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Aims: The experiment tested the effects of a web‐push survey research protocol, compared with the standard mailed paper‐and‐pencil protocol, among young adults aged 19–30 years in the 'Monitoring the Future' (MTF) longitudinal study. Design, Setting and Participants: The US‐based MTF study has measured substance use trends among young adults in panel samples followed biennially, using consistent mailed survey procedures from 1977 to 2017. In 2018, young adult participants in the MTF longitudinal component scheduled to be surveyed at ages 19–30 in 2018 (from high school senior cohorts of 2006–17, n = 14 709) were randomly assigned to receive the standard mail/paper survey procedures or new web‐push procedures. Measurements Primary outcomes were responding to the survey and prevalence estimates for past 30‐day use of alcohol, cigarettes, marijuana and illicit drugs. Findings The web‐push response rate was 39.07% [95% confidence interval (CI) = 37.889, 40.258]; this was significantly better than the standard MTF response rate of 35.12% (95% CI = 33.964, 36.285). After adjusting for covariates, the web‐push condition was associated with a 19% increase in the odds of responding compared with standard MTF (adjusted odds ratio = 1.188; 95% CI = 1.096, 1.287). Substance use prevalence estimates were very similar and differences became negligible when using attrition weights and controlling for socio‐demographic characteristics. Conclusions: The web‐push protocol produced a higher response rate than the mailed pencil and paper protocol in the Monitoring the Future panel study, without substantially affecting estimates of substance use once attrition weights and socio‐demographic variables were factored in. [ABSTRACT FROM AUTHOR]

The article announces an open call for submissions to a special issue in the journal that broadly addresses disposable e-cigarettes.

The article describes the Paper Authoring Tool (PAT), funded by the periodical "Addiction," and designed to write-up randomized control trials. Widely available to any researcher, it generates a Word file and a machine-readable version of the paper to support automated evidence synthesis in the form of a JSON-LD file.

Background and aims: The use and manufacture of methamphetamine has increased in Afghanistan in recent years. Recent research and reports have pointed to the ephedra plant, which grows wildly, as a key source of ephedrine used in the manufacture of methamphetamine. This paper aimed to estimate the relative efficiencies and scale of inputs required to manufacture methamphetamine in Afghanistan. Methods: Monte Carlo simulations model of the amount of ephedra or cold medications needed to render a pure kilogram of methamphetamine in Afghanistan, accounting for uncertainty in ranges of key parameters informed from the literature and elsewhere. Final estimates were extrapolated to recent seizure totals. Results: For dried ephedra, the median estimate is 196.8 kg (25th–75th percentiles 119.3–346.6 kg) needed to produce 1 kg of methamphetamine compared with 27.9 kg (25th–75th percentiles 21.9–36.8 kg) for cold medications. Nearly 2.7 t of methamphetamine were seized in Afghanistan in 2021. Assuming a purity range of 50%–90%, some 266–478 t of dried ephedra or 38–68 t of cold medication would need to have been processed. Conclusion: Simulated estimates show that considerable amounts of either ephedra or cold medication are needed to produce 1 kg of methamphetamine in Afghanistan. This raises questions about the plausibility of ephedra as the dominant source of Afghanistan's methamphetamine. [ABSTRACT FROM AUTHOR]

Randomized controlled trials (RCTs) are considered the gold standard for causal inference. With a sufficient sample size, randomization removes confounding up to the time of randomization and allows the treatment effect to be isolated. However, RCTs may have limited generalizability and transportability and are often not feasible in addiction research due to ethical or logistical constraints. The importance of observational studies from real‐world settings has been increasingly recognized in research on health. This paper provides an overview of modern approaches to designing observational studies that enable causal inference. It illustrates three key techniques, Directed Acyclic Graphs (DAGs), modified Disjunctive Cause Criterion and Target Trial Emulation, and discusses the strengths and limitations of their applications. [ABSTRACT FROM AUTHOR]

Background and aims Method Results Conclusion Population‐level alcohol use data are available from high‐income countries, but limited research has been conducted in sub‐Saharan Africa. This systematic review and meta‐analysis aimed to summarize population‐level alcohol use in sub‐Saharan Africa.Databases searched included PubMed, EMBASE, PsycINFO and AJOL, without language restrictions. Searches were also conducted in the Global Health Data Exchange (GHDx) and Google Scholar. Search terms encompassed ‘substance’ or ‘substance‐related disorders’ and ‘prevalence’ and ‘sub‐Saharan Africa’. We included general population studies on alcohol use (including any use, high‐risk alcohol use and alcohol use disorders) from 2018 onwards. Prevalence data for alcohol use among sub‐Saharan African adolescents (10–17) and adults (18+) were extracted. Analyses included life‐time and past 12‐ and 6‐month alcohol use.We included 141 papers. Among adolescents, the life‐time prevalence of alcohol use was 23.3% [95% confidence interval (CI) = 11.3–37.1%], 36.2% (CI = 18.4–56.1%) in the past year and 11.3% (CI = 4.5–20.4%) in the past 6 months. Among adolescents, 12‐month prevalence of alcohol use disorder and alcohol dependence were 7.7% (CI = 0.0–27.8%) and 4.1% (CI = 1.4–7.9%), respectively. Among adults, the life‐time prevalence of alcohol use was 34.9% (CI = 17.7–54.1%), 27.1% (CI = 5.0–56.4%) in the past year and 32.2% (CI = 19.8–46.0%) in the past 6 months. Among adults, the 12‐month prevalence of alcohol use disorder and alcohol dependence were 9.5% (CI = 0.0–30.4%) and 4.3% (CI = 0.8–9.8%), respectively. The highest weighted life‐time prevalence of alcohol use, 86.4%, was reported in Tanzania among adults. The highest weighted past 6‐month prevalence of alcohol use, 80.6%, was found in Zambia among adolescents.Alcohol use patterns vary across countries and subregions within sub‐Saharan Africa, and comprehensive population‐level data on alcohol use remain scarce in numerous sub‐Saharan African countries. The prevalence of alcohol use disorder is common among adolescents in sub‐Saharan Africa. [ABSTRACT FROM AUTHOR]

Background and aims Methods Results Conclusions There has been much concern regarding potential harmful effects of video game‐play in the past 40 years, but limited progress in understanding its causal role. This paper discusses the basic requirements for identifying causal effects of video game‐play and argues that most research to date has focused upon ambiguous causal questions.Video games and mental health are discussed from the perspective of causal inference with compound exposures; that is, exposures with multiple relevant variants that affect outcomes in different ways.Not only does exposure to video games encompass multiple different factors, but also not playing video games is equally ambiguous. Estimating causal effects of a compound exposure introduces the additional challenge of exposure‐version confounding.Without a comparison of well‐defined interventions, research investigating the effects of video game‐play will be difficult to translate into actionable health interventions. Interventions that target games should be compared with other interventions aimed at improving the same outcomes. [ABSTRACT FROM AUTHOR]

Background and Aims: Even though a ban of alcohol marketing has been declared a 'best buy' of alcohol control policy, comprehensive systematic reviews on its effectiveness to reduce consumption are lacking. The aim of this paper was to systematically review the evidence for effects of total and partial bans of alcohol marketing on alcohol consumption. Methods: This descriptive systematic review sought to include all empirical studies that explored how changes in the regulation of alcohol marketing impact on alcohol consumption. The search was conducted between October and December 2022 considering various scientific databases (Web of Science, PsycINFO, MEDLINE, Embase) as well as Google and Google Scholar. The titles and abstracts of a total of 2572 records were screened. Of the 26 studies included in the full text screening, 11 studies were finally included in this review. Changes in consumption in relation to marketing bans were determined based on significance testing in primary studies. Four risk of bias domains (confounding, selection bias, information bias and reporting bias) were assessed. Results: Seven studies examined changes in marketing restrictions in one location (New Zealand, Thailand, Canadian provinces, Spain, Norway). In the remaining studies, between 17 and 45 locations were studied (mostly high‐income countries from Europe and North America). Of the 11 studies identified, six studies reported null findings. Studies reporting lower alcohol consumption following marketing restrictions were of moderate, serious and critical risk of bias. Two studies with low and moderate risk of bias found increasing alcohol consumption post marketing bans. Overall, there was insufficient evidence to conclude that alcohol marketing bans reduce alcohol consumption. Conclusions: The available empirical evidence does not support the claim of alcohol marketing bans constituting a best buy for reducing alcohol consumption. [ABSTRACT FROM AUTHOR]

Medications for opioid use disorder (MOUD) increase retention in care and decrease mortality during active treatment; however, information about the comparative effectiveness of different forms of MOUD is sparse. Observational comparative effectiveness studies are subject to many types of bias; a robust framework to minimize bias would improve the quality of comparative effectiveness evidence. This paper discusses the use of target trial emulation as a framework to conduct comparative effectiveness studies of MOUD with administrative data. Using examples from our planned research project comparing buprenorphine‐naloxone and extended‐release naltrexone with respect to the rates of MOUD discontinuation, we provide a primer on the challenges and approaches to employing target trial emulation in the study of MOUD. [ABSTRACT FROM AUTHOR]

The authors discuss the report which examines evidence on electronic cigarettes commissioned by the World Health Organization (WHO). They mention that the significant issue to regard is the role of marketing in urging smokers to move away from smoking while not drawing in non-smokers. They say that there is proof that smokers tries electronic (e)-cigarettes due to their desire for safer alternatives and a concern on the health risks of smoking.

Background: Low‐Risk Alcohol Drinking Guidelines (LRDGs) aim to reduce the harms caused by alcohol. However, considerable discrepancies exist in the 'low‐risk' thresholds employed by different countries. Argument/analysis: Drawing upon Canada's LRDGs update process, the current paper offers the following propositions for debate regarding the establishment of 'low‐risk' thresholds in national guidelines: (1) as an indicator of health loss, years of life lost (YLL) has several advantages that could make it more suitable for setting guidelines than deaths, premature deaths or disability adjusted years of life (DALYs) lost. (2) Presenting age‐specific guidelines may not be the most appropriate way of providing LRDGs. (3) Given past overemphasis on the so‐called protective effects of alcohol on health, presenting cause‐specific guidelines may not be appropriate compared with a 'whole health' effect derived from a weighted composite risk function comprising conditions that are causally related to alcohol consumption. (4) To help people reduce their alcohol use, presenting different risk zones associated with alcohol consumption instead of a single low risk threshold may be advantageous. Conclusions: National LRDGs should be based on years of life lost and should be neither age‐specific nor cause‐specific. We recommend using risk zones rather than a single drinking threshold to help people assess their own risk and encourage the adoption of behaviours with positive health impacts across the alcohol use spectrum. [ABSTRACT FROM AUTHOR]

The article comments on the paper by B. Pardo and colleagues about the production of methamphetamine in Afghanistan. Topics discussed include the role of ephedra in the expansion of methamphetamine production in the country, the uncertainty of the Taliban's ban on drug production, and the possible increase in the manufacture of methamphetamine or other synthetic substances using synthetic precursors.

Comments on methodological issues linked to the alcohol Stroop paradigm in the paper of Sharma, Albery and Cook. Assessment on the attentional bias of drinkers for alcohol-related stimuli; Objections to the card format used in the presentation of the Stroop stimuli; Employment of the Alcohol Use Disorders Identification Test.

Background and aims: In 1561, physician and philosopher Pascasius Justus Turq published a monograph on the description and treatment of pathological gambling. When the monograph came to the attention of the authors in 2006, there existed no known translation of it in any modern language. In 2014, it was translated and published in French. This paper analyses the monograph's key content elements and its place in the history of the concept of addiction. Methods: A contextual analysis of the late Italian Renaissance, followed by key excerpts from the text and commentaries on the meaning and significance of the monograph. Findings and conclusions: Pascasius Justus Turq's 1561 monograph on pathological gambling outlines a disease view of gambling, identifies cognitive processes and biological vulnerabilities as aetiological factors, avoids religious or moral judgements and recommends cognitive treatment to change the beliefs and expectancies of gamblers. This study shows that a 'disease formulation' of addiction was enunciated as early as the 16th century, and its contemporary resonance suggests that current clinical features of addictive disorders have existed for centuries. [ABSTRACT FROM AUTHOR]

Discusses the importance of review papers in the field of addiction and substance abuse. Definition of a review; Quality of reviews in the addiction field; Meta-analysis as a growth point; Recommendations.

Aims: In the article, ancient concepts linking animals and wine are discussed. This paper provides a description of animals that in antiquity were considered to be especially fond of grapes and wine, as well as animals that were, for various reasons, given wine to drink by humans, and animals that in ancient literature had an averse association with wine. In the paper, the author attempts to answer the following questions, what was the conceptual framework for the tales about drunk animals? In what circumstances were observations of animals becoming inebriated conducted? Which animal species were considered as most susceptible to the effects of wine? Last, was wine believed to affect animals and humans in a similar way? Methods: Ancient literature provides a set of extant information about animals that willingly become inebriated with grapes or are given wine by humans, which deserves a separate analysis. The ancient authors commonly interspersed narration with information about the animals and invoked personal experiences of contact with the described animal and information obtained from those who had the opportunity to conduct 'zoological' observations or even medical experiments. Results: There is a large group of animals that appear in ancient accounts consuming alcohol in the form of fermented fruit and wine. The ancients held the mostly incorrect belief that snakes had an enormous predilection for wine; moreover, contemporary research confirms that, as the ancients rightly observed, insects and birds do display a fondness for fermented fruit and wine. It was correctly observed that an excess of wine induced extreme states, such as sleepiness and aggression in animals, in a manner similar to humans. Conclusions: Accounts in ancient literature show a close association between animals and wine existed among the Greeks and Romans. [ABSTRACT FROM AUTHOR]

The Cochrane Tobacco Addiction Group has created risk of bias tools, which are topic‐agnostic. In 2012 the Cochrane Tobacco Addiction Group created guidance specific to considerations for reviews of randomized controlled trials of tobacco cessation interventions, building on existing Cochrane tools. The guidance covers issues relating to selection bias, performance bias, detection bias, attrition bias and selective reporting. In this paper, we set out to make this guidance publicly available, so that others can use and cite it. We provide advice for using this tool to appraise trials critically as a systematic reviewer. We also provide guidance for triallists on ways to use this tool to improve trial design and reporting. [ABSTRACT FROM AUTHOR]

Background and Aims: The Scottish Government introduced minimum unit pricing (MUP) for alcohol on 1 May 2018. This means retailers in Scotland cannot sell alcohol to consumers for less than £0.50 per unit (1 UK unit = 8 g ethanol). The Government intended the policy to increase the price of cheap alcohol, cut alcohol consumption overall and particularly among those drinking at hazardous or harmful levels, and ultimately reduce alcohol‐related harm. This paper aims to summarise and assess the evidence to date evaluating the impact of MUP on alcohol consumption and related behaviours in Scotland. Argument: Evidence from analyses of population‐level sales data suggest, all else being equal, MUP reduced the volume of alcohol sold in Scotland by ~ 3.0% to 3.5%, with the largest reductions affecting cider and spirits sales. Analyses of two time series datasets on household‐level alcohol purchasing and individual‐level alcohol consumption suggest reductions in purchasing and consumption among those drinking at hazardous and harmful levels, but offer conflicting results for those drinking at the most harmful levels. These subgroup analyses are methodologically robust, but the underlying datasets have important limitations as they rely on non‐random sampling strategies. Further studies identified no clear evidence of reduced alcohol consumption among those with alcohol dependence or those presenting to emergency departments and sexual health clinics, some evidence of increased financial strain among people with dependence and no evidence of wider negative outcomes arising from changes in alcohol consumption behaviours. Conclusions: Minimum unit pricing for alcohol in Scotland has led to reduced consumption, including among heavier drinkers. However, there is uncertainty regarding its impact on those at greatest risk and some limited evidence of negative outcomes, specifically financial strain, among people with alcohol dependence. [ABSTRACT FROM AUTHOR]

Background and Aims: Long‐acting injectable buprenorphine (LAIB) is a new treatment for opioid use disorder that is generating positive outcomes. Negative effects are typically mild and transient, but can occasionally be serious, resulting in treatment discontinuation/non‐adherence. This paper aims to analyse patients' accounts of how they felt during the first 72 h after initiating LAIB. Methods: Semi‐structured interviews were conducted (June 2021–March 2022) with 26 people (18 males and 8 females) who had started LAIB within the previous 72 h. Participants were recruited from treatment services in England and Wales and were interviewed by telephone using a topic guide. Interviews were audio‐recorded, transcribed and coded. The concepts of embodiment and embodied cognition framed the analyses. Data on participants' substance use, initiation onto LAIB and feelings were tabulated. Next, participants' accounts of how they felt were analysed following the stages of Iterative Categorization. Results: Participants reported complex combinations of changing negative and positive feelings. Bodily experiences included withdrawal symptoms, poor sleep, injection‐site pain/soreness, lethargy and heightened senses inducing nausea ('distressed bodies'), but also enhanced somatic wellbeing, improved sleep, better skin, increased appetite, reduced constipation and heightened senses inducing pleasure ('returning body functions'). Cognitive responses included anxiety, uncertainties and low mood/depression ('the mind in crisis') and improved mood, greater positivity and reduced craving ('feeling psychologically better'). Whereas most negative effects reported are widely recognized, the early benefits of treatment described are less well‐documented and may be an overlooked distinctive feature of LAIB. Conclusions: During the first 72 h after initiating long‐acting injectable buprenorphine, new patients report experiencing a range of interconnected positive and negative short‐term effects. Providing new patients with information about the range and nature of these effects can prepare them for what to expect and help them manage feelings and reduce anxiety. In turn, this may increase medication adherence. [ABSTRACT FROM AUTHOR]

Background and aims: There are concerns that availability of recreational cannabis dispensaries (RCDs) and point‐of‐sale marketing may lead to increased cannabis use in jurisdictions where cannabis retail sale is legal. This paper examined whether the availability RCDs and the presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs were associated with cannabis use and risk perceptions. Design: Cross‐sectional, secondary data analysis. Setting: California, USA. Participants: A representative sample of 3385 adults in California who participated in the 2020 probability‐based Marijuana Use and Environment Survey. Measurements Binary outcomes included past‐month overall cannabis use, perceiving cannabis smoking as harmful and past‐month cannabis use by purpose (medical only, recreational only and dual). The objectively assessed predictors included proximity and density of RCDs and presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs. Findings In terms of proximity, thepresence of storefront signage in the nearest RCD was associated with smaller odds of perceiving cannabis smoking as harmful [odds ratio (OR) = 0.63, 95% confidence interval (CI) = 0.39, 0.99] if the RCD was located within 2 miles of home. Presence of health benefit signs in the nearest RCD was associated with greater odds of overall cannabis use (OR = 2.45, 95% CI = 1.17, 5.16) and recreational use (OR = 3.50, 95% CI = 1.027, 11.91) if the RCD was located within 2–4 miles of home. In terms of density, count of RCDs, count of RCDs with storefront signage and count of RCDs with health benefit signs within 2 miles of home were each separately associated with greater odds of overall cannabis use and cannabis use for dual purposes. Conclusions: The availability of recreational cannabis dispensaries within 2 miles of one's home and the presence of storefront signage indicating the availability of cannabis and signs promoting health benefits of cannabis appear to be associated with increased cannabis use and reduced risk perceptions among adults in California, USA. [ABSTRACT FROM AUTHOR]

This paper critically analyses a statement by Australia's National Health and Medical Research Council (NHMRC) on e‐cigarettes in May 2022 that will be used to guide national policy. We reviewed the evidence and the conclusions drawn in the NHMRC Statement. In our view, the Statement is not a balanced reflection of the benefits and risks of vaping because it exaggerates the risks of vaping and fails to compare them to the far greater risks of smoking; it uncritically accepts evidence of harms from e‐cigarettes while adopting a highly sceptical attitude towards evidence of their benefits; it incorrectly claims that the association between adolescent vaping and subsequent smoking is causal; and it understates the evidence of the benefits of e‐cigarettes in assisting smokers to quit. The Statement dismisses the evidence that vaping is probably already having a positive net public health effect and misapplies the precautionary principle. Several sources of evidence supporting our assessment were published after the NHMRC Statement's publication and are also referenced. The NHMRC Statement on e‐cigarettes does not present a balanced assessment of the available scientific literature and fails to meet the standard expected of a leading national scientific body. [ABSTRACT FROM AUTHOR]

Background and aims: Low outcome prevalence, often observed with opioid‐related outcomes, poses an underappreciated challenge to accurate predictive modeling. Outcome class imbalance, where non‐events (i.e. negative class observations) outnumber events (i.e. positive class observations) by a moderate to extreme degree, can distort measures of predictive accuracy in misleading ways, and make the overall predictive accuracy and the discriminatory ability of a predictive model appear spuriously high. We conducted a simulation study to measure the impact of outcome class imbalance on predictive performance of a simple SuperLearner ensemble model and suggest strategies for reducing that impact. Design, Setting, Participants: Using a Monte Carlo design with 250 repetitions, we trained and evaluated these models on four simulated data sets with 100 000 observations each: one with perfect balance between events and non‐events, and three where non‐events outnumbered events by an approximate factor of 10:1, 100:1, and 1000:1, respectively. Measurements: We evaluated the performance of these models using a comprehensive suite of measures, including measures that are more appropriate for imbalanced data. Findings Increasing imbalance tended to spuriously improve overall accuracy (using a high threshold to classify events vs non‐events, overall accuracy improved from 0.45 with perfect balance to 0.99 with the most severe outcome class imbalance), but diminished predictive performance was evident using other metrics (corresponding positive predictive value decreased from 0.99 to 0.14). Conclusion: Increasing reliance on algorithmic risk scores in consequential decision‐making processes raises critical fairness and ethical concerns. This paper provides broad guidance for analytic strategies that clinical investigators can use to remedy the impacts of outcome class imbalance on risk prediction tools. [ABSTRACT FROM AUTHOR]

Background and Aims: The alcohol harm paradox (AHP) posits that disadvantaged groups suffer from higher rates of alcohol‐related harm compared with advantaged groups, despite reporting similar or lower levels of consumption on average. The causes of this relationship remain unclear. This study aimed to identify explanations proposed for the AHP. Secondary aims were to review the existing evidence for those explanations and investigate whether authors linked explanations to one another. Methods: This was a systematic review. We searched MEDLINE (1946–January 2021), EMBASE (1974–January 2021) and PsycINFO (1967–January 2021), supplemented with manual searching of grey literature. Included papers either explored the causes of the AHP or investigated the relationship between alcohol consumption, alcohol‐related harm and socio‐economic position. Papers were set in Organization for Economic Cooperation and Development high‐income countries. Explanations extracted for analysis could be evidenced in the empirical results or suggested by researchers in their narrative. Inductive thematic analysis was applied to group explanations. Results: Seventy‐nine papers met the inclusion criteria and initial coding revealed that these papers contained 41 distinct explanations for the AHP. Following inductive thematic analysis, these explanations were grouped into 16 themes within six broad domains: individual, life‐style, contextual, disadvantage, upstream and artefactual. Explanations related to risk behaviours, which fitted within the life‐style domain, were the most frequently proposed (n = 51) and analysed (n = 21). Conclusions: While there are many potential explanations for the alcohol harm paradox, most research focuses on risk behaviours while other explanations lack empirical testing. [ABSTRACT FROM AUTHOR]

Background and Aims: The Transformative Research on the Alcohol industry, Policy and Science (TRAPS) programme investigates the alcohol industry, with an innovative focus on public health sciences. TRAPS adds to an under‐developed literature on the study of alcohol industry influence on alcohol science and policymaking. This paper provides a synthesis of TRAPS findings to inform future research. Methods: We conducted an interpretive review of TRAPS research findings across its component studies, identifying and integrating the key contributions made by individual studies to the literature on alcohol policymaking and science, and identifying areas where TRAPS progress was limited. This produced themes for consideration in future research agenda setting. Results: TRAPS explored the interventions of the alcohol industry in science and policymaking using various methods, including systematic reviews and qualitative interviews. These studies identified the industry's activities in several key areas, such as the debate over minimum unit pricing (MUP), cardiovascular health and alcohol research and a long‐running public relations programme developed in close connection with the tobacco industry. Collectively, the research shows that alcohol policymaking has involved a contest between the research community and alcohol industry actors about whether and how science should be used to inform policy. Conclusions: The TRAPS programme demonstrates the need for a transdisciplinary approach to understand the nature of corporate political activity; the crucial role industry involvement in science plays in the development of corporate political power; and how public health actors have successfully overcome industry opposition to evidence‐based policies. Advances in alcohol policy should be underpinned by strong, reflexive public health sciences, alert to the role of industry in the alcohol harms under study and thorough in their investigation of the alcohol industry as an object of study in itself. [ABSTRACT FROM AUTHOR]

Background and aims: Among European countries, France is particularly concerned by adolescent tobacco smoking, especially in disadvantaged socio‐economic backgrounds (SES). We measured the respective contributions of parental smoking and family living arrangement to social disparities in smoking during adolescence. Design: Secondary analysis of survey data. Setting: A cross‐sectional nation‐wide exhaustive 12‐day survey in March 2017 of French youth aged 17–18.5 years participating in the national mandatory civic information day. Participants: A total of 13 314 adolescents answering a pen‐and‐paper questionnaire about their own tobacco consumption and the smoking of their parents. Measurements Risk ratios (RRs) were computed using modified Poisson regressions, and population‐attributable fraction (PAF) was used as a measure of the explanatory roles of the different factors as mediators of SES. Findings Adolescents living within very privileged and privileged SES were significantly less likely to report daily tobacco smoking (20.4 and 22.7%, respectively) than those within modest and disadvantaged ones (26.0 and 28.6%, respectively). Parental smoking and family living arrangement independently explained the smoking inequalities among adolescents. After adjusting for schooling factors, the risks associated with parental smoking ranged between RR = 1.64 [95% confidence interval (CI) = 1.50–1.79] when the father only smoked and RR = 2.17 (95% CI = 1.99–2.36) when both parents smoked, compared with non‐smoking parents; the risk associated with living in a non‐intact family was 1.35 (95% CI = 1.26–1.43) and that of living outside the parental home was 1.20 (95% CI = 1.10–1.30). Apprentices and adolescents out of school had higher risks than those at school (RR = 1.82, 95% CI = 1.68–1.98) and RR = 2.10, 95% CI = 1.92–2.29). The contribution of parental smoking to adolescent smoking (PAF = 32%) was greater than that of SES (PAF = 9%), family living arrangement (PAF = 17%) or schooling factors (14%). The share of SES decreased from 18 to 9% when considering these mediating factors. Conclusion: In France, parental smoking appears to be the factor that most influences adolescent smoking, followed by family living arrangement; the role of family socio‐economic status is small in comparison. [ABSTRACT FROM AUTHOR]

Background and aims: Alcohol consumption increased in the early phases of the COVID‐19 pandemic in the United States. Alcohol use disorder (AUD) and risky drinking are linked to harmful health effects. This paper aimed to project future health and cost impacts of shifts in alcohol consumption during the COVID‐19 pandemic. Design: An individual‐level simulation model of the long‐term drinking patterns for people with life‐time AUD was used to simulate 10 000 individuals and project model outcomes to the estimated 25.9 million current drinkers with life‐time AUD in the United States. The model considered three scenarios: (1) no change (counterfactual for comparison); (2) increased drinking levels persist for 1 year ('increase‐1') and (3) increased drinking levels persist for 5 years ('increase‐5'). Setting: United States. Participants: Current drinkers with life‐time AUD. Measurements: Life expectancy [life‐years (LYs)], quality‐adjusted life‐years (QALYs), alcohol‐related hospitalizations and associated hospitalization costs and alcohol‐related deaths, during a 5‐year period. Findings Short‐term increases in alcohol consumption (increase‐1 scenario) resulted in a loss of 79 000 [95% uncertainty interval (UI]) 26 000–201 000] LYs, a loss of 332 000 (104 000–604 000) QALYs and 295 000 (82 000–501 000) more alcohol‐related hospitalizations, costing an additional $5.4 billion ($1.5–9.3 billion) over 5 years. Hospitalizations for cirrhosis of the liver accounted for approximately $3.0 billion ($0.9–4.8 billion) in hospitalization costs, more than half the increase across all alcohol‐related conditions. Health and cost impacts were more pronounced for older age groups (51+), women and non‐Hispanic black individuals. Increasing the duration of pandemic‐driven increases in alcohol consumption in the increase‐5 scenario resulted in larger impacts. Conclusions: Simulations show that if the increase in alcohol consumption observed in the United States in the first year of the pandemic continues, alcohol‐related mortality, morbidity and associated costs will increase substantially over the next 5 years. [ABSTRACT FROM AUTHOR]

Background and aims: Ontologies are ways of representing information that improve clarity and the ability to connect different data sources. This paper proposes an initial version of an ontology of tobacco, nicotine and vaping products with the aim of reducing ambiguity and confusion in the field. Methods: Terms related to tobacco, nicotine and vaping products were identified in the research literature and their usage characterised. Basic Formal Ontology was used as a unifying upper‐level ontology to describe the domain, and classes with definitions and labels were developed linking them to this ontology. Labels, definitions and properties were reviewed and revised in an iterative manner until a coherent set of classes was agreed by the authors. Results: Overlapping, but distinct classes were developed: 'tobacco‐containing product', 'nicotine‐containing product' and 'vaping device'. Subclasses of tobacco‐containing products are 'combustible tobacco‐containing product', 'heated tobacco product' and 'smokeless tobacco‐containing product'. Subclasses of combustible tobacco‐containing product include 'cigar', 'cigarillo', 'bidi' and 'cigarette' with further subclasses including 'manufactured cigarette'. Manufactured cigarettes have properties that include 'machine‐smoked nicotine yield' and 'machine‐smoked tar yield'. Subclasses of smokeless tobacco product include 'nasal snuff', 'chewing tobacco product', and 'oral snuff' with its subclass 'snus'. Subclasses of nicotine‐containing product include 'nicotine lozenge' and 'nicotine transdermal patch'. Subclasses of vaping device included 'electronic vaping device' with a further subclass, 'e‐cigarette'. E‐cigarettes have evolved with a complex range of properties including atomiser resistance, battery power, properties of consumables including e‐liquid nicotine concentration and flavourings, and the ontology characterises classes of product accordingly. Conclusions: Use of an ontology of tobacco, nicotine and vaping products should help reduce ambiguity and confusion in tobacco control research and practice. [ABSTRACT FROM AUTHOR]

Background and aims: The ability to regulate emotions effectively has been associated with resilience to psychopathology. Individuals with substance use disorders (SUDs) have been shown to have higher levels of negative emotionality, with some evidence suggesting impairment in emotion regulation compared with individuals without SUDs. However, no previous attempt has been made to systematically review the literature to assess the magnitude of this difference. We aimed to assess the association between SUD diagnosis and emotion regulation as measured by the Difficulties in Emotion Regulation Scale (DERS) and Emotion Regulation Questionnaire (ERQ) through a systematic review and meta‐analysis of existing findings. Methods: The systematic review was conducted using PubMed, PsycINFO and Embase. We examined cross‐sectional studies that compared a SUD group with a control group and measured emotion regulation using the DERS or the ERQ. The primary analysis focused on papers using the DERS, as this was the predominant instrument in the literature. Results: Twenty‐two studies met our primary analysis criteria, representing 1936 individuals with a SUD and 1567 controls. Individuals with SUDs relative to controls had significantly greater DERS scores, with a mean difference of 21.44 [95% confidence interval (CI) = 16.49–26.40, P < 0.001] and Hedges' g = 1.05 (95% CI = 0.86–1.24, P < 0.001). The difference was robust, remaining significant after removing outliers and studies with high risk of bias. Individuals with SUDs demonstrated poorer emotion regulation on each subscale of the DERS, with the largest deficits in the Strategies and Impulse subscales. The ERQ analysis revealed greater use of expressive suppression in those with SUDs relative to controls (Hedges' g = 0.76, 95% CI = 0.25–1.28, P = 0.004). Conclusions: People with substance use disorders appear to have greater difficulties in emotion regulation than people without substance use disorders. [ABSTRACT FROM AUTHOR]

Randomized controlled trials (RCTs) are the gold standard for making causal inferences, but RCTs are often not feasible in addiction research for ethical and logistic reasons. Observational data from real‐world settings have been increasingly used to guide clinical decisions and public health policies. This paper introduces the potential outcomes framework for causal inference and summarizes well‐established causal analysis methods for observational data, including matching, inverse probability treatment weighting, the instrumental variable method and interrupted time‐series analysis with controls. It provides examples in addiction research and guidance and analysis codes for conducting these analyses with example data sets. [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]

Background and aim: In Uruguay, residents age 18 and older seeking legal cannabis must register with the government and choose one of three supply mechanisms: self‐cultivation, non‐profit cannabis clubs or pharmacies. This is the first paper to measure the association between type of legal cannabis supply mechanism and traffic crashes involving injuries. Design Ecological study using ordinary least squares regression to examine how department‐level variation in registrations (overall and by type) is associated with traffic crashes involving injuries. Setting: Uruguay. Cases 532 department‐quarters. Measurements Quarterly cannabis registration counts at the department level and incident‐level traffic crash data were obtained from government agencies. The analyses controlled for department‐level economic and demographic characteristics and, as a robustness check, we included traffic violations involving alcohol for departments reporting this information. Department‐level data on crashes, registrations and alcohol violations were denominated by the number of residents ages 18 and older. Findings From 2013 to 2019, the average number of registrations at the department‐quarter level per 10 000 residents age 18 and older for self‐cultivation, club membership and pharmacy purchasing were 17.7 (SD = 16.8), 3.6 (SD = 8.6), and 25.1 (SD = 50.4), respectively. In our multivariate regression analyses, we did not find a statistically significant association between the total number of registrations and traffic crashes with injuries (β = −0.007; P = 0.398; 95% CI = −0.023, 0.01). Analyses focused on the specific supply mechanisms found a consistent, positive and statistically significant association between the number of individuals registered as self‐cultivators and the number of traffic crashes with injuries (β = 0.194; P = 0.008; 95% CI = 0.058, 0.329). Associations for other supply mechanisms were inconsistent across the various model specifications. Conclusions: In Uruguay, the number of people allowed to self‐cultivate cannabis is positively associated with traffic crashes involving injuries. Individual‐level analyses are needed to assess better the factors underlying this association. [ABSTRACT FROM AUTHOR]

Background/Aims: The COVID‐19 pandemic has significantly impacted face‐to‐face research. This has propelled ideas and plans for more remote styles of research and provided new perspectives on conducting research. This paper aimed to identify challenges specific to conducting remote forms of experimental addiction research, although some of these challenges apply to all types of addiction research. Argument The impact of the COVID‐19 pandemic has led to important lessons for future addiction research. Although remote research has been conducted for decades, little experimental research has been performed remotely. To do so require a new perspective on what research questions we can ask and could also enable preferential capture of those who may be more reluctant to engage in research based in clinical settings. There may, however, be crucial factors that will compromise this process. We illustrate our argument with three real‐world, ongoing case studies centred on gambling behaviour, opioid overdose, and cannabinoid psychopharmacology. We highlight the obstacles to overcome to enable more remote methods of study. Conclusions: The future of experimental research and, more generally, addiction research, will be shaped by the pandemic and may result in advantages, such as reaching different populations and conducting addiction research in more naturalistic settings. [ABSTRACT FROM AUTHOR]

Background and Aims: The pathways model is a highly cited etiological model of problem gambling. In the past two decades, a number of studies have found support for the model's utility in classifying gambling subtypes. The aims of this paper were to refine empirically the model subtypes and to revise and update the model based on those findings. Design and Measurement: Observational study using data collected from treatment‐seeking problem gamblers using the Problem Gambling Severity Index (PGSI) and the Gambling Pathways Questionnaire (GPQ). Setting: Treatment clinics in Canada, Australia and the United States. Participants: A convenience sample of 1168 treatment‐seeking problem gamblers, aged 18 years or older. Findings Empirically validated risk factors were analyzed using latent class analyses, identifying a three‐class solution as the best‐fitting model. Those in the largest class (class 1: 44.3%, n = 517) reported the lowest levels of all etiological risk factors. Participants in class 2 (39.5%, n = 461) reported the highest rates of anxiety and depression, both before and after gambling became a problem, as well as childhood maltreatment, and a high level of gambling for stress‐coping. Those in class 3 (16.3%, n = 190) reported high levels of impulsivity; risk‐taking, including sexual risk‐taking; antisocial traits; and coping to provide meaning in life and to alleviate stress. Conclusions: The revised pathways model of problem gambling includes three classes of gamblers similar to the three subtypes in the original pathways model, but class 3 in the revised pathways model is distinct from class 2, showing higher levels of risk‐taking and antisocial traits and gambling motivated by a desire for meaning/purpose and/or to alleviate stress. Class 2 in the revised pathways model demonstrates high levels of childhood maltreatment as well as gambling for stress‐coping. [ABSTRACT FROM AUTHOR]

The article discusses a paper by K. M. Keyes and M. E. Patrick on legal changes in the use of pyschedelics. Topics mentioned include the factors that contributed to the increase in non-lysergic acid diethylamide hallucinogen, the improvement in well-being of patients during the coronavirus pandemic after using hallucinogens based on psychopathology measures, and the need to consider structural factors producing racial and socio-economic disparities in the use of hallucinogens.

The article discusses a paper by C. Miele and colleagues on sexual cravings. Topics mentioned include the similarities between sexual craving and substance craving, the definition of the term egodystonic, the difference between egodystonic and egosyntonic sexual cravings, the impact of self concept of every individual on sexual desires, and the use of psychophysiological measures and functional magnetic resonance imaging to understand the nature of behavior cravings.

The article discusses comments on a paper by S. Allaf and colleagues about the comparison of legal cannabis markets from various countries. Topics mentioned include the impact of the increase in acute cannabis poisoning in pediatric patients on the decision to legalize and decriminalize cannabis products, the ban of cannabis products with high content of tetrahydrocannabinol, and the advantages of regulations to minimize harm caused by cannabis products.

Background and Aims: There is a growing literature using event‐level methods to estimate associations between contextual characteristics of drinking occasions, consumption levels and acute harms. This literature spans many research traditions and has not been brought together as a whole. This mapping review aimed to identify and describe the theoretical approaches to conceptualizing drinking occasions, study designs, predictors and outcome measures used in existing research with a view to identifying dominant approaches, research gaps and areas for further synthesis. Methods: Eligible papers studied adults' drinking occasions using quantitative event‐level methods and considered one or more contextual characteristics (e.g. venue, timing or company) and at least one event‐level consumption or acute alcohol‐related harm outcome. We systematically searched Ovid MEDLINE, PsycInfo and the Web of Science Social Sciences Citation Index, extracting data on studies' theoretical approach, data collection methods, settings, populations, drinking occasion characteristics and outcome measures. Results: Searches identified 278 eligible papers (from 1975 to 2019), predominantly published after 2010 (n = 181; 65.1%). Most papers reported research conducted in the United States (n = 170; 61.2%) and half used student participants (n = 133; 47.8%). Papers typically lacked a stated theoretical approach (n = 203; 73.0%). Consistent with this, only 53 (19.1%) papers studied three or more occasion characteristics and most used methods that assume occasion characteristics do not change during an occasion (n = 189; 68.0%). The most common outcome type considered was consumption (n = 224; 80.6%) and only a few papers studied specific acute harm outcomes such as unprotected sex (n = 24; 8.6%), drink driving (n = 14; 5.0%) or sexual violence (n = 9; 3.2%). Conclusions: Studies from 1975 to 2019 using event‐level methods to estimate associations between contextual characteristics of drinking occasions, consumption levels and acute harms were largely focused on students and consumption outcomes, and most have considered a limited range of contextual characteristics. [ABSTRACT FROM AUTHOR]

Background and aim: To understand the use of psychoactive substances, one must consider the context and the social circumstances in which the substance use occurs. This paper discusses alcohol use from a socio‐cultural perspective, based on the use of alcoholic beverages among the Portuguese servicemen who fought in the Portuguese Colonial War (1961–74). Method: In‐depth interviews were carried out with 17 former Portuguese soldiers. Simultaneously, extensive bibliographic and documentary research was carried out based on a broad set of biographical and autobiographical texts by former military personnel. Finally, an on‐line survey (n = 210) was conducted among ex‐combatants of the Portuguese Colonial War. Results: Alcohol drinking among Portuguese servicemen was high during the Portuguese Colonial War. Socio‐cultural factors (such as regarding alcohol consumption as therapeutic and affirming masculinity) explain why alcohol drinking was so intense and frequent, and why repeated drunken behaviour was tolerated and undervalued by the military authorities, who considered it normal and not a health problem or disorder. Conclusion: The use of alcohol in the Portuguese Colonial War is an empirical example of how what is considered 'acceptable', 'normal' or 'pathological' may depend more on socio‐cultural norms than on objective and measurable criteria, including clinical criteria. [ABSTRACT FROM AUTHOR]

Background and Aims: A range of experimental paradigms claim to measure the cognitive processes underpinning alcohol use, suggesting that heightened attentional bias, greater approach tendencies and reduced cue‐specific inhibitory control are important drivers of consumption. This paper identifies methodological shortcomings within this broad domain of research and exemplifies them in studies focused specifically on alcohol‐related attentional bias. Argument and analysis: We highlight five main methodological issues: (i) the use of inappropriately matched control stimuli; (ii) opacity of stimulus selection and validation procedures; (iii) a credence in noisy measures; (iv) a reliance on unreliable tasks; and (v) variability in design and analysis. This is evidenced through a review of alcohol‐related attentional bias (64 empirical articles, 68 tasks), which reveals the following: only 53% of tasks use appropriately matched control stimuli; as few as 38% report their stimulus selection and 19% their validation procedures; less than 28% used indices capable of disambiguating attentional processes; 22% assess reliability; and under 2% of studies were pre‐registered. Conclusions: Well‐matched and validated experimental stimuli, the development of reliable cognitive tasks and explicit assessment of their psychometric properties, and careful consideration of behavioural indices and their analysis will improve the methodological rigour of cognitive alcohol research. Open science principles can facilitate replication and reproducibility in alcohol research. [ABSTRACT FROM AUTHOR]

Background and aim: New Zealand has recently legalized medicinal cannabis and has explored the possibility of legalizing large‐scale recreational cannabis supply. In the process, concerns have emerged regarding whether corporations involved in the large‐scale production and sale of legalized cannabis will invest in tactics of influence with policymakers and the public. This paper aimed to examine the various ways a legalized cannabis industry could seek to influence governments and the public in the New Zealand reform context. Method: Based on the study of industry tactics with alcohol, tobacco and gambling, we applied a three‐chain model of industry influence that breaks tactics into the 'public good', 'knowledge' and 'political' chains. Results: Exploratory analysis of the nascent cannabis industry's activity in New Zealand provided signs of industry influence strategies related to all three chains. The medicinal cannabis industry has associated the establishment of a legal cannabis sector with regional economic development and employment, supported lobbying for recreational law reform, funded NGOs involved in lobbying for law reform, established research partnerships with universities, invited ex‐politicians on advisory boards, and participated in government public sector partnerships. Conclusion: There is emerging evidence that the legal cannabis industry is using strategies to influence the regulatory environment in New Zealand. [ABSTRACT FROM AUTHOR]

Background and Aims: This study explores the role of the public health advocacy coalition in alcohol policy development in Ireland. Compared with industry actors, much less is known about the membership, activities and influence of public health advocates in alcohol policymaking. To address this gap, this paper identifies several advocacy strategies, drawn from the advocacy coalition framework and other policy theories, and then analyses them in the context of recent Irish developments. Methods: The study used theory‐building process‐tracing to construct a record of the public health advocacy coalition and its campaign to promote the Public Health (Alcohol) Act 2018 in Ireland. Specifically, we drew upon 131 primary documents produced by advocates, 464 newspaper articles and 18 semi‐structured interviews with key advocates, public health experts and elected officials to undertake a thematic analysis. Results: Public health advocates in Ireland have developed sophisticated political strategies to foster major alcohol policy change. First, public health advocates led the formation of a broad‐based advocacy coalition that helped members to effectively pool their limited resources as well as coordinate their strategy and messaging. Secondly, issue‐framing and message discipline played a key role in the coalition's success. Advocates strategically focused upon the policy problem, specifically health harms, rather than the detailed content of the proposed measures. Finally, there is evidence of political learning, where advocates' prior experiences and knowledge of the political system in Ireland spurred innovations in campaigning. These strategies were interdependent and mutually reinforcing, and succeeded in building support for public health advocates' preferred policies among politicians and the general public. Discussion/conclusion: There are distinct capabilities that public health actors can mobilize in the policy process to win alcohol policy debates and capitalize on the constraints on industry influence on alcohol policymaking. [ABSTRACT FROM AUTHOR]

Background and aims: Reports of youth e‐cigarette use often do not disaggregate by underlying smoking status. This study compared annual 2014–19 youth estimates of past 30‐day e‐cigarette use prevalence and frequency by smoking status in the United States. Design Nationally representative, cross‐sectional, school‐based survey [National Youth Tobacco Surveys (NYTS)]. General linear models accounting for complex survey design compared e‐cigarette use prevalence by smoking status by year, overall and stratified by frequency, separately for high school (HS) and middle school (MS) students. The 2019 survey was analyzed separately because of its change in survey methodology. Setting: MSs and HSs in the United States. Participants: A total of 116 704 students from 1268 schools, ages 9–19. Measurements Students self‐reported (paper 2014–18, electronic 2019) ever and past 30‐day (current) use of e‐cigarettes and cigarettes, as well as frequent use (20–30 days of month). Findings From 2014 to 2018, current e‐cigarette use prevalence increased among never, current and former smokers in HS, but only among never and current smokers in MS (each P‐value < 0.001). E‐cigarette use increases for current HS smokers were primarily among frequent e‐cigarette users. In 2018, the absolute number of HS frequent users who were never or former smokers (420 000 combined) surpassed current smokers (370 000). In 2019, current e‐cigarette use prevalence for never, former and current smokers was 17.5% [95% confidence interval (CI) = 16.0–19.0], 53.6% (95% CI = 45.2–61.9) and 85.8% (95% CI = 81.6–89.9) for HS students, respectively, and 6.8% (95% CI = 5.9–7.7), 40.8% (95% CI = 34.7–47.0) and 78.0% (95% CI = 71.9–84.2) for MS students. That year, the number of HS never (420 000) and former smokers (570 000) using e‐cigarettes frequently eclipsed that of current smokers (390 000). Conclusions: E‐cigarette use prevalence and frequency among youth vary by smoking status, with highest levels of use among current smokers. However frequent e‐cigarette use among never smokers and former smokers has increased. [ABSTRACT FROM AUTHOR]

Aims: The United Kingdom and Australia have developed highly divergent policy responses to electronic nicotine delivery systems (ENDS). To understand the historical origins of these differences, we describe the history of tobacco control in each country and the key roles played in setting ENDS policy in its early stages by public health regulations and policy networks, anti‐smoking organizations, 'vaper' activist networks and advocates of harm reduction policies towards injecting drug use. Methods: We analysed key government reports, policy statements from public health bodies and non‐government organizations (e.g. cancer councils and medical organizations) on ENDS; submissions to an Australian parliamentary inquiry; media coverage of policy debates in medical journals; and the history of tobacco control policy in Australia and England. Key discourses about ENDS were identified for each country. These were compared across countries during a multi‐day face‐to‐face meeting, where consensus was reached on the key commonalities and divergences in historical approaches to nicotine policy. This paper focuses on England, as different policy responses were apparent in constituent countries of the United Kingdom, and Scotland in particular. Results: Policymakers in Australia and England differ markedly in the priority that they have given to using ENDS to promote smoking cessation or restricting smokers' access to prevent uptake among young people. In understanding the origins of these divergent responses, we identified the following key differences between the two countries' approaches to nicotine regulation: an influential scientific network that favoured nicotine harm reduction in the United Kingdom and the absence of such a network in Australia; the success of different types of health activism both in England and in Europe in opposing more restrictive policies; and the greater influence on policy in England of the field of illicit drug harm reduction. Conclusions: An understanding of the different policy responses to electronic nicotine delivery systems (ENDS) in England and Australia requires an appreciation of how actors within the different policy structures, scientific networks and activist organizations in each country and region have interpreted the evidence and the priority that policymakers have given to the competing goals of preventing adolescent uptake and encouraging smokers to use ENDS to quit smoking. [ABSTRACT FROM AUTHOR]

Background and aims: Solitary drinking in adolescents and young adults is associated with greater risk for alcohol problems, but it is unclear whether this association exists in older demographics. The current paper is the first meta‐analysis and systematic review, to our knowledge, to determine whether adult solitary drinking is associated with greater risk for alcohol problems. Methods: PsychINFO, PubMed and Google Scholar were searched following a pre‐registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42019147075) and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) methodology. Following the methodology used in our recent systematic review and meta‐analysis on adolescent/young adult solitary drinking, we systematically reviewed solitary drinking measures/definitions, prevalence rates and associated demographic variables in adults. We then meta‐analyzed (using random‐effects models) associations between adult solitary drinking and alcohol use/problems, negative affect and negative/positive reinforcement‐related variables (e.g. drinking to cope or for enhancement). Results: Solitary drinking was defined as drinking while physically alone in nearly all studies, but measures varied. Prevalence rates were generally in the 30–40% range, with some exceptions. In general, males were more likely than females to report drinking alone, and married individuals were less likely than unmarried individuals to report drinking alone; racial/ethnic differences were mixed. Meta‐analytical results showed significant effects for the associations between solitary drinking and the following factors: alcohol consumption, r = 0.25, 95% confidence interval (CI) = 0.18, 0.33, k = 15, I2 = 97.41; drinking problems, r = 0.15, 95% CI = 0.10, 0.21, k = 14, I2 = 92.70; and negative reinforcement, r = 0.24, 95% CI = 0.14, 0.32, k = 11, I2 = 89.77; but not positive reinforcement, r = 0.02, 95% CI = 0.06, 0.09, k = 8, I2 = 76.18; or negative affect, r = 0.03, 95% CI = −0.02, 0.08, k = 8, I2 = 52.06. Study quality moderated the association between solitary drinking and negative affect (β = −0.07, P < 0.01) such that lower‐quality studies were significantly associated with larger effect sizes. Study quality was generally low; the majority of studies were cross‐sectional. Conclusions: Solitary drinking appears to have a small positive association with alcohol problems. [ABSTRACT FROM AUTHOR]

Background and aims: Several reports have documented risk factors for opioid use following treatment discharge, yet few have assessed sex differences, and no study has assessed risk using contemporary machine learning approaches. The goal of the present paper was to inform treatments for opioid use disorder (OUD) by exploring individual factors for each sex that are most strongly associated with opioid use following treatment. Design Secondary analysis of Global Appraisal of Individual Needs (GAIN) database with follow‐ups at 3, 6 and 12 months post‐OUD treatment discharge, exploring demographic, psychological and behavioral variables that predict post‐treatment opioid use. Setting One hundred and thity‐seven treatment sites across the United States. Participants: Adolescents (26.9%), young adults (40.8%) and adults (32.3%) in treatment for OUD. The sample (n = 1,126) was 54.9% male, 66.1% white, 20% Hispanic, 9.8% multi‐race/ethnicity, 2.8% African American and 1.3% other. Measurement Primary outcome was latency to opioid use over 1 year following treatment admission. Results: For women, regularized Cox regression indicated that greater withdrawal symptoms [hazard ratio (HR) = 1.31], younger age (HR = 0.88), prior substance use disorder (SUD) treatment (HR = 1.11) and treatment resistance (HR = 1.11) presented the largest hazard for post‐treatment opioid use, while a random survival forest identified and ranked substance use problems [variable importance (VI) = 0.007], criminal justice involvement (VI = 0.006), younger age (VI = 0.005) and greater withdrawal symptoms (VI = 0.004) as the greatest risk factors. For men, Cox regression indicated greater conduct disorder symptoms (HR = 1.34), younger age (HR = 0.76) and multiple SUDs (HR = 1.27) were most strongly associated with post‐treatment opioid use, while a random survival forests ranked younger age (VI = 0.023), greater conduct disorder symptoms (VI = 0.010), having multiple substance use disorders (VI = 0.010) and criminal justice involvement (VI = 0.006) as the greatest risk factors. Conclusion: Risk factors for relapse to opioid use following opioid use disorder treatment appear to be, for women, greater substance use problems and withdrawal symptoms and, for men, younger age and histories of conduct disorder and multiple substance use disorder. [ABSTRACT FROM AUTHOR]

During the past decade, 'alcohol's harm to others' (AHTO) has emerged as an international approach to studying alcohol problems and informing policy. The AHTO approach seeks to increase political will for alcohol policy by mapping, measuring and often costing harms beyond the person who drinks (e.g. family members, co‐workers). In this paper we consider the implications of a 'harm to others' approach for illicit drugs. We ask whether it could and should be used as a policy tool, given the high risks of further stigmatizing people who use drugs. We consider the ways in which the concept and measurement of 'harm to others' may be either productive or potentially harmful, depending on the extent to which the AHTO is replicated for illicit drugs. Shifting the language may assist: the term 'harm from others' appears to carry less risk of stigma. In addition, all harms inclusive of drug supply and drug consumption need to be included if a full picture of harms that accrue to other people from illicit drugs is to be achieved. [ABSTRACT FROM AUTHOR]

Background and aims: Recent reports have highlighted the emergence of 'wasp dope' as an issue of concern, but epidemiological evidence is lacking. Wasp dope is a crystalline substance created by electrifying pyrethroid‐containing insecticides (e.g. wasp sprays) that may give users a methamphetamine‐like 'rush'. This paper describes wasp dope use and correlates of use in a sample of people who use drugs (PWUD) in Appalachian Kentucky, a region that has been an epicenter of opioid use and related harms in the United States. Methods: Respondent‐driven sampling and targeted street outreach were used to recruit PWUD. Eligibility criteria included being aged at least 18 years, residing in one of five Appalachian Kentucky counties, and having either used opioids or injected any drug to get high in the prior 30 days. Interviewer‐administered surveys queried participants' (n = 278) recent (past 6 months) wasp dope use, other substance use and demographic characteristics. Prevalence ratios (PR) were estimated using generalized estimating equations assuming a Poisson outcome distribution in a cross‐sectional analysis. Results: Recent wasp dope use was reported by 16.1% of participants. Men and people who recently experienced homelessness and transportation difficulties were twice or more as likely to have used wasp dope compared with their counterparts [PR = 2.08, 95% confidence interval (CI) = 1.11, 3.87, PR = 2.78, 95% CI = 1.64, 4.72 and PR = 2.01, 95% CI = 1.06–3.81, respectively]. While wasp dope use was associated with injection drug use and using opioids and other substances to get high in unadjusted analyses, the factor most strongly associated with wasp dope use was methamphetamine use (PR = 17.23, 95% CI = 2.57, 115.61), specifically methamphetamine injection (PR = 4.47, 95% CI = 1.56, 12.78). Conclusions: Among people who use drugs in rural Kentucky, USA, more than one in six people surveyed reported using wasp dope in the past 6 months, nearing the percentage using cocaine/crack (20%) and fentanyl/carfentanil (25%). Wasp dope use was higher among men and strongly associated with homelessness, transportation access, methamphetamine use and injection drug use. [ABSTRACT FROM AUTHOR]

Background: Nationally representative data of cannabis–tobacco co‐use have shown that these substances are closely entwined and have significant adverse health consequences, although population‐level harms of co‐use are largely unknown. Current epidemiological research does not assess co‐use in a manner that has yielded the necessary data to draw conclusions regarding health effects. This has given rise to a hidden population of co‐users who go under‐served. Therefore, this paper has two aims: (1) to review new challenges in the collection of co‐use data due to rapidly changing regulations of cannabis and nicotine products and (2) to provide recommendations for the terminology and assessment of co‐use. Argument We argue that: (1) the prevalence of co‐use is not being assessed accurately at a population level and (2) changes in legalization have created novel challenges, but without proper monitoring the impact on co‐use will go undetected. We propose a three‐level tiered set of recommendations for co‐use assessments, which includes assessments of cannabis, tobacco and co‐use metrics ranging from least burdensome (self‐report of co‐administered products) to most burdensome (assays, event‐level data). Conclusions: We propose that clinical studies begin to incorporate cannabis–tobacco co‐use assessments to justify better their inclusion in clinical trials and national surveillance surveys. Integration of co‐use assessments will aid in understanding the true impact on co‐use of the changing cannabis and tobacco/nicotine regulatory environments. Co‐use is prevalent and problematic, and the ability to make conclusions about its health outcomes is hindered by lack of nuance in data collection. If you do not measure it, you cannot manage it. [ABSTRACT FROM AUTHOR]