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Introduction The prevalence of adolescent nicotine vaping declined substantially after the COVID-19 pandemic onset in the United States during the Spring of 2020. This study examines whether the decline continued from 2022 to 2023, and the extent to which any decline reflects the lasting influence of lowered levels of initiation 3 years earlier, at the onset of the pandemic. Aims and Methods Data for this study come from nationally representative, cross-sectional surveys of U.S. 12th-grade (n  = 9854) and 10th-grade (n  = 14 663) students administered in the Spring of 2022 and 2023. The main outcomes are past 12-month nicotine vaping and grade first ever vaped nicotine. Results From 2022 to 2023 prevalence of past 12-month nicotine vaping declined a relative 20% for 12th-grade students, from 24.3% to 19.1%, and for 10th-grade students by a relative 16%, from 17.8% to 15.1%. Among 12th-grade students who vaped nicotine in the past 12 months, a significant decline in prevalence took place only among those who first ever vaped nicotine in ninth grade, and not among those who first ever vaped nicotine in any other grade. Among 10th grade students who vaped nicotine in the past 12 months, a significant decline in prevalence took place only among those who first ever vaped nicotine in seventh grade, and not among those who first ever vaped nicotine in any other grade. Conclusions These results contribute national-level evidence that forestalled initiation of nicotine use for 1 year may have a lasting effect that continues to lower adolescents' levels of use many years afterward. Implications These findings caution against looking to contemporaneous policy for explanations of the large, 1-year decline in nicotine vaping from 2022 to 2023. It can be tempting to interpret the decline as a victory for current efforts to restrict adolescent access to vaping products, or current education/media campaigns that warn adolescents of the dangers of vaping. The findings of this study suggest, instead, that the 1-year vaping declines primarily result from declines in initiation that were set into place 3 years ago during the pandemic onset, more so than the immediate result of contemporaneous policy. [ABSTRACT FROM AUTHOR]

Key Points: Question: What is the prevalence of self-reported Δ8-tetrahydrocannabinol (THC) and marijuana use among 12th-grade students in the US and its distribution across sociodemographic factors and state cannabis policies? Findings: In this nationally representative 2023 survey, 11.4% of 2186 US 12th-grade students self-reported Δ8-THC use and 30.4% self-reported marijuana use in the past year. Δ8-THC use prevalence was higher in the South and Midwest US and in states without legal adult-use marijuana or Δ8-THC regulations. Marijuana use prevalence did not differ by cannabis policies. Meaning: Δ8-THC use prevalence is appreciable among US adolescents and is a potential public health concern. Importance: Gummies, flavored vaping devices, and other cannabis products containing psychoactive hemp-derived Δ8-tetrahydrocannabinol (THC) are increasingly marketed in the US with claims of being federally legal and comparable to marijuana. National data on prevalence and correlates of Δ8-THC use and comparisons to marijuana use among adolescents in the US are lacking. Objective: To estimate the self-reported prevalence of and sociodemographic and policy factors associated with Δ8-THC and marijuana use among US adolescents in the past 12 months. Design, Setting, and Participants: This nationally representative cross-sectional analysis included a randomly selected subset of 12th-grade students in 27 US states who participated in the Monitoring the Future Study in-school survey during February to June 2023. Exposures: Self-reported sex, race, ethnicity, and parental education; census region; state-level adult-use (ie, recreational) marijuana legalization (yes vs no); and state-level Δ8-THC policies (regulated vs not regulated). Main Outcomes and Measures: The primary outcome was self-reported Δ8-THC and marijuana use in the past 12 months (any vs no use and number of occasions used). Results: In the sample of 2186 12th-grade students (mean age, 17.7 years; 1054 [48.9% weighted] were female; 232 [11.1%] were Black, 411 [23.5%] were Hispanic, 1113 [46.1%] were White, and 328 [14.2%] were multiracial), prevalence of self-reported use in the past 12 months was 11.4% (95% CI, 8.6%-14.2%) for Δ8-THC and 30.4% (95% CI, 26.5%-34.4%) for marijuana. Of those 295 participants reporting Δ8-THC use, 35.4% used it at least 10 times in the past 12 months. Prevalence of Δ8-THC use was lower in Western vs Southern census regions (5.0% vs 14.3%; risk difference [RD], −9.4% [95% CI, −15.2% to −3.5%]; adjusted risk ratio [aRR], 0.35 [95% CI, 0.16-0.77]), states in which Δ8-THC was regulated vs not regulated (5.7% vs 14.4%; RD, −8.6% [95% CI, −12.9% to −4.4%]; aRR, 0.42 [95% CI, 0.23-0.74]), and states with vs without legal adult-use marijuana (8.0% vs 14.0%; RD, −6.0% [95% CI, −10.8% to −1.2%]; aRR, 0.56 [95% CI, 0.35-0.91]). Use in the past 12 months was lower among Hispanic than White participants for Δ8-THC (7.3% vs 14.4%; RD, −7.2% [95% CI, −12.2% to −2.1%]; aRR, 0.54 [95% CI, 0.34-0.87]) and marijuana (24.5% vs 33.0%; RD, −8.5% [95% CI, −14.9% to −2.1%]; aRR, 0.74 [95% CI, 0.59-0.94]). Δ8-THC and marijuana use prevalence did not differ by sex or parental education. Conclusions and Relevance: Δ8-THC use prevalence is appreciable among US adolescents and is higher in states without marijuana legalization or existing Δ8-THC regulations. Prioritizing surveillance, policy, and public health efforts addressing adolescent Δ8-THC use may be warranted. This cross-sectional nationally representative classroom-based survey of US 12th-grade students examines the self-reported prevalence of and sociodemographic and policy factors associated with Δ8-THC and marijuana use during a 12-month period. [ABSTRACT FROM AUTHOR]

Background and Aims: Increasing numbers of school‐based drug surveys are transitioning data collection to electronic tablets from paper‐and‐pencil, which may produce a survey mode effect and consequent discontinuity in time trends for population estimates of drug prevalence. This study tested whether (a) overall, self‐reported drug use prevalence is higher on electronic tablets versus paper‐and‐pencil surveys, (b) socio‐demographics moderate survey mode effects and (c) levels of missing data are lower for electronic tablet versus paper‐and‐pencil modes. Design A randomized controlled experiment. Setting: Results are nationally representative of students in the contiguous United States. Participants: A total of 41 866 8th, 10th and 12th grade students who participated in the 2019 Monitoring the Future school‐based survey administration. Intervention and comparator: Surveys were administered to students in a randomly selected half of schools with electronic tablets (intervention) and with paper‐and‐pencil format (comparator) for the other half. Measurements Primary outcome was the total number of positive drug use responses. Secondary outcomes were the percentage of respondents completing all drug questions, percentage of drug questions unanswered and mean number of missing drug items. Findings The relative risk (RR) for total number of positive drug use responses for electronic tablets versus paper‐and‐pencil surveys were small and their 95% confidence intervals (CI) included the value of one for reporting intervals of life‐time (RR = 1.03; 95% CI, 0.93–1.14), past 12 months (RR = 1.01; 95% CI, 0.91–1.11), past 30 days (RR = 1.05; 95% CI, 0.93–1.20) and for heavy use (RR = 1.10; 95% CI, 0.93–1.29). Multiplicative interaction tests indicated no moderation of these relative risks by race (white versus non‐white), population density, census region, public/private school, year of school participation, survey version or non‐complete drug responses. Levels of missing data were significantly lower for electronic tablets versus paper‐and‐pencil surveys. Conclusions: Adolescent drug prevalence estimates in the United States differed little across electronic tablet versus paper‐and‐pencil survey modes, and showed little to no effect modification by socio‐demographics. Levels of missing data were lower for electronic tablets. [ABSTRACT FROM AUTHOR]

This study assesses trends in the percentage of adolescents with an unsuccessful cigarette quit attempt and compares quit attempts of combustible cigarettes and e-cigarettes in 2020. [ABSTRACT FROM AUTHOR]

National programs that reduce adolescent cannabis use warrant renewed attention in light of current discussions to reform cannabis legislation, including the possibility of legalization for recreational use. This study measures the size of a decrease in a country's prevalence of adolescent cannabis use that accompanies a decrease in its prevalence of adolescents who had ever smoked a cigarette. Data are from the European School Survey Project on Alcohol and Other Drugs (ESPAD), which is a collaborative effort of more than 40 European countries to surveil adolescent substance use. This study uses data from the seven survey administrations in 1995, 1999, 2003, 2007, 2011, 2015, and 2019. The main analysis is a fixed-effect regression analysis of country-level, four-year changes in adolescent lifetime cannabis use prevalence on country-level, four-year changes in adolescent lifetime cigarette use prevalence. Decreases in the national prevalence of adolescents who had ever smoked a cigarette were accompanied by decreases half as large in national prevalence of adolescent lifetime cannabis use. For European countries considering the legalization of adult recreational cannabis use, tobacco control can offer a tool to help counter potential increases in cannabis use among adolescents. [ABSTRACT FROM AUTHOR]

Aims: In the last decade the relatively lower levels of marijuana use for black relative to non-black high school seniors has grown smaller and disappeared, drawing to a close a unique disparity that actually favored a disadvantaged group for at least thirty years. In this study we test trends in cigarette smoking and religiosity as possible explanations for this closing disparity. The study also examines whether increasing marijuana levels for black adolescents is better characterized as a cohort effect or an historical period effect.Design: Analyses use relative risk regression and focus on data from yearly, cross-sectional surveys from the time period 2008-2017.Setting and Participants: Data comes from the nationally-representative Monitoring the Future survey, which conducts in-school surveys of secondary school students. The analysis uses data from 114,552 high school seniors (in 12th grade), 123,594 in 10th grade, and 136,741 in 8th grade.Findings: Past 12-month marijuana prevalence significantly increased for black as compared to non-black adolescents from 2008 to 2017 in 12th grade, 10th grade, and 8th grade. The increase attenuated by more than half and was not statistically significant after adjusting for cigarette smoking. In contrast, the increase was little changed after adjusting adolescent levels of religiosity. The increase is better characterized as a cohort effect than a period effect.Conclusions: These results support the increase in marijuana use for black relative to non-black adolescents as an unexpected consequence of the great decline in adolescent cigarette smoking, which has occurred slower for black adolescents. [ABSTRACT FROM AUTHOR]

This national survey study characterizes JUUL e-cigarette flavors (mint, mango, fruit, and others) most often used by US middle school and high school students in 2019. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adolescent marijuana prevalence has not increased since 2005 despite a substantial decrease in the percentage of adolescents who believe marijuana use leads to great risk of harm. This finding calls into question the long-standing, inverse connection between marijuana prevalence and perceived risk of use, a connection central to many arguments opposing marijuana legalization. We tested 2 hypotheses for why marijuana prevalence did not increase after 2005: (1) decreases in adolescent use of cigarettes and alcohol reduced risk for marijuana use and counteracted the expected risk in marijuana prevalence, and/or (2) perceived risk of harm now plays a smaller role in marijuana use. METHODS: Data came from the annual, nationally-representative Monitoring the Future study from 1991 to 2016, in which 1 100 000 US students in eighth, 10th, and 12th grade were surveyed. RESULTS: The entire sample was stratified into 3 mutually exclusive and exhaustive groups on the basis of cigarette and alcohol use. Within each of the 3 groups, marijuana prevalence increased from 2005 to 2016. Paradoxically, when the 3 groups were combined into 1 analysis pool, overall marijuana prevalence did not increase. The seeming paradox results from a decline in the percentage of adolescents who used cigarettes; as this group grew smaller, so too did its disproportionately large contribution to overall marijuana prevalence. Perceived risk of harm from marijuana remained a strong indicator of use throughout 2005 to 2016. CONCLUSIONS: Perceived risk of marijuana remains tightly associated with use, and adolescent marijuana prevalence today would be at or near record highs if cigarette use had not declined since 2005, according to study projections. [ABSTRACT FROM AUTHOR]

Objectives. To examine a potential increase in marijuana initiation among US college students as compared with their age peers not in college before and after 2013, a watershed year for increasing tolerance of marijuana use in the United States. Methods. Data come from the Monitoring the Future study, which has followed longitudinal panels drawn from annual nationally representative, baseline samples of 12th-grade students starting with the class of 1976. We studied panel members aged 19 to 22 years who had never used marijuana by 12th grade between 1977 and 2015. Results. College as a risk factor for marijuana initiation has increased significantly since 2013. The increased probability of past-year marijuana use for those enrolled versus not enrolled in college was 51% in 2015, 41% in 2014, and 31% in 2013; it averaged 17% to 22% from 1977 to 2012 among youths who had never used marijuana by 12th grade. Conclusions. College has grown as a risk factor for marijuana initiation since 2013. Public Health Implications. College students are in position to usher in new increase [ABSTRACT FROM AUTHOR]

Objective: The study describes the most common reasons for using vaporizers (such as e-cigarettes) among US adolescents and investigates how reasons for use differ by grade, lifetime cigarette use, frequency of vaporizer use, gender, race/ethnicity, and parent education.Method: Data were collected from 4066 students in the 8th, 10th, and 12th grades in 2015 as part of the Monitoring the Future study, a cross-sectional and nationally representative US survey.Results: Common reasons for vaporizer use reported by respondents who had ever used a vaporizer were experimentation (53.0%), taste (37.2%), boredom (23.5%), having a good time (22.4%), and relaxation (21.6%). Reasons differed little across grades or parent education; reasons differed by lifetime use of regular cigarettes, frequency of vaping, gender, and race/ethnicity.Conclusions: Overall, results suggest that decisions to vape are based on curiosity, taste, and pleasure, rather than for reasons such as quitting regular cigarettes or substituting for regular cigarette smoking. [ABSTRACT FROM AUTHOR]

Introduction: This study examines the role of e-cigarettes in the drug use patterns of adolescents. Of specific interest is whether adolescent e-cigarette users fall into a group of (1) youth who do not use traditional drugs of abuse or (2) polysubstance users.Methods: Using latent class analysis, we identify major "classes" of substance users on the basis of recent use of e-cigarettes, alcohol, marijuana, cigarettes, and prescription drugs. Analyses are conducted separately for adolescents in 8th, 10th, and 12th grades. Data come from 16 615 participants in the 2014 Monitoring the Future survey.Results: Youth who do not use traditional drugs of abuse account for about 50% of e-cigarette users in 8th grade, 35% in 10th grade, and 17% in 12th grade. These youth come from a large "low-level users" group found in each grade, characterized by low probability of use for all substances (e-cigarette probability in this group for 8th graders = .046; 10th graders = .071; 12th graders = .027). Other e-cigarette users come from a smaller, "poly-users" group found in each grade, characterized by high-to-moderate probabilities (.83-.21) of using e-cigarettes and other substances. Specific to 12th grade is a third, additional polysubstance group characterized by high likelihood of e-cigarette use (.93).Conclusions: The proportion of e-cigarette users who do not use traditional drugs of abuse is larger at younger ages. Longitudinal panel studies starting at 8th and 10th grades may best inform the current debate on whether e-cigarette use is a risk or protective factor for future transition to the use of other substances.Implications: The proportion of e-cigarette users who do not use traditional drugs of abuse is larger at younger ages. Longitudinal panel studies starting at 8th and 10th grades may best inform the current debate on whether e-cigarette use is a risk or protective factor for future transition to the use of other substances. [ABSTRACT FROM AUTHOR]

In this study we consider the health implications of the sequencing of a college degree vis-à-vis familial roles during the transition to adulthood. We hypothesize that people who earned a college degree before assuming familial roles will have better health than people who earned a college degree afterwards. To test this hypothesis, we focus on obesity and use data from the National Longitudinal Study of Adolescent Health. Results show that marriage before completion of college was associated with a 50% higher probability of becoming obese when compared with marriage after completion of college. Parenthood before college completion was associated with a greater than twofold increase in the probability of becoming obese when compared to parenthood afterwards for black men. These findings suggest that the well-established association of education with health depends on its place in a sequence of roles. [ABSTRACT FROM PUBLISHER]

Background: This analysis examines decriminalization as a risk factor for future increases in youth marijuana acceptance and use. Specifically, we examine marijuana-related behaviors and attitudes of 8th, 10th, and 12th graders in California as compared to other U.S. states during the years before and after California passed legislation in 2010 to decriminalize marijuana.Methods: Data come from Monitoring the Future, an annual, nationally representative survey of 8th, 10th, and 12th grade students.Results: In 2012 and afterwards California 12th graders as compared to their peers in other states became (a) 25% more likely to have used marijuana in the past 30 days, (b) 20% less likely to perceive regular marijuana use as a great health risk, (c) 20% less likely to strongly disapprove of regular marijuana use, and (d) about 60% more likely to expect to be using marijuana five years in the future. Analysis of 10th graders raises the possibility that the findings among 12th graders may reflect a cohort effect that was set into place two years earlier.Conclusion: These results provide empirical evidence to support concerns that decriminalization may be a risk factor for future increases in youth marijuana use and acceptance. [ABSTRACT FROM AUTHOR]

Background This analysis examines decriminalization as a risk factor for future increases in youth marijuana acceptance and use. Specifically, we examine marijuana-related behaviors and attitudes of 8th, 10th, and 12th graders in California as compared to other U.S. states during the years before and after California passed legislation in 2010 to decriminalize marijuana. Methods Data come from Monitoring the Future, an annual, nationally representative survey of 8th, 10th, and 12th grade students. Results In 2012 and afterwards California 12th graders as compared to their peers in other states became (a) 25% more likely to have used marijuana in the past 30 days, (b) 20% less likely to perceive regular marijuana use as a great health risk, (c) 20% less likely to strongly disapprove of regular marijuana use, and (d) about 60% more likely to expect to be using marijuana five years in the future. Analysis of 10th graders raises the possibility that the findings among 12th graders may reflect a cohort effect that was set into place two years earlier. Conclusion These results provide empirical evidence to support concerns that decriminalization may be a risk factor for future increases in youth marijuana use and acceptance. [ABSTRACT FROM AUTHOR]

Abstract: Background: Evaluating population-level patterns of heavy episodic drinking by age, period, and cohort is critical to understanding population-level influences on rates over time and to forecasting future trends for public health planning efforts. The present study examined trends in heavy episodic drinking in the US from 1985 through 2009 in a nationally representative sample that included adolescents and adults. Methods: Data are drawn from repeated cross-sectional surveys of US households as part of the National Household Survey on Drug Use and Health conducted in 1985, 1988, and annually from 1990 though 2009, inclusive (N =809,281). Heavy episodic drinking was defined as any instance of consuming five or more drinks in one sitting in the past month. Age–period–cohort models were identified using the Intrinsic Estimator algorithm. Results: Heavy episodic drinking is decreasing in the US among adolescents and young adults, with the most recently born cohorts (born in the 1990s) at lower odds of heavy episodic drinking compared with cohorts born in the 1960s, 1970s, and 1980s. Results were consistent across sex and race/ethnicity, with the exception that the decrease is not apparent among Hispanics. Conclusions: These data are promising in that young cohorts appear to be reducing heavy episodic drinking, however the lack of decrease among Hispanics suggests targeted intervention and prevention as well as increased surveillance are necessary. [Copyright &y& Elsevier]

We analyze long-term trends in past-year hallucinogen use among veterans as compared to nonveterans. This topic is theoretically strategic because the military adopted stringent and successful antidrug policies in the mid-1980s, which serves as a natural experiment to examine the potential long-term impact of comprehensive drug policies on illegal drug use. Drawing on self-reported data from the National Survey of Drug Use and Health in years 1985, 1988, and 1990-2010, the analysis uses age-period-cohort analysis to update trends in past-year hallucinogen use and to examine the impact of veteran status. Results are consistent with the hypothesis that a stringent antidrug policy can lead to a life-long reduction in hallucinogen use. Among birth cohorts who were young adults immediately before the implementation of the antidrug policies (those in the 1960-1964 birth cohort) odds of past-year hallucinogen use were twice as high for veterans as compared to nonveterans over the life course. This difference disappeared among birth cohorts that were young adults after the antidrug policies were implemented, when the prevalence of past-year hallucinogen use would be expected to be higher for veterans because of their significantly higher rates of illegal drug use in adolescence. After the drug-testing policies were implemented veterans actually had significantly lower prevalence of past-year hallucinogen use in comparison to nonveterans among the subgroup of respondents who reported a history of illegal drug use before age 18 (OR = .77, p < .01). These trends across veterans and nonveterans were not explained by trends in recruits' tendencies for illegal drug use. These findings point to service in today's armed forces as a turning point that, overall, leads to a lasting, lifelong reduction in substance use. [ABSTRACT FROM AUTHOR]

Abstract: Background: We present a formal age–period–cohort analysis to examine if the recent increase in past-year marijuana use among the young is specific to the younger generation or if, instead, it is part of a general increase present across cohorts of all ages. This is the first age–period–cohort analysis of past-year marijuana use that includes adult trends from 2001 to 09. Methods: Data come from the National Survey on Drug Use and Health, a series of annual, nationally representative, cross-sectional surveys of the U.S. civilian, non-institutionalized population. The analysis focuses on the 25 year time span from 1985 to 2009 and uses the recently developed ‘intrinsic estimator’ algorithm to estimate independent effects of age, period, and cohort. Results: The recent increase in past-year marijuana use is not unique to the youngest birth cohorts. An independent, positive influence of cohort membership on past-year marijuana use, net of historical period and age effects, is smaller for today''s youngest cohorts than it was for the cohorts that came immediately before, and, in fact, is at its lowest level in three decades. The recent increase in marijuana use among the young is more consistent with a historical period effect that has acted across all cohorts. Period and cohort trends differ substantially for Hispanics. Conclusions: The major forces that drive trends in past-year marijuana use are moving away from cohort-specific factors and toward broad-based influences that affect cohorts of all ages. Strategic public health and policy efforts aimed at addressing the recent increase in past-year marijuana use should do the same. [Copyright &y& Elsevier]

This article examines how educational disparities in mortality emerge, grow, decline, and disappear across causes of death in the United States, and how these changes contribute to the enduring association between education and mortality over time. Focusing on adults age 40 to 64 years, we first examine the extent to which educational disparities in mortality persisted from 1989 to 2007. We then test the fundamental cause prediction that educational disparities in mortality persist, in part, by shifting to new health outcomes over time. We focus on the period from 1999 to 2007, when all causes of death were coded to the same classification system. Results indicate (1) substantial widening and narrowing of educational disparities in mortality across causes of death, (2) almost all causes of death with increasing mortality rates also had widening educational disparities, and (3) the total educational disparity in mortality would be about 25 percent smaller today if not for newly emergent and growing educational disparities since 1999. These results point to the theoretical and policy importance of identifying social forces that cause health disparities to widen over time. [ABSTRACT FROM PUBLISHER]

In this study we examine whether the recent, sharp increase in mortality in the United States due to accidental poisoning since 2000 is the result of the aging of the baby boom cohort or, instead, a historical trend apparent among decedents of all ages. We conducted an age-period-cohort analysis using data from the US Vital Statistics and the US Census covering the period 1968-2007. The United States population aged 15-64 years. Cause of death and demographic data as recorded on death certificates. The increase in mortality due to accidental poisoning since the year 2000 stems primarily from a historical period effect across all ages for whites, but results in large part from a rate spike in the baby boom cohort among blacks. For all demographic groups baby boomers had higher odds of death due to accidental poisoning than the cohorts that came before and after them. Historical influences acting across all ages led to an increase in accidental poisoning mortality that was almost 10-fold for whites and threefold for blacks over the study period. While the recent, sharp increase in accidental poisoning mortality stems in part from the aging of the baby boom cohort, substantially more of the increase results from influences unique to recent years that have affected all age groups. These results point to the need to bolster overdose prevention programs and policies as the historical increase in accidental poisoning mortality appears to continue unabated. [ABSTRACT FROM AUTHOR]

The social meaning of cocaine changed during the 1980s and 1990s. The present study examined changes in the psychological profile of cocaine users. We used Baltimore data of the National Institute of Mental Health-funded Epidemiologic Catchment Area study during 1981 ( n = 3,006; 60% female) and 1993–1994 ( n = 1,679; 52% female). The diagnostic interview schedule measured cocaine use and depressive disorders (dysthymia, major depressive disorder). The odds ratio of cocaine use for those with depression was 1.28 and 3.53 in 1981 and 1993–1994 respectively. The results suggest a historical period effect in the association of cocaine use and depression. Limitations and implications are discussed. [ABSTRACT FROM AUTHOR]

Abstract: This study examines whether the racial disparity in functional health grows unabated over the adult life course – the cumulative disadvantage hypothesis – or shrinks among the oldest old – the age-as-leveler hypothesis. Special emphasis is placed on the role of socioeconomic status (SES), which is highly associated with race. The analysis uses latent growth-curve modeling to examine differences in age trajectories of functional health between Black and White Americans and is based on nationally representative panel data of 3497 adults. Results cautiously support the age-as-leveler hypothesis. Net of functional health at baseline, Black adults experience a growing disadvantage in functional health over time until the oldest ages, when the gap in functional health begins to shrink. Results indicate that the potential leveling mechanisms of age may be specific to women. SES including financial assets explains the divergence in functional health across young and middle-aged Black and White adults, but not the later-life convergence. This study reveals the life-course pattern of racial disparity in functional health and suggests that more theoretical development is needed in this field to explain why the age-as-leveler and cumulative disadvantage processes are different for functional health than for other outcomes. [Copyright &y& Elsevier]

Background: Whether a disparity in diabetes-related death across education levels is widening, narrowing, or stable is not known. This analysis examined trends in diabetes-related death by education levels over a 17-year period. Methods: The first part of the analysis calculated diabetes-related mortality rates for adults aged 40–64 years and adults aged 65–79 years using U.S. Vital Statistics data from 1989 to 2005 to provide the number of deaths per year in the U.S. (the numerator) and also U.S. Census data to provide the population size (the denominator). The second part of the analysis examined trends by education level in possible mechanisms that link education and diabetes-related mortality using the U.S. National Health and Nutrition Examination Surveys (NHANES) program in 1988–1994 and 1999–2004. Results: Disparity in diabetes-related mortality across education levels widened from the late 1980s to 2005 overall and in the subgroups of men, women, blacks, whites, and Hispanics. Analysis of NHANES data indicated that progress in diabetes care and management (as indicated by HbA1c levels less than 8%) has helped people of all education levels but has been of greater benefit to those with higher education. Conclusions: The reduction of disparities in diabetes-related mortality requires improved policies and interventions that redress the slower pace of improvement in diabetes care and self-management among people with lower education. [Copyright &y& Elsevier]

Despite the substantial and prolonged sociological interest in health disparities, much remains unknown about the processes that initiate them. To investigate this topic, we focus on the case study of cocaine use, for which a socioeconomic disparity emerged across all age groups in a short period of time around 1990. We examine whether the newly-formed disparity represents a selective remnant of previous users or, instead, a selective recruitment of new users. To evaluate these two potential processes we use latent class regression on a nationally representative cohort with repeated measures of past-year cocaine use before and after 1990. Results support the "remnant" hypothesis and show that the newly-formed disparity resulted primarily because people in the lower social strata were less likely to have a trajectory of cocaine use with a sharp drop in use after 1990. These results point to the "remnant" concept as a way to bring together disparity analysis of very different and diverse health outcomes. [ABSTRACT FROM AUTHOR]

Few service systems are currently in place with the explicit purpose to reduce youth mental health disparities across socioeconomic status and race–ethnicity, despite substantial interest by the federal government and other institutions to redress health disparities. This study examines the potential for the Comprehensive Community Mental Health Services for Children and Their Families Program to address health disparities, even though this program was not explicitly designed for disparity reduction. Specifically, this study examines whether program sites disproportionately provide services within their catchment areas for youth who come from poor families, who are Black, and who are Hispanic. Data for this study come from 45 sites and 19,189 youth who were enrolled in program sites from 1997 to 2005. Meta-analysis was used to generate Forest plots and to obtain single, pooled estimates of risk ratios and their standard errors across all Children’s Mental Health Initiative communities. The results indicate that in comparison to the targeted catchment area (a) the percentage poor youth in the programs was almost three times higher, (b) the percentage Black in the programs was about twice as high, and (c) the percentage Hispanic in the programs was about the same. These results indicate that the program successfully reaches disadvantaged youth and can bring substantial infrastructure to address youth mental health disparities. In fact, to the extent that the program successfully improves mental health among enrollees it may be serving as one of the largest initiatives to redress health disparities, although its role in disparity reduction is not widely recognized. [ABSTRACT FROM AUTHOR]

Background: Around the year 1990, the reputation of cocaine use changed from glamorous to undesirable, and at the same time, a socioeconomic disparity in cocaine use emerged. This study examined (1) whether the socioeconomic disparity was created by differential incidence, differential cessation, or both, (2) whether a socioeconomic disparity also developed in marijuana use, and (3) whether disparities formed across race, Hispanic ethnicity, and/or gender.Methods: The analyses center on 6544 respondents aged 14-21 in 1979 in the National Longitudinal Survey of 1979 that provided information on past-year use of powder cocaine and marijuana use before and after 1990--specifically, in 1984, 1988, 1992, 1994, and 1998.Results: Both differential incidence and differential cessation across education contributed to the formation of the socioeconomic disparity in cocaine use, although differential cessation played a more influential role in this cohort. A socioeconomic disparity in marijuana use also came about around the same time. No emerging disparities by race, Hispanic ethnicity, or gender were observed.Conclusions: This case study suggests that the redefinition of a health behavior as unhealthy will result in a socioeconomic disparity in the behavior across socioeconomic strata as a result of both differential incidence and cessation, but disparities will not necessarily form by race, ethnicity, or gender. [ABSTRACT FROM AUTHOR]

Purpose: Disparities in psychological distress across socioeconomic status and sex persist throughout adulthood as cohorts age. In this study, we investigate the extent to which this persistence represents either (i) a single set of individuals who at the start of adulthood show distress that is chronic and long lasting or (ii) different sets of individuals that have a staggered onset of short-term distress throughout adulthood. Methods: We use path analysis on data from the National Child Development Study, a longitudinal cohort study that assessed psychological distress at ages 23, 33, and 42 years. Results: About 80% of distress disparities at age 42 result from chronic distress that was present in a single set of individuals at least 19 years earlier at the beginning of adulthood. Conclusions: These results support a targeted approach to the reduction of distress disparities that focuses on young adults with high levels of distress and seeks to improve their long-term mental health. [Copyright &y& Elsevier]

The article reports on marijuana legalization in the U.S. from 2000 to 2019, noting that to date, legalization appears to have had little effect on marijuana prevalence among adolescents. Two states are discussed in detail: California and Pennsylvania. The overall decline in tobacco smoking among adolescents is also discussed.

This national survey study uses Monitoring the Future data to characterize trends in the prevalence of marijuana vaping in 2017, 2018, and 2019 among 8th, 10th, and 12th graders. [ABSTRACT FROM AUTHOR]

The article presents a medical study that examines the association of poverty and overweight adolescents in the U.S. The study also looks at trends in relevant health behavior such as physical activity and eating habits. Adolescent overweight was defined as having a body mass index at or above the 95th percentile for age and sex in the growth charts from the Centers for Disease Control and Prevention. The study found that there is a greater number of overweight older adolescents that come from families living below the poverty line. The article discusses high consumption of sweetened beverages, breakfast skipping, physical inactivity, and obesity prevention programs for adolescents.

Abstract: During the 1980s the social distribution of adult cocaine use in the US changed, according to qualitative analyses, and its use became more prevalent in the lower as compared to the upper social strata. In this paper, we use national data to investigate the association of education and adult cocaine use to test whether this trend represents either a ‘historical period’ process that occurred concurrently across adults of all age groups or a cohort process that started with younger cohorts and only extended to older age groups as these younger cohorts aged. We also estimate the extent to which the emergence of crack cocaine use accounts for trends in the socioeconomic distribution of cocaine use over historical time. To address these questions we analyze data from each survey of the National Household Survey on Drug Abuse from 1979 to 1998 inclusive. The results point to a ‘historical period’ process that is explained in large part – but not entirely – by the emergence of crack cocaine. Important differences are apparent across racial and ethnic groups, as well as age groups. Cocaine use joins a growing list of potentially addictive drugs that have become more prevalent in the lower as compared to the upper social strata over historical time. [Copyright &y& Elsevier]

Current evidence indicates that in the USA illegal drug use among adolescents between the 1980s and 1990s became significantly more prevalent in families with lower maternal education in comparison to families with higher maternal education. In this study, we examine whether this inter-generational change results from either (a) a changing influence of socioeconomic status on drug use, as predicted by the inter-generational social ‘causation’ hypothesis, or (b) a negative influence of drug use on socioeconomic status, as predicted by the inter-generational social ‘selection/drift’ hypothesis. The analyses are based on the US National Longitudinal Study of 1979, which includes information on drug use for both a nationally representative sample of respondents aged 19–27 in 1984, as well as drug use information for the children of these respondents, who were aged 18–27 in 1998. The results indicate that inter-generation change in cocaine and marijuana use resulted almost entirely from social causation. These findings support illegal drug use as a good candidate for analyses in the ‘fundamental cause’ tradition that seek to understand the social factors that concentrate poor health and health behaviors in the lower social strata over historical time. [Copyright &y& Elsevier]

This study uses growth curve analysis to examine whether disparities in the occupational standing of White men relative to women and minorities grew larger or smaller with advancing age during the 1980s and 1990s. The analyses are based on The National Longitudinal Survey of Youth 1979 and the Baltimore Epidemiologic Catchment Area Follow-Up. Results indicate that disparities in occupational standing stayed constant over the life course across all demographic groups except for African Americans, whose gap in occupational status relative to Whites and Hispanics grew significantly larger with advancing age. Implications of these findings for theories of occupational inequality are discussed. [ABSTRACT FROM AUTHOR]

The current study uses data from the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program to examine child functioning in rural (n = 8) as compared to nonrural (n = 18) system-of-care communities across the United States. In this study, the topic of rural versus nonruraI differences is approached from a community-level perspective with aggregated functional impairment scores as the dependent variable of interest in weighted least squares regression. The demographic characteristics of children, particularly age, were more important predictors of functional impairment than geographic locale (ie, rural vs nonrural). Specifically, while children served in nonrural communities were older than those served in rural communities, after controlling for this difference functional impairment levels were similar. It appears from these analyses that youth served in rural and nonrural communities with systems of care were more similar than they were different with regard to their level of functional impairment. This lack of aggregate functional difference between the rural and nonrural sites reminds policymakers and funding agents that youth in rural areas need equity in both access and resource for mental health services. As indicated by the findings in the current investigation youth in rural areas are not immune to the types of mental health challenges often publicized by researchers examining youth in nonrural areas. [ABSTRACT FROM AUTHOR]

Competing theoretical interpretations posit children's capacity for self-regulation as playing a spurious role, a mediating role, and a moderating role in the relationship between children's socioeconomic status (SES) and the adjustment to school. This study empirically examined these interpretations by investigating the rote of children's self-regulation in the relationship between children's SES and three school adjustment outcome: (1) overall problems in children's interpersonal relationships in school, (2) teachers assessment of hyperactivity-attention deficiency, and (3) teachers' expectations of children's present and future scholastic ability. The results indicated that associations between self-regulation outcomes and the adjustment to school were not spurious; they persisted after children's SES background was controlled Self-regulation served as a mediator of the association between children's SES and both interpersonal problems at school and teachers' expectations, and self-regulation served as a moderator of the relationship between children's SES and teachers' assessment of hyperactivity-attention deficiency. [ABSTRACT FROM AUTHOR]

Numerous studies document lower levels of depression among adults with higher education, but little is known about the way in which the association varies over the life course. Do depression levels diverge or converge across educational strata with age? This study investigates how the association between education and depression changes with age and tests the extent to which these changes are accounted for by physical health problems, widowed status, employment status, coping resources, household income, and financial strain. Data for this investigation come from the Work, Family, and Well-Being Study, 1990, a nationally representative sample of 2,031 adults aged 18 to 90 interviewed by telephone. Findings indicate that the association between depression and education strengthens with increasing age. Physical health problems among adults with lower education account for most of the diverging gap in depression. These results show that an integration of insights from the stress paradigm and the life course perspective can lead to a fuller understanding of socioeconomic inequality and its influence on psychological functioning. [ABSTRACT FROM AUTHOR]

Background: How adolescent substance use and perceived availability of substances have changed during the COVID-19 pandemic remain largely unknown. Substantial reduction in availability of substances would present a unique opportunity to consider the supply-side hypothesis that reductions in drug availability will lead to reductions in drug prevalence.Methods: Longitudinal data come from Monitoring the Future and are based on responses from 582 adolescents who were originally surveyed as part of a national sample of 12th grade students in early 2020, one month before social distancing policies began. They were surveyed again after social distancing policies were implemented, in the summer of 2020.Results: Perceived availability of marijuana and alcohol declined across the two survey waves at the largest levels ever recorded in the 46 years of the project, by an absolute 17 %, p < .01 and 24 %, p < .01, respectively. Despite these declines, prevalence levels did not significantly change across the two waves for marijuana use in the past 30 days or for binge drinking in the past two weeks. Perceived availability of vaping devices significantly declined, from 73 % to 63 %, as did nicotine vaping prevalence in the past 30 days, from 24 % to 17 %.Conclusions: Perceived availability of marijuana, alcohol, and vaping devices declined at historic rates during the pandemic of 2020. Lack of accompanying reductions in prevalence for marijuana and binge drinking demonstrates the substantial challenges facing a supply-side approach to the reduction of adolescent use of these substances. [ABSTRACT FROM AUTHOR]

Pathways to attainment are modified through historical time, reflecting the progressive consolidation of the educational trajectory in the life courses as well as changing patterns of social class and the economy. Using data from the Occupational Changes in a Generation surveys, this study examines a series of hypotheses that interrelate educational attainment with historical change- expansions and contractions in labor market sectors; and socioeconomic status. Consistent with expectations, opportunities in manufacturing drew students from primary school before World War II, while expansions in the government sector increased the likelihood of drop-out at the secondary and tertiary levels after the war. In this later period, students from the lower and middle classes often were more like! to leave school because of economic expansion. Thus, through historical time the capacity of the economy to draw students from school has progressed upward through the educational career and has affected the lower and middle classes disproportionately. [ABSTRACT FROM AUTHOR]

The values that shape individuals' career decisions are not necessarily reinforced by subsequent work experience. Those who value service to society, for example, are most likely to enter teaching, but qualitative research suggests that service-oriented teachers encounter much frustration and are prime candidates for leaving teaching. This study investigated the effect of motivation for service on persistence in teaching among two cohorts of American teachers: a 1960s cohort in an era that highlighted the call to public service and a 1970s cohort in a more egocentric era. The authors found that strong service values increased the likelihood that men in both cohorts and women in the 1970s cohort would leave the profession, but not women in the 1960s cohort, when few alternative careers were open to women. [ABSTRACT FROM AUTHOR]

The article presents the concerns towards rapid increase in adolescents' use of electronic cigarettes, known as vaping since 2017-2019. It mentions the potential links between vaping and acute lung injury for adolescents who vape use a device such as an e-cigarette to inhale a heated aerosol that typically contains nicotine and also mentions annual increases of the use of nicotine vaping.

Past research has found significant nicotine use disparities for reservation-area American Indian adolescents when compared to national levels. However, adolescent nicotine use has changed markedly, with reduced smoking and rapid increases in nicotine vaping. This study presents 2021–2022 prevalence estimates of tobacco product use, perceived harm and availability for reservation-area American Indian youth, with comparisons to the Monitoring the Future (MTF) national study. Participants were 8th, 10th and 12th grade students. American Indian data were 33 reservation-area schools in 2021–2022 (n=2420); MTF data were 308 schools in Spring 2022 (n=31,438). Measures were lifetime, 30-day cigarette smoking, smokeless tobacco use, and nicotine vaping; past-year nicotine vaping; daily smoking; perceived harmfulness and availability of these tobacco products. Prevalence and 95% confidence intervals were computed by grade. Estimated prevalence of lifetime, monthly and daily cigarette smoking among American Indian 8th and 10th graders was higher than national levels. Nicotine vaping prevalence was similar between samples. American Indian students were less likely to report tobacco product use poses great risk, but also less likely to report tobacco products are easily available. Although estimated smoking prevalence among American Indian 8th and 10th graders was higher than national levels, prevalence appears lower than reported in earlier studies, suggesting declining disparities. Prevalence of nicotine vaping among reservation-area American Indian adolescents generally mirrors the national population; however, a lower percentage reported regular nicotine vaping poses a serious risk. This discrepancy suggests a need for prevention and intervention efforts culturally tailored for this population. • 2021–2022 tobacco use prevalence in reservation-area American Indian youth appears to be lower than previous estimates. • Nicotine vaping prevalence among American Indian adolescents mirrors national prevalence. • Nicotine vaping is more prevalent than other tobacco use among American Indian adolescents. • American Indian adolescents perceived less risk from nicotine vaping compared to a national sample. • Culturally-tailored education about harms of vaping is critical to lowering use. [ABSTRACT FROM AUTHOR]

The authors comment on a study by Dawson and colleagues which assessed age variation in correlates of drinking cessation. The authors agree with Dawson and colleagues "sick quitter" effect according to which individuals with incident cardiovascular disease and those rating health as good/fair/poor at age 55+ were more likely to stop drinking, as well as individuals with liver disease at ages 18-34. They also agree on the point that the case for moderate drinking should not be closed.

Introduction: In the past decade, marijuana use prevalence among adolescents has remained relatively steady while cigarette and alcohol prevalence has declined. We examined historical trends in: average grade of onset of marijuana, alcohol, and cigarette use by 12th grade; proportion who try alcohol/cigarettes before first marijuana use, among those who use by 12th grade; and conditional probability of marijuana use by 12th grade after trying alcohol/cigarettes.Methods: Data were drawn from 40 yearly, cross-sectional surveys of 12th grade US adolescents. A subset of students (N = 246,050) were asked when they first used each substance. We reconstructed cohorts of substance use from grade-of-onset to determine sequence of drug use, as well as probability of marijuana use in the same or later grade.Results: Average grade of first alcohol and cigarette use by 12th grade increased across time; e.g., first cigarette increased from grade 7.9 in 1986 to 9.0 by 2016 (β=0.04, SE = 0.001, p < 0.01). The proportion of 12th grade adolescents who smoke cigarettes before marijuana fell below 50% in 2006. Each one-year increase was associated with 1.11 times increased odds of first cigarette in a grade after first marijuana (95% C.I. 1.11-1.12). Among those who initiate alcohol/cigarettes prior to marijuana by 12th grade, the probability of subsequent marijuana use is increasing.Conclusion: Marijuana is increasingly the first substance in the sequence of adolescent drug use. Reducing adolescent smoking has been a remarkable achievement of the past 20 years; those who continue to smoke are at higher risk for progression to marijuana use. [ABSTRACT FROM AUTHOR]

Introduction: This study assessed the prevalence of current high-intensity drinking (i.e., having ten or more drinks in a row in the past 2 weeks) among national samples of U.S. eighth and tenth grade students (at modal ages 14 and 16 years, respectively).Methods: Data on high-intensity drinking were provided by 10,210 students participating in the nationally representative Monitoring the Future study in 2016, and analyzed in 2016-2017. Prevalence levels and interactions between grade and key covariates were estimated using procedures that adjusted for the Monitoring the Future study's complex sampling design.Results: Approximately 2% of adolescents reported current high-intensity drinking, with significant differences by grade (1.2% of eighth graders; 3.1% of tenth graders) and gender (1.7% female; 2.3% male). High-intensity drinking was significantly higher among eighth and tenth grade students who reported any cigarette or marijuana use than among students who reported never using either substance.Conclusions: A meaningful percentage of young adolescents in the U.S. engage in high-intensity drinking. [ABSTRACT FROM AUTHOR]

The military is described as a social context that contributes to the (re-)initiation or intensification of cigarette smoking. We draw on data from the 1985-2014 National Survey of Drug Use and Health (NSDUH) and the Wisconsin Longitudinal Study (WLS) to conduct complementary sub-studies of the influence of military service on men's smoking outcomes across the life course. Descriptive findings from an age-period-cohort analysis of NSDUH data document higher probabilities of current smoking and heavy smoking among veteran men across a broad range of cohorts and at all observed ages. Findings from sibling fixed-effects Poisson models estimated on the WLS data document longer durations of smoking among men who served in the military and no evidence that selection explains the observed relationship. Together, these results provide novel and potentially generalizable evidence that participation in the military in early adulthood exerts a causal influence on smoking across the life course. [ABSTRACT FROM AUTHOR]

Background This study examined changes during the past decade, from 2005 to 2015, in binge and high-intensity drinking in 7 separate age groups of U.S. 12th graders and young adults. Methods National longitudinal data ( N = 6,711) from Monitoring the Future were used to examine trends in consuming 5+, 10+, and 15+ drinks on the same occasion in the past 2 weeks from ages 18 to 29/30 overall and by gender. Results were compared with trends in past 12-month and 30-day alcohol use for the same age groups. Results Between 2005 and 2015, binge (5+) and high-intensity drinking (10+, 15+) generally decreased for individuals in their early 20s, remained somewhat stable for individuals in their mid-20s, and increased for individuals at the end of young adulthood (age 29/30). The observed historical trends in binge and high-intensity drinking were similar to those for past 12-month and past 30-day alcohol use for those aged 18 to 20, but diverged for most other age groups in young adulthood. Trends were generally similar for men and women, except that the increase in prevalence began earlier in young adulthood for women than for men. Conclusions Binge and high-intensity drinking among U.S. 12th graders and young adults are dynamic phenomena. Prevention and intervention efforts aimed at reducing the harms resulting from 5+, 10+, and 15+ drinking should acknowledge and focus on differences in trends in these behaviors by age and gender. [ABSTRACT FROM AUTHOR]

Aim: To quantify the trends in frequent and occasional cannabis vaping, demographic differences and concurrent nicotine and alcohol use. Design: Observational study. Survey‐weighted multinomial logistic regression models assessed trends and disparities in past 30‐day cannabis use. Trends were assessed overall and by sex, race/ethnicity, parental education and urbanicity. Multinomial logistic regression models also estimated associations of cannabis use (none, use without vaping, use with vaping) with past 2‐week binge drinking and past 30‐day nicotine/tobacco use. Setting: United States, 2017–19. Participants: Participants in the national Monitoring the Future (n = 51 052) survey. Measurements Past 30‐day frequent cannabis use (six or more times/30 days) and past 30‐day occasional use (one to five times/30 days), with and without vaping. Findings Past 30‐day frequent cannabis use with vaping and occasional use with vaping rose from 2017 to 2019. Past 30‐day frequent and occasional cannabis use without vaping declined. Certain groups, such as Hispanic/Latino or lower socio‐economic status adolescents, experienced particularly notable increases in frequent cannabis use with vaping (e.g. prevalence among Hispanic/Latino adolescents). Adolescents who reported smoking and vaping nicotine, and 10+ occasions of binge drinking, were 42.28 [95% confidence interval (CI) = 33.14–53.93] and 10.09 (95% CI = 4.51–22.53) times more likely to report past 30‐day cannabis use with vaping, respectively, compared with no use. Discussion Cannabis use without vaping appears to be declining among adolescents in the United States, while cannabis use with vaping is accelerating; frequent cannabis vaping is especially increasing, with consistent increases across almost all adolescent demographic groups. Cannabis use among US adolescents remains highly associated with other substance use. [ABSTRACT FROM AUTHOR]