2% fueron positivos para cocaína, 2,6% para cannabinoides, 2,0% para anfetaminas, 0,4% para benzodiazepinas, 0,3% para metanfetaminas y 1,4% para el uso combinado de drogas. Los conductores de camiones jóvenes y solteros consumían tabaco, marihuana y anfetaminas y necesitaban recibir una breve intervención. Para los camioneros de la región Norte, con bajo nivel educativo, era necesario un tratamiento especializado para el tabaquismo. Los camioneros consumen mucho tabaco, alcohol, cocaína y otras drogas. Se necesitan medidas para mejorar la calidad de vida de los conductores, así como para prevenir y tratar a los usuarios de drogas, con el fin de reducir la participación en accidentes de tráfico. O objetivo deste estudo foi estimar a prevalência do uso de drogas lícitas e ilícitas e verificar o perfil comportamental de caminhoneiros. Foram entrevistados 697 motoristas de caminhões em um posto de gasolina da BR-153, de fevereiro de 2014 a fevereiro de 2015. O questionário ASSIST foi aplicado para rastreamento do uso de bebidas alcoólicas, tabaco e drogas ilícitas. Informações sociodemográficas e profissionais também foram coletadas. Amostras de urina foram testadas para drogas lícitas e ilícitas. Todos os caminhoneiros eram do sexo masculino, idade mediana de 42 anos, a maioria casados e com baixa escolaridade. 47% relataram consumo moderado ou alto de álcool e tabaco e precisariam de uma intervenção breve. 21% consumiam cocaína, canabinoides, anfetaminas, hipnóticos/sedativos, opioides, inalantes e necessitam de tratamento especializado. Dos 697 participantes, 94% forneceram amostras de urina. 10,5% foram positivos para drogas. 5,2% foram positivos para cocaína, 2,6% para canabinoides, 2,0% para anfetaminas, 0,4% para benzodiazepínicos, 0,3% para metanfetaminas e 1,4% para uso combinado de duas drogas. Caminhoneiros jovens e solteiros usavam tabaco, maconha e anfetaminas e precisavam receber intervenção breve para essas drogas. Aos caminhoneiros da região Norte, com baixa escolaridade, o tratamento especializado para o tabagismo era necessário. Os caminhoneiros fazem alto uso de tabaco, álcool, cocaína e outras drogas ilícitas. São necessárias medidas para melhorar a qualidade de vida dos motoristas, bem como prevenir e tratar os usuários de drogas lícitas e ilícitas, a fim de reduzir o envolvimento em acidentes de trânsito.

Adolescent experimentation with alcohol, tobacco, or other drugs is commonplace, and limited access to screening and treatment services poses a significant public health risk. This study identified alcohol, tobacco, and other drug services available for adolescents at community health center sites in New York. A survey was distributed to medical and behavioral health directors across 54 community health center organizations serving 255 primary care adolescent sites. One third of sites required adolescent screening for substance use disorders (SUDs). Twenty-eight percent of sites said all/nearly all (80%-100%) and 12% said most (60%-79%) adolescents actually were screened. On-site tobacco cessation treatment and substance abuse counseling were offered at 53% and 14% of sites, respectively. Multilevel models suggested that community health center organizations positively influenced sites’ adolescent SUD screening and tobacco treatment. Additional investment in adolescent behavioral health screening and treatment is needed to reduce alcohol, illicit drug, or tobacco use among the underserved.

Introduction and Aims. Little is known about social–ecological correlates of simultaneous use of alcohol with other substances. This study examined places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults. Design and Methods. We used survey data obtained from 1538 young adult recent alcohol drinkers (49% male; 18–30 years old) in 24 non-contiguous cities in California. Event-level measures included alcohol, tobacco and marijuana use, drinking places and social characteristics of the event. Individual-level measures included alcohol expectancies, depression and demographics. Results. Bars and restaurants had less alcohol and marijuana use (odds ratio = 0.34; 95% confidence interval 0.18, 0.62; P

Introduction Alcohol, caffeine, and tobacco are frequently used in the community, and the timing of use may impact daytime sleepiness. The present analysis examined relationships between daytime sleepiness and timing of alcohol, tobacco, and caffeine use in a real-world sample. Methods Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study of N=1007 adults age 22–60 from the community. Daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). Participants were asked if they had ever used caffeine, alcohol and tobacco. If they reported using a substance, they were then asked which times of day they were likely to use the substance: 5AM-8AM, 8AM-11AM, 11AM-2PM, 2PM-5PM, 5PM-8PM, 8PM-11PM, 11PM-2AM, and 2AM-5AM. Logistic regression analyses examined the relationship between ESS score and likelihood of use of substances at each time. Results ESS score was associated with increased odds of ever using alcohol (OR: 1.05, 95% CI: 1.01 to 1.09) or tobacco (OR: 1.04, 95% CI: 1.01 to 1.07). ESS score was associated with an increased likelihood of drinking alcohol in the morning (5AM-8AM, OR: 1.13) and night (11PM-5AM, OR: 1.05). Sleepiness was also associated with increased likelihood of tobacco use in the afternoon (11AM-2PM, OR 1.04) and night (11PM-2AM, OR 1.05). Finally, ESS score was associated with increased likelihood of caffeine use during the midday and afternoon (11AM-5PM, OR: 1.04). Conclusion Greater sleepiness is associated with use of alcohol in the morning and at night, and with use of tobacco in the afternoon and at night. Finally, increased sleepiness was associated with caffeine use during the latter part of the workday. Some of these use patterns may be a cause of sleepiness (e.g., morning alcohol use or nighttime smoking) and some a consequence (e.g., daytime caffeine and tobacco use). More research on the impact of real-world sleepiness on real-world substance use is warranted. Support This work was supported by a grant from Jazz Pharmaceuticals Dr. Grandner is supported by R01MD011600The SHADES study was funded by R21ES022931

BackgroundPsychoactive substance use is lower among married compared to divorced or unmarried men; yet, the nature of this effect remains unclear because becoming and staying married is potentially confounded with substance-related background familial and individual factors, like parental divorce and personality. The authors investigated the associations between marital status and substance use; how substance use changed across the transition to marriage; and whether marriage effects were likely to be causal.MethodThe sample included 1790 adults from male–male twin pairs from a population-based registry. Measures of marital status and alcohol, tobacco, and cannabis use came from Life History Calendars. Data were analyzed using regression, co-twin comparison, and within-person models. The latter models are tools for quasi-causal inference that control for familial and individual-level confounders.ResultsMarried men used less alcohol, tobacco, and cannabis than men who were divorced/separated or single. In analyses of substance use across the transition to marriage, men reduced their alcohol and cannabis use both before and after marriage, but their tobacco use only after marriage. These effects were largely robust in co-twin and within-person analyses.ConclusionsMarriage was associated with substantial reductions in substance use compared to being divorced/separated or single, and these reductions began prior to marriage. The co-twin comparison and within-person models ruled out the alternative explanation that marriage effects were due to confounding background familial and individual factors. These results provide strong evidence that the social role expectations associated with marriage reduce psychoactive substance use.

Background Prevalence estimates of the use of tobacco, alcohol, illegal drugs, and psychoactive medications and of substance-related disorders enable an assessment of the effects of substance use on health and society. Methods The data used for this study were derived from the 2018 Epidemiological Survey of Substance Abuse (Epidemiologischer Suchtsurvey, ESA). The sample of the German adult population comprised 9267 persons aged 18 to 64 (response rate, 42%). Population estimates were obtained by extrapolation to a total resident population of 51 544 494 people. Results In the 30 days prior to the survey, 71.6% of the respondents (correspond- ing to 36.9 million persons in the population) had consumed alcohol, and 28.0% (14.4 million) had consumed tobacco. 4.0% reported having used e-cigarettes, and 0.8% reported having used heat-not-burn products. Among illegal drugs, cannabis was the most commonly used, with a 12-month prevalence of 7.1% (3.7 million), followed by amphetamines (1.2%; 619 000). The prevalence of the use of anal- gesics without a prescription (31.4%) was markedly higher than that of the use of prescribed analgesics (17.5%, 26.0 million); however, analgesics were taken daily less commonly than other types of medication. 13.5% of the sample (7.0 million) had at least one dependence diagnosis (12-month prevalence). Conclusion Substance use and the consumption of psychoactive medications are widespread in the German population. Substance-related disorders are a major burden to society, with legal substances causing greater burden than illegal substances.

Background Little is known about event-level patterns of marijuana co- or tri-use with alcohol and tobacco. Thus, the study goal was to examine patterns of same-day alcohol, cigarette, and marijuana co- and tri-use at the individual level in non-treatment-seeking alcohol users. Methods Participants (N = 551) completed an in-person interview for alcohol, cigarette, and marijuana use over the previous 30 days, and the event-level substance use patterns of n = 179 participants who reported using each of these substances at least once per month were analyzed. Results The use of alcohol, marijuana, or cigarettes independently increased the probability of subsequent, simultaneous co-use of one of the two remaining substances. The co-use of alcohol with cigarettes and marijuana with cigarettes produced generally additive effects on the odds of same day tri-use of marijuana and alcohol, respectively. Conversely, the co-use of alcohol and marijuana produced sub-additive effects on likelihood of cigarette use. Sex moderated several of the observed patterns of co- and tri-use: the relationship between alcohol or cigarette use predicting marijuana co-use was stronger in men, whereas the observed additive relationships between drug co-use leading to tri-use was stronger in women. Conclusions The presented results may aid in the understanding of how simultaneous co-use of marijuana with alcohol and/or tobacco relates to the etiology, maintenance, and treatment of comorbid and trimorbid substance use disorder. Replication and extension of the results in treatment seeking populations using more fine-grained analysis approaches, e.g. ecological momentary assessment, is needed.

Background The use, misuse and co-use of alcohol, cannabis, tobacco, and other licit and illicit controlled substances has increased in past decades leading to higher rates of morbidity, overdose, and mortality in women of reproductive age. Co-use compounds the adverse health effects of substance use compared to single-use of similar substances. Little is known about the full range of substance combinations used by pregnant and non-pregnant women. We sought to describe patterns of co-use of alcohol, tobacco, and controlled substances, and examine correlates of co-use in a nationally-representative sample of women. Methods Cross-sectional study using self-reported survey data from 2006 to 2014 for women ages 18–49 years (N = 160,371) in National Survey on Drug Use and Health data. We use weighted proportions and 95% confidence intervals (CI) to report differences in substance use patterns in pregnant and non-pregnant women. Multivariate logistic regression models assessed association between characteristics and type of substance use pattern. Results Prevalence of substance co-use among pregnant women is 5.1% and among non-pregnant women is 23.6%. Nearly all of the most frequent co-use patterns included alcohol, cannabis, or tobacco. Determinants of co-use among pregnant women included: younger age (18–25 years) compared to ≥ 26 years [AOR (95% CI): 1.81 (1.18, 2.80)]; and past year history of substance use [AOR 5.42 (3.59, 8.20)]. Conclusions Co-use of several substances, including and especially of tobacco, alcohol and cannabis, persists among pregnant women in the United States. Efforts that aim to improve maternal and child health should address the complexity of substance use during pregnancy, including and beyond opioids.