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Background: Delta-8 tetrahydrocannabinol (THC) has experienced significant cultivation, use, and online marketing growth in recent years. Objectives: This study utilized natural language processing on Twitter data to examine trends in public discussions regarding this novel psychoactive substance. Methods: This study analyzed the frequency of #Delta8 tweets over time, most commonly used words, sentiment classification of words in tweets, and a qualitative analysis of a random sample of tweets containing the hashtag “Delta8” from January 1, 2020 to September 26, 2021. Results: A total of 41,828 tweets were collected, with 30,826 unique tweets (73.7%) and 11,002 quotes, retweets, or replies (26.3%). Tweet activity increased from 2020 to 2021, with daily original tweets rising from 8.55 to 149. This increase followed a high-engagement retailer promotion in June 2021. Commonly used terms included “cbd,” “cannabis,” “edibles,” and “cbdoil.” Sentiment classification revealed a predominance of “positive” (30.93%) and “trust” (14.26%) categorizations, with 8.42% classified as “negative.” Qualitative analysis identified 20 codes, encompassing substance type, retailers, links, and other characteristics. Conclusion: Twitter discussions on Delta-8 THC exhibited a sustained increase in prevalence from 2020 to 2022, with online retailers playing a dominant role. The content also demonstrated significant overlap with cannabidiol and various cannabis products. Given the growing presence of retailer marketing and sales on social media, it is crucial for public health researchers to monitor and promote relevant Delta-8 health recommendations on these platforms to ensure a balanced conversation.

Supplemental Material for Predictors of Discussing Lung Cancer Screening with a Health Care Provider Among Current and Former Smokers in HINTS: A Secondary Data Analysis by Shacoria L. Anderson, MPH, Melvin D. Livingston, PhD, Kristin A. Higgins, MD, and Colleen M. McBride, PhD in Cancer Control

Additional file 2. SPIRIT 2013 Checklist.

Additional file 1. Detailed Measures Table.

BACKGROUND: Opioid-related overdoses are a major cause of mortality in the US. Medicaid Expansion is posited to reduce opioid overdose-related mortality (OORM), and may have a particularly strong effect among people of lower socioeconomic status. This study assessed the association between state Medicaid Expansion and county-level OORM rates among individuals with low educational attainment. METHODS: This quasi-experimental study used lagged multilevel difference-in-difference models to test the relationship of state Medicaid Expansion to county-level OORM rates among people with a high-school diploma or less. Longitudinal (2008–2018) OORM data on 2,978 counties nested in 48 states and the District of Columbia (DC) were drawn from the National Center for Health Statistics. The state-level exposure was a time-varying binary-coded variable capturing pre- and post-Medicaid Expansion under the Affordable Care Act (an “on switch”-type variable). The main outcome was annual county-level OORM rates among low-education adults adjusted for potential underreporting of OORM. FINDINGS: The adjusted county-level OORM rates per 100,000 among the study population rose on average from 10.26 (SD=13.56) in 2008 to 14.51 (SD=18.20) in 2018. In the 1-year lagged multivariable model that controlled for policy and sociodemographic covariates, the association between state Medicaid Expansion and county-level OORM rates was statistically insignificant. CONCLUSIONS: We found no evidence that expanding Medicaid eligibility reduced OORM rates among adults with lower educational attainment. Future work should seek to corroborate our findings and also identify – and repair – breakdowns in mechanisms that should link Medicaid Expansion to reduced overdoses.

AIMS: We evaluated the effects of a community organizing intervention, Communities Mobilizing for Change on Alcohol (CMCA), on the propensity of retail alcohol outlets to sell alcohol to young buyers without age identification and on alcohol acquisition behaviors of underage youth. DESIGN: Random assignment of community to treatment (n=3) or control (n=2). Student surveys were conducted four times per year for three years; the cohort was in 9th and 10th grades in the 2012–13 academic year. Alcohol purchase attempts were conducted every 4 weeks at alcohol retailers in each community (31 repeated waves). SETTING: The Cherokee Nation, located in northeastern Oklahoma, USA. PARTICIPANTS: 1399 high school students (50% male; 45% American Indian) and 113 stores licensed to sell alcohol across 5 study communities. INTERVENTION: Local community organizers formed independent citizen Action Teams to advance policies, procedures and practices of local institutions in ways to reduce youth access to alcohol and foster community norms opposed to teen drinking. MEASUREMENTS: Perceptions regarding police enforcement and perceived difficulty of and self-reported actual acquisition of alcohol from parents, adults, peers, and stores. FINDINGS: Alcohol purchases by young-appearing buyers declined significantly, an 18 (95% CI: 3, 33) percentage-point reduction over the intervention period. Student survey results show statistically significant differences in the trajectory of perceived police enforcement, increasing 7 (4, 10) percentage-points, alcohol acquisition from parents, decreasing 4, (0.1, 8) percentage-points, acquisition from 21+ adults, decreasing 6 (0.04, 11) percentage points, from