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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]

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 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]

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]

Aims: To estimate pooled all‐cause and cause‐specific mortality risk for people with regular or problematic cocaine use. Methods: Systematic review and meta‐analysis of prospective or retrospective cohort studies or clinical trials (n ≥30) of people with regular or problematic cocaine use with data on all‐cause or cause‐specific mortality. Of 2808 papers, 28 were eligible and reported on 21 cohorts, with a total 170 019 individuals. Cohorts identified based on acute care for drug poisoning or other severe health presentation were excluded. Title/abstract screening was conducted by one reviewer; a second reviewer independently checked 10% of excluded studies. Two reviewers conducted full‐text screening. Data were extracted by one reviewer and checked by a second. A customized review‐specific study reporting quality/risk of bias tool was used. Data on crude mortality rates (CMR) and standardized mortality ratios were extracted for both all‐cause and cause‐specific mortality. Standardized mortality ratios were imputed where not provided by the author using extracted data and information from the Global Burden of Disease Study 2017. Data were pooled using a random‐effects model. Results: The pooled all‐cause crude mortality rate was 1.24 per 100 person‐years [95% confidence interval (CI) = 0.86, 1.78; n = 16 cohorts], but with considerable heterogeneity (I2 = 98.8%). The pooled all‐cause standardized mortality ratio (SMR) was 6.13 (95% CI = 4.15, 9.05; n = 16 cohorts). Suicide (SMR = 6.26, 95% CI = 2.84, 13.80), accidental injury (SMR = 6.36, 95% CI = 4.18, 9.68), homicide (SMR = 9.38, 95% CI 3.45–25.48) and AIDS‐related mortality (SMR = 23.12, 95% CI = 11.30, 47.31) were all elevated compared with age and sex peers in the general population. Conclusions: There are elevated rates of mortality among people with regular or problematic cocaine use for traumatic deaths and deaths attributable to infectious disease. [ABSTRACT FROM AUTHOR]

Background and Aims: Organizational change interventions involve systems and cultural change within health‐care services to make smoking cessation care delivery part of usual treatment. Six strategies for organizational change have been proposed. This study examined the evidence for organizational change interventions in the alcohol and other drug (AOD) setting on: (a) smoking cessation care; and (b) smoking cessation and cessation‐related outcomes. Methods: A systematic review with narrative synthesis was conducted. MEDLINE, PsycINFO, CINAHL, EMBASE and Scopus were searched using keywords and MeSH terms from database inception to 1 June 2018. Interventions were assessed against the six organizational change strategies. Results: Of the 5155 papers identified, 14 publications from seven unique studies were included. Most studies employed four or fewer organizational change strategies. The majority (n = 11) were rated weak to moderate in methodological quality. Nine published papers, four unique studies, examined staff reported provision of smoking cessation care; eight reported an increase, one found no change. Three papers, two unique studies, examined client receipt of care; all found significant increases. Three papers, two unique studies, assessed staff smoking prevalence from pre‐ to post‐intervention. Only one study reported a significant reduction in staff smoking prevalence (35.2 versus 21.8%, P = 0.005). Nine papers, six unique studies, assessed client smoking cessation and smoking‐related outcomes. Seven papers reported on client smoking prevalence; two found a significant decrease and five found no change to smoking. Four papers reported on number of cigarettes per day, three found a significant decrease and one found no change. Two papers reported on smoking cessation finding a 10% and a 25% seven‐day point prevalence abstinence post‐discharge from the AOD service. Conclusions: Organizational change interventions within health‐care services to make smoking cessation care delivery part of usual treatment offer promise for increasing smoking cessation care and reducing smoking prevalence. [ABSTRACT FROM AUTHOR]

Abstract: Background and aims: Resilience and recovery are of increasing importance in the field of alcohol dependence (AD). This paper describes how imaging studies in man can be used to assess the neurobiological correlates of resilience and, if longitudinal, of disease trajectories, progression rates and markers for recovery to inform treatment and prevention options. Methods: Original papers on recovery and resilience in alcohol addiction and its neurobiological correlates were identified from PubMed and have been analyzed and condensed within a systematic literature review. Results: Findings deriving from functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) studies have identified links between increased resilience and less task‐elicited neural activation within the basal ganglia, and benefits of heightened neural pre‐frontal cortex (PFC) engagement regarding resilience in a broader sense; namely, resilience against relapse in early abstinence of AD. Furthermore, findings consistently propose at least partial recovery of brain glucose metabolism and executive and general cognitive functioning, as well as structural plasticity effects throughout the brain of alcohol‐dependent patients during the course of short‐, medium‐ and long‐term abstinence, even when patients only lowered their alcohol consumption to a moderate level. Additionally, specific factors were found that appear to influence these observed brain recovery processes in AD, e.g. genotype‐dependent neuronal (re)growth, gender‐specific neural recovery effects, critical interfering effects of psychiatric comorbidities, additional smoking or marijuana influences or adolescent alcohol abuse. Conclusions: Neuroimaging research has uncovered neurobiological markers that appear to be linked to resilience and improved recovery capacities that are furthermore influenced by various factors such as gender or genetics. Consequently, future system‐oriented approaches may help to establish a broad neuroscience‐based research framework for alcohol dependence. [ABSTRACT FROM AUTHOR]

Background and aims: Emerging evidence suggests that solitary drinking may be an important early risk marker for alcohol use disorder. The current paper is the first meta‐analysis and systematic review on adolescent and young adult solitary drinking to examine associations between solitary drinking and increased alcohol consumption, alcohol problems, and drinking to cope motives. Methods: PsychINFO, PubMed, and Google Scholar were searched using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) methodology and a pre‐registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (no. CRD42020143449). Data from self‐report questionnaires regarding negative correlates of solitary drinking (e.g. alcohol problems) and solitary drinking motives (e.g. drinking to cope) were pooled across studies using random‐effects models. Studies included adolescents (aged 12–18 years) and young adults (mean age between 18 and 30 years or samples with the majority of participants aged 30 years or younger). Results: Meta‐analytical results from 21 unique samples including 28,372 participants showed significant effects for the associations between solitary drinking and the following factors: increased alcohol consumption, r = 0.23, 95% confidence interval (CI) = 0.12, 0.33; drinking problems, r = 0.23, 95% CI = 0.13, 0.32; negative affect, r = 0.21, 95% CI = 0.16, 0.26; social discomfort, r = 0.17, 95% CI = 0.06, 0.27; negative reinforcement, r = 0.28, 95% CI = 0.24, 0.31; and positive reinforcement, r = 0.10, 95% CI = 0.03, 0.17. These associations were not moderated by age group (i.e. adolescent versus young adult), study quality, or differing solitary drinking definitions. Accounting for publication bias increased the effect sizes from r = 0.23 to 0.34 for alcohol consumption and from r = 0.23 to 0.30 for drinking problems, and lowered it from r = 0.10 to 0.06 and r = 0.17 to 0.11 for positive reinforcement and social discomfort, respectively. Conclusions: Solitary drinking among adolescents and young adults appears to be associated with psychosocial/alcohol problems and drinking to cope motives. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the study "Specialty Substance Use Disorder Services Following Brief Alcohol Intervention: A Meta-Analysis of Randomized Controlled Trials" by J.E. Glass, A.M. Hamilton, B.J. Powell, B.E. Perron, R.T. Brown, and M.A. Ilgen in volume 110 of the periodical.

Background and aims: Fetal alcohol spectrum disorder (FASD) is a preventable condition that imposes a significant financial burden on societies. Funding of FASD prevention is a small portion of the total expenditures associated with FASD. This paper aimed to review the literature on the costs of and savings from prevention of FASD and present a model for the United States and Canada of projected savings based on expansion of existing evidence‐based prevention models. Methods: A systematic review of published literature on the cost of FASD prevention was conducted and experts in the field were interviewed. Studies that reported the cost of primary prevention of FASD were eligible for further consideration. Results: Applying evidenced‐based prevention programs to women at highest risk to have a future child with FASD greatly reduces the cost of prevention. In the United States, one case of FASD can be prevented for as little as USD $20 200 – 47 615. Cost of prevention is considerably less expensive than cost of care for a case of FASD. Conclusion: Expansion of risk‐based prevention strategies for fetal alcohol spectrum disorder in the United States and Canada would be an economically efficient and worthwhile investment for society. [ABSTRACT FROM AUTHOR]

Background and aims: Randomized controlled trials (RCTs) are important for evaluating interventions, and qualitative research is increasingly recognized as being crucial to the success of this enterprise. We aimed to describe and demonstrate a temporal parallel purpose framework to help researchers understand how to make optimum use of qualitative research before, during and after RCTs. This framework sets out specific rationales for conducting qualitative research at each stage of a trial, where the rationales presented relate to both the intervention and evaluation methodology. Method and results: We conducted a scoping review of published qualitative studies undertaken alongside RCTs focusing on illicit drug use. We then used the temporal parallel purpose framework to present key findings to demonstrate how qualitative studies can add value to addiction RCTs by enhancing understanding of the intervention being trialled and/or the RCT itself. In so doing, we highlight the missed opportunities for addiction science when qualitative research is overlooked. We also explain why barriers to combining qualitative research and RCTs are neither inevitable nor insurmountable. Conclusions: The temporal parallel purpose framework provides a tool for assessing when and why to combine qualitative research with addiction treatment and prevention RCTs. Our paper and framework can help researchers formulate key questions that qualitative research can address. This can potentially save resources by reducing the number of poorly designed interventions and trials and prevent morbidity, mortality, and other addiction‐related harms by facilitating the identification and implementation of interventions that are most likely to be effective. [ABSTRACT FROM AUTHOR]

Background and aims: Amphetamines are the second most commonly used class of illicit drugs. We aimed to produce pooled estimates of mortality risks among people with regular or dependent use of amphetamines, with a focus upon all‐cause mortality as well as specific causes of death. Design Systematic review and meta‐analysis of cohorts of people with problematic use or dependence on amphetamines with data on all‐cause or cause‐specific mortality. Setting and participants: Of 4240 papers, 30 were eligible, reporting on 25 cohorts that measured all‐cause mortality, drug poisoning, suicide, accidental injuries, homicide and cardiovascular mortality. Cohorts (n = 35–74 139) were in North America, several Nordic countries and Asia Pacific. Measurement Titles/abstracts were independently screened by one reviewer and excluded those reviewed by a second reviewer. Full‐text screening was by two reviewers with discrepancies resolved via a third reviewer. We extracted data on crude mortality rates (CMR) per 100 person‐years (py), standardized mortality ratios (SMRs). We imputed SMRs where possible if not reported by study authors. We also calculated mortality relative risks. Data were pooled using random‐effects models; potential reasons for heterogeneity were explored using subgroup analyses and meta‐regressions. Findings Twenty‐three cohorts contributed data for the pooled all‐cause CMR: 1.14 per 100 py [95% confidence interval (CI) = 0.92–1.42]. Pooled cause‐specific mortality rates were: drug poisoning, 0.14 per 100 py (95% CI = 0.06–0.34); cardiovascular disease, 0.13 per 100 py (95% CI = 0.06–0.29); suicide, 0.20 per 100 py (95% CI = 0.07–0.55); accidental injury, 0.20 per 100 py (95% CI = 0.08–0.47) and homicide, 0.03 per 100 py (95% CI = 0.02–0.06). There was substantial heterogeneity for all pooled CMR estimates except homicide. The pooled all‐cause SMR was 6.83 (95% CI = 5.27–8.84). Pooled cause‐specific SMRS were: poisoning, 24.70 (95% CI = 16.67, 36.58); homicide, 11.90 (95% CI = 7.82–18.12); suicide, 12.20 (95% CI = 4.89–30.47); cardiovascular disease, 5.12 (95% CI = 3.74–7.00) and accidental injury, 5.12 (95% CI = 2.88–9.08). Conclusions: People with regular or dependent amphetamine use are at elevated risk of a range of causes of mortality compared with people without regular or dependent amphetamine use. [ABSTRACT FROM AUTHOR]

Background and Aims Despite decades of research on co-occurring smoking and depression, cessation rates remain consistently lower for depressed smokers than for smokers in the general population, highlighting the need for theory-driven models of smoking and depression. This paper provides a systematic review with a particular focus upon psychological states that disproportionately motivate smoking in depression, and frame an incentive learning theory account of smoking-depression co-occurrence. Methods We searched PubMed, Scopus, PsychINFO and CINAHL to December 2014, which yielded 852 papers. Using pre-established eligibility criteria, we identified papers focused on clinical issues and motivational mechanisms underlying smoking in established, adult smokers (i.e. maintenance, quit attempts and cessation/relapse) with elevated symptoms of depression. Two reviewers determined independently whether papers met review criteria. We included 297 papers in qualitative synthesis. Results Our review identified three primary mechanisms that underlie persistent smoking among depressed smokers: low positive affect, high negative affect and cognitive impairment. We propose a novel application of incentive learning theory which posits that depressed smokers experience greater increases in the expected value of smoking in the face of these three motivational states, which promotes goal-directed choice of smoking behavior over alternative actions. Conclusions The incentive learning theory accounts for current evidence on how depression primes smoking behavior and provides a unique framework for conceptualizing psychological mechanisms of smoking maintenance among depressed smokers. Treatment should focus upon correcting adverse internal states and beliefs about the high value of smoking in those states to improve cessation outcomes for depressed smokers. [ABSTRACT FROM AUTHOR]

Background and Aims With governments relying increasingly upon the alcohol industry's self-regulated marketing codes to restrict alcohol marketing activity, there is a need to summarize the findings of research relevant to alcohol marketing controls. This paper provides a systematic review of studies investigating the content of, and exposure to, alcohol marketing in relation to self-regulated guidelines. Methods Peer-reviewed papers were identified through four literature search engines: SCOPUS, Web of Science, PubMed and PsychINFO. Non-peer-reviewed reports produced by public health agencies, alcohol research centers, non-governmental organizations and government research centers were also identified. Ninety-six publications met the inclusion criteria. Results Of the 19 studies evaluating a specific marketing code and 25 content analysis studies reviewed, all detected content that could be considered potentially harmful to children and adolescents, including themes that appeal strongly to young men. Of the 57 studies of alcohol advertising exposure, high levels of youth exposure and high awareness of alcohol advertising were found for television, radio, print, digital and outdoor advertisements. Youth exposure to alcohol advertising has increased over time, even as greater compliance with exposure thresholds has been documented. Conclusions Violations of the content guidelines within self-regulated alcohol marketing codes are highly prevalent in certain media. Exposure to alcohol marketing, particularly among youth, is also prevalent. Taken together, the findings suggest that the current self-regulatory systems that govern alcohol marketing practices are not meeting their intended goal of protecting vulnerable populations. [ABSTRACT FROM AUTHOR]

Background and Aims Youth alcohol consumption is a major global public health concern. Previous reviews have concluded that exposure to alcohol marketing was associated with earlier drinking initiation and higher alcohol consumption among youth. This review examined longitudinal studies published since those earlier reviews. Methods Peer-reviewed papers were identified in medical, scientific and social science databases, supplemented by examination of reference lists. Non-peer-reviewed papers were included if they were published by organizations deemed to be authoritative, were fully referenced and contained primary data not available elsewhere. Papers were restricted to those that included measures of marketing exposure and alcohol consumption for at least 500 underage people. Multiple authors reviewed studies for inclusion and assessed their quality using the National Heart, Lung and Blood Institute's Quality Assessment Tool for Observation Cohort and Cross-Sectional Studies. Results Twelve studies (ranging in duration from 9 months to 8 years), following nine unique cohorts not reported on previously involving 35 219 participants from Europe, Asia and North America, met inclusion criteria. All 12 found evidence of a positive association between level of marketing exposure and level of youth alcohol consumption. Some found significant associations between youth exposure to alcohol marketing and initiation of alcohol use (odds ratios ranging from 1.00 to 1.69), and there were clear associations between exposure and subsequent binge or hazardous drinking (odds ratios ranging from 1.38 to 2.15). Mediators included marketing receptivity, brand recognition and alcohol expectancies. Levels of marketing exposure among younger adolescents were similar to those found among older adolescents and young adults. Conclusions Young people who have greater exposure to alcohol marketing appear to be more likely subsequently to initiate alcohol use and engage in binge and hazardous drinking. [ABSTRACT FROM AUTHOR]

Background and aims The rising use of digital media in the last decade, including social networking media and downloadable applications, has created new opportunities for marketing a wide range of goods and services, including alcohol products. This paper aims to review the evidence in order to answer a series of policy-relevant questions: does alcohol marketing through digital media influence drinking behaviour or increases consumption; what methods of promotional marketing are used, and to what extent; and what is the evidence of marketing code violations and especially of marketing to children? Method and findings A search of scientific, medical and social journals and authoritative grey literature identified 47 relevant papers (including 14 grey literature documents). The evidence indicated (i) that exposure to marketing through digital media was associated with higher levels of drinking behaviour; (ii) that the marketing activities make use of materials and approaches that are attractive to young people and encourage interactive engagement with branded messaging; and (iii) there is evidence that current alcohol marketing codes are being undermined by alcohol producers using digital media. Conclusions There is evidence to support public health interventions to restrict the commercial promotion of alcohol in digital media, especially measures to protect children and youth. [ABSTRACT FROM AUTHOR]

Background and Aims Since its market release, gabapentin has been presumed to have no abuse potential and subsequently has been prescribed widely off-label, despite increasing reports of gabapentin misuse. This review estimates and describes the prevalence and effects of, motivations behind and risk factors for gabapentin misuse, abuse and diversion. Methods Databases were searched for peer-reviewed papers demonstrating gabapentin misuse, characterized by taking a larger dosage than prescribed or taking gabapentin without a prescription, and diversion. All types of studies were considered; grey literature was excluded. Thirty-three papers met inclusion criteria, consisting of 23 case studies and 11 epidemiological reports. Published reports came from the United States, the United Kingdom, Germany, Finland, India, South Africa and France, and two analyzed websites not specific to a particular country. Results Prevalence of gabapentin misuse in the general population was reported to be 1%, 40-65% among individuals with prescriptions and between 15 and 22% within populations of people who abuse opioids. An array of subjective experiences reminiscent of opioids, benzodiazepines and psychedelics were reported over a range of doses, including those within clinical recommendations. Gabapentin was misused primarily for recreational purposes, self-medication or intentional self-harm and was misused alone or in combination with other substances, especially opioids, benzodiazepines and/or alcohol. Individuals with histories of drug abuse were most often involved in its misuse. Conclusions Epidemiological and case report evidence suggests that the anti-epileptic and analgesic medication gabapentin is being misused internationally, with substance abuse populations at special risk for misuse/abuse. [ABSTRACT FROM AUTHOR]

Abstract: Background and Aims: Chronic skin and soft tissue infections (SSTI) among people who inject drugs (PWID) can lead to AA amyloidosis: a serious, yet neglected, multi‐organ disease. We aim to synthesize findings on the epidemiology, risk factors, clinical outcomes, screening recommendations and challenges to treatment for AA amyloidosis among PWID. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). We searched the following bibliographic databases in July 2017: CINAHL Plus, Embase, Global Health, MEDLINE, PsycEXTRA, PsycINFO and SCOPUS. Studies were included if they investigated AA amyloidosis in PWID. Studies were not restricted to location, study type, year or language of publication. Study heterogeneity precluded meta‐analysis; we present a narrative review of the literature. Results: Thirty‐seven papers from eight countries met inclusion criteria. A total of 781 PWID are reported on, of whom 177 had AA amyloidosis. Where disease causality is established, it is attributed to chronic inflammation caused by injecting‐related SSTIs. Most (88.7%) PWID with AA amyloidosis had SSTIs. The proportion of PWID with AA amyloidosis at post‐mortem ranged from 1.6% (Germany) to 22.5% (Serbia). Biopsy studies reported from 5.26% (Portugal) to 50% (Germany) of AA amyloidosis in PWID with suspected or known kidney disease. Following diagnosis, the typical trajectory for PWID with AA amyloidosis was rapid deterioration of renal function requiring haemodialysis. Treatment difficulties, end‐stage renal failure and premature death from sepsis were observed. Good outcomes, including reversibility of AA amyloidosis, are attributed to rapid treatment of the underlining inflammation and injecting cessation. Notably, given the population in question, no studies were published in addiction or harm reduction journals; most (92%) appeared in specialist nephrology and medical journals. Conclusion: There is strong evidence of an association between skin and soft tissue infections (SSTIs) and AA amyloidosis. Among people who inject drugs, injecting‐related SSTIs are a significant cause of morbidity and premature mortality and there is evidence of increasing SSTI prevalence. Limitations in the literature make it difficult to estimate AA amyloidosis prevalence among people who inject drugs. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To review systematically the published literature on extended‐release naltrexone (XR‐NTX, Vivitrol®), marketed as a once‐per‐month injection product to treat opioid use disorder. We addressed the following questions: (1) how successful is induction on XR‐NTX; (2) what are adherence rates to XR‐NTX; and (3) does XR‐NTX decrease opioid use? Factors associated with these outcomes as well as overdose rates were examined. Methods: We searched PubMed and used Google Scholar for forward citation searches of peer‐reviewed papers from January 2006 to June 2017. Studies that included individuals seeking treatment for opioid use disorder who were offered XR‐NTX were included. Results: We identified and included 34 studies. Pooled estimates showed that XR‐NTX induction success was lower in studies that included individuals that required opioid detoxification [62.6%, 95% confidence interval (CI) = 54.5–70.0%] compared with studies that included individuals already detoxified from opioids (85.0%, 95% CI = 78.0–90.1%); 44.2% (95% CI = 33.1–55.9%) of individuals took all scheduled injections of XR‐NTX, which were usually six or fewer. Adherence was higher in prospective investigational studies (i.e. studies conducted in a research context according to a study protocol) compared to retrospective studies of medical records taken from routine care (6‐month rates: 46.7%, 95% CI = 34.5–59.2% versus 10.5%, 95% CI = 4.6–22.4%, respectively). Compared with referral to treatment, XR‐NTX reduced opioid use in adults under criminal justice supervision and when administered to inmates before release. XR‐NTX reduced opioid use compared with placebo in Russian adults, but this effect was confounded by differential retention between study groups. XR‐NTX showed similar efficacy to buprenorphine when randomization occurred after detoxification, but was inferior to buprenorphine when randomization occurred prior to detoxification. Conclusions: Many individuals intending to start extended‐release naltrexone (XR‐NTX) do not and most who do start XR‐NTX discontinue treatment prematurely, two factors that limit its clinical utility significantly. XR‐NTX appears to decrease opioid use but there are few experimental demonstrations of this effect. [ABSTRACT FROM AUTHOR]

Aim To systematically review, using a qualitative, narrative synthesis approach, papers examining alcohol industry efforts to influence alcohol marketing policy, and compare with those used by the tobacco industry. Methods Literature searches were conducted between April and July 2011, and updated in March 2013. Papers were included if they: made reference to alcohol industry efforts to influence (a) policy debates concerning marketing regulations, (b) new specific marketing policies or (c) broad alcohol policy which included marketing regulations; were written in English; and concerned the period 1990-2013. Alcohol industry political activity was categorized into strategies/tactics and frames/arguments. Data extraction was undertaken by the lead author and 100% of the papers were fully second-reviewed. Seventeen papers met the review criteria. Results Five main political strategies and five main frames were identified. The alcohol industry argues against marketing regulation by emphasizing industry responsibility and the effectiveness of self-regulation, questioning the effectiveness of statutory regulation and by focusing on individual responsibility. Arguments relating to industry responsibility are often reinforced through corporate social responsibility activities. The industry primarily conveys its arguments through manipulating the evidence base and by promoting ineffective voluntary codes and non-regulatory initiatives. Conclusions The alcohol industry's political activity is more varied than existing models of corporate political activity suggest. The industry's opposition to marketing regulation centres on claims that the industry is responsible and that self regulation is effective. There are considerable commonalities between tobacco and alcohol industry political activity, with differences due potentially to differences in policy contexts and perceived industry legitimacy. [ABSTRACT FROM AUTHOR]

Background and aims Many women quit smoking during pregnancy, but relapse after the baby is born. To understand why and identify ways of preventing this, this study reviewed the qualitative literature on women's experience of postpartum smoking relapse. Methods A systematic review of qualitative studies and process evaluations of trials. We undertook a thematic synthesis of published qualitative data. Results We screened 1336 papers. Twenty-two papers reporting on 16 studies were included, reporting on the views of 1031 postpartum women. Factors affecting relapse and barriers and facilitators to relapse prevention were identified around the key themes of beliefs, social influences, motivation, physiological factors and identity. Women's beliefs about smoking as a means of coping with stress and the need for social support, especially from a partner, emerged as important. Extrinsic motivation to quit during the pregnancy (for the health of the fetus) appeared to be a factor in prompting relapse after the baby was born. During the immediate postpartum period women believed that physiological changes influence cigarette cravings. The stress of caring for a newborn, sleeplessness and adjusting to a new mothering identity were also reported to be important. Conclusions Among women who quit smoking during pregnancy, those who relapse postpartum talk commonly about no longer needing to protect the baby and the effects of stress. Partner support and a sense of changed identity are cited as factors preventing relapse. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To conduct a systematic review and meta‐analysis of studies in order to estimate the effect of US medical marijuana laws (MMLs) on past‐month marijuana use prevalence among adolescents. Methods: A total of 2999 papers from 17 literature sources were screened systematically. Eleven studies, developed from four ongoing large national surveys, were meta‐analyzed. Estimates of MML effects on any past‐month marijuana use prevalence from included studies were obtained from comparisons of pre–post MML changes in MML states to changes in non‐MML states over comparable time‐periods. These estimates were standardized and entered into a meta‐analysis model with fixed‐effects for each study. Heterogeneity among the study estimates by national data survey was tested with an omnibus F‐test. Estimates of effects on additional marijuana outcomes, of MML provisions (e.g. dispensaries) and among demographic subgroups were abstracted and summarized. Key methodological and modeling characteristics were also described. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. Results: None of the 11 studies found significant estimates of pre–post MML changes compared with contemporaneous changes in non‐MML states for marijuana use prevalence among adolescents. The meta‐analysis yielded a non‐significant pooled estimate (standardized mean difference) of −0.003 (95% confidence interval = −0.012, +0.007). Four studies compared MML with non‐MML states on pre‐MML differences and all found higher rates of past‐month marijuana use in MML states pre‐MML passage. Additional tests of specific MML provisions, of MML effects on additional marijuana outcomes and among subgroups generally yielded non‐significant results, although limited heterogeneity may warrant further study. Conclusions: Synthesis of the current evidence does not support the hypothesis that US medical marijuana laws (MMLs) until 2014 have led to increases in adolescent marijuana use prevalence. Limited heterogeneity exists among estimates of effects of MMLs on other patterns of marijuana use, of effects within particular population subgroups and of effects of specific MML provisions. [ABSTRACT FROM AUTHOR]

Background and aims This narrative review aims to highlight key insights from qualitative research on drug use and drug users by profiling a selection of classic works. Methods Consensus methods were used to identify and select four papers published in 1938, 1969, 1973 and 1984 considered to be classics. Results These landmark qualitative studies included the first account of addiction as a social process, demonstrating that people have meaningful responses to drug use that cannot be reduced to their pharmacological effects; the portrayal of inner-city heroin users as exacting, energetic and engaged social agents; identification of the interactive social learning processes involved in becoming a drug user; the application of the 'career' concept to understanding transitions and trajectories of drug use over time; and the articulation of a framework for understanding drug use that incorporates the interaction between pharmacology, psychology and social environments. Conclusions These classic sociological and anthropological studies deployed qualitative research methods to show how drug use is shaped by complex sets of factors situated within social contexts, viewing drug users as agents engaged actively in social processes and worlds. Their findings have been used to challenge stereotypes about drug use and drug users, develop a deeper understanding of drug use among hidden, hard-to-research and under-studied populations, and provide the foundations for significant developments in scientific knowledge about the nature of drug use. They continue to retain their relevance, providing important correctives to biomedical and behaviourist paradigms, reminding us that drug use is a social process, and demonstrating how the inductive approach of qualitative research can strengthen the way we understand and respond to drug use and related harms. [ABSTRACT FROM AUTHOR]

Background and aims Preventing young people from initiating smoking is a vital public health objective. There is strong evidence that exposure to smoking imagery in movies is associated with an increased risk of smoking uptake. However, the estimate of the magnitude of effect is not clear, as previous reviews have synthesized estimates of cross-sectional and longitudinal associations. Therefore, we have performed a systematic review to quantify cross-sectional and longitudinal associations between exposure to smoking in movies and initiating smoking in adolescents. Methods Four electronic databases (MEDLINE, EMBASE, PsycINFO and International Bibliography of the Social Sciences, IBSS) and grey literature were searched from inception to May 2015 for comparative epidemiological studies (cross-sectional and cohort studies) that reported the relation between exposure to smoking in movies and smoking initiation in adolescence (10-19 years). Reference lists of studies and previous reviews were also screened. Two authors screened papers and extracted data independently. Results Seventeen studies met our inclusion criteria. Random-effects meta-analysis of nine cross-sectional studies demonstrated higher exposure (typically highest versus lowest quantile) to smoking in movies was associated significantly with a doubling in risk of ever trying smoking [relative risk (RR) = 1.93, 95% confidence interval (CI) = 1.66-2.25]. In eight longitudinal studies (all deemed high quality), higher exposure to smoking in movies was associated significantly with a 46% increased risk of initiating smoking (RR = 1.46; 95% CI = 1.23-1.73). These pooled estimates were significantly different from each other ( P = 0.02). Moderate levels of heterogeneity were seen in the meta-analyses. Conclusions The cross-sectional association between young people reporting having seen smoking imagery in films and smoking status is greater than the prospective association. Both associations are substantial, but it is not clear whether or not they are causal. [ABSTRACT FROM AUTHOR]

Background and Aims Consistent review-level evidence supports the effectiveness of population-level alcohol policies in reducing alcohol-related harms. Such policies interact with well-established social, cultural and biological differences in how men and women perceive, relate to and use alcohol, and with wider inequalities, in ways which may give rise to gender differences in policy effectiveness. This paper aimed to examine the extent to which gender-specific data and analyses were considered in, and are available from, systematic reviews of population-level alcohol policy interventions, and where possible, to conduct a narrative synthesis of relevant data. Methods A prior systematic 'review of reviews' of population level alcohol interventions 2002-2012 was updated to May 2014, all gender-relevant data extracted, and the level and quality of gender reporting assessed. A narrative synthesis of extracted findings was conducted. Results Sixty-three systematic reviews, covering ten policy areas, were included. Five reviews (8%) consistently provided information on baseline participation by gender for each individual study in the review and twenty-nine (46%) reported some gender-specific information on the impact of the policies under consideration. Specific findings include evidence of possible gender differences in the impact of and exposure to alcohol marketing, and a failure to consider potential unintended consequences and harm to others in most reviews. Conclusions Gender is poorly reported in systematic reviews of population-level interventions to reduce alcohol-related harm, hindering assessment of the intended and unintended effects of such policies on women and men. [ABSTRACT FROM AUTHOR]

Aims Motivational interviewing (MI) is a commonly used intervention approach to promote reduction or cessation of substance abuse. Effects may be different for adolescents, so it is useful to assess the state of the evidence in this subpopulation. This paper aimed to assess evidence for MI effectiveness in adolescents. Method EBSCOhost, ProQuest and Digital Dissertation Consortium were searched using keywords. Ten randomized trials from the United Kingdom, United States and Taiwan, including 1466 participants, were identified and analysed using a random effects model. Primary outcome measures captured were: the extent of drug use, intention to use drugs and readiness to change. Each study received a high-quality score based on the Miller Quality Scoring Coding System. Moderator analyses were also conducted to examine the impacts of follow-up period, delivery setting and study design on the effectiveness of MI. Results No statistically significant effect of MI on was found change of drug use behaviours [ d = 0.05, 95% confidence interval (CI) = −0.06, 0.17, P = 0.36]. A significant effect was found on attitude change ( d = 0.44, 95% CI = 0.20, 0.67, P = 0.0002). The funnel plot was asymmetrical, suggesting publication bias favouring small studies with higher effect sizes. Conclusion Motivational interviewing has not been found thus far to reduce adolescent use of illicit drugs. It may influence intentions to change, but evidence of publication bias weakens confidence in this conclusion. [ABSTRACT FROM AUTHOR]

Background and Aims Behavioral economists assess alcohol consumption as a function of unit price. This method allows construction of demand curves and demand indices, which are thought to provide precise numerical estimates of risk for alcohol problems. One of the more commonly used behavioral economic measures is the Alcohol Purchase Task (APT). Although the APT has shown promise as a measure of risk for alcohol problems, the construct validity and incremental utility of the APT remain unclear. This paper presents a meta-analysis of the APT literature. Methods Sixteen studies were included in the meta-analysis. Studies were gathered via searches of the PsycInfo, PubMed, Web of Science and EconLit research databases. Random-effects meta-analyses with inverse variance weighting were used to calculate summary effect sizes for each demand index-drinking outcome relationship. Moderation of these effects by drinking status (regular versus heavy drinkers) was examined. Additionally, tests of the incremental utility of the APT indices in predicting drinking problems above and beyond measuring alcohol consumption were performed. Results The APT indices were correlated in the expected directions with drinking outcomes, although many effects were small in size. These effects were typically not moderated by the drinking status of the samples. Additionally, the intensity metric demonstrated incremental utility in predicting alcohol use disorder symptoms beyond measuring drinking. Conclusions The Alcohol Purchase Task appears to have good construct validity, but limited incremental utility in estimating risk for alcohol problems. [ABSTRACT FROM AUTHOR]

Aims This paper provides a concise review of the efficacy, effectiveness and affordability of health-care interventions to promote and assist tobacco cessation, in order to inform national guideline development and assist countries in planning their provision of tobacco cessation support. Methods Cochrane reviews of randomized controlled trials (RCTs) of major health-care tobacco cessation interventions were used to derive efficacy estimates in terms of percentage-point increases relative to comparison conditions in 6-12-month continuous abstinence rates. This was combined with analysis and evidence from 'real world' studies to form a judgement on the probable effectiveness of each intervention in different settings. The affordability of each intervention was assessed for exemplar countries in each World Bank income category (low, lower middle, upper middle, high). Based on World Health Organization (WHO) criteria, an intervention was judged as affordable for a given income category if the estimated extra cost of saving a life-year was less than or equal to the per-capita gross domestic product for that category of country. Results Brief advice from a health-care worker given opportunistically to smokers attending health-care services can promote smoking cessation, and is affordable for countries in all World Bank income categories (i.e. globally). Proactive telephone support, automated text messaging programmes and printed self-help materials can assist smokers wanting help with a quit attempt and are affordable globally. Multi-session, face-to-face behavioural support can increase quit success for cigarettes and smokeless tobacco and is affordable in middle- and high-income countries. Nicotine replacement therapy, bupropion, nortriptyline, varenicline and cytisine can all aid quitting smoking when given with at least some behavioural support; of these, cytisine and nortriptyline are affordable globally. Conclusions Brief advice from a health-care worker, telephone helplines, automated text messaging, printed self-help materials, cytisine and nortriptyline are globally affordable health-care interventions to promote and assist smoking cessation. Evidence on smokeless tobacco cessation suggests that face-to-face behavioural support and varenicline can promote cessation. [ABSTRACT FROM AUTHOR]

Aims According to the World Health Organization (WHO), the total amount of alcohol consumed in the African region is expected to increase due to the growth of new alcohol consumers, especially young people and women. With the changing alcohol environment, increases in the alcohol-attributable burden of disease are inevitable. To our knowledge, there has not been a comprehensive analysis of the factors that could be driving those increases. The objective of this study was to examine the evidence from peer reviewed literature regarding the factors that could be instrumental in this process, in order to inform strategic policy-related decisions. Method A narrative review was conducted using a thematic analysis approach. We searched papers published between January 2000 and July 2014 in PubMed, the WHO's Global Health Library and African Journals Online. Results Our analysis identified seven factors (demographics, rapid urbanization, economic development, increased availability, corporate targeting, weak policy infrastructure and trade agreements) which are potentially tied to changes in alcohol consumption in Africa. Driven largely by globalization, a potential convergence of these various factors is likely to be associated with continued growth in alcohol consumption and alcohol-related morbidity and mortality. Conclusions To address the emerging risk factors associated with increased alcohol consumption, African governments need to take a more active role in protecting the public's health. In particular, important strategic shifts are needed to increase implementation of intersectoral strategies, community involvement in the policy dialogue, health services re-orientation and better regulation of the alcohol beverage industry. [ABSTRACT FROM AUTHOR]

Background and aims Brief alcohol interventions in medical settings are efficacious in improving self-reported alcohol consumption among those with low-severity alcohol problems. Screening, Brief Intervention and Referral to Treatment initiatives presume that brief interventions are efficacious in linking patients to higher levels of care, but pertinent evidence has not been evaluated. We estimated main and subgroup effects of brief alcohol interventions, regardless of their inclusion of a referral-specific component, in increasing the utilization of alcohol-related care. Methods A systematic review of English language papers published in electronic databases to 2013. We included randomized controlled trials (RCTs) of brief alcohol interventions in general health-care settings with adult and adolescent samples. We excluded studies that lacked alcohol services utilization data. Extractions of study characteristics and outcomes were standardized and conducted independently. The primary outcome was post-treatment alcohol services utilization assessed by self-report or administrative data, which we compared across intervention and control groups. Results Thirteen RCTs met inclusion criteria and nine were meta-analyzed ( n = 993 and n = 937 intervention and control group participants, respectively). In our main analyses the pooled risk ratio (RR) was = 1.08, 95% confidence interval (CI) = 0.92-1.28. Five studies compared referral-specific interventions with a control condition without such interventions (pooled RR = 1.08, 95% CI = 0.81-1.43). Other subgroup analyses of studies with common characteristics (e.g. age, setting, severity, risk of bias) yielded non-statistically significant results. Conclusions There is a lack of evidence that brief alcohol interventions have any efficacy for increasing the receipt of alcohol-related services. [ABSTRACT FROM AUTHOR]

Background and Aims A crucial, but under-appreciated, aspect in experimental research on psychosocial treatments of substance use disorders concerns what kinds of control groups are used. This paper examines how the distinction between different control-group designs have been handled by the Cochrane and the Campbell Collaborations in their systematic reviews of psychosocial treatments of substance abuse disorders. Methods We assessed Cochrane and Campbell reviews ( n = 8) that were devoted to psychosocial treatments of substance use disorders. We noted what control groups were considered and analysed the extent to which the reviews provided a rationale for chosen comparison conditions. We also analysed whether type of control group in the primary studies influenced how the reviews framed the effects discussed and whether this was related to conclusions drawn. Results The reviews covered studies involving widely different control conditions. Overall, little attention was paid to the use of different control groups (e.g. head-to-head comparisons versus untreated controls) and what this implies when interpreting effect sizes. Seven of eight reviews did not provide a rationale for the choice of comparison conditions. Conclusions Cochrane and Campbell reviews of the efficacy of psychosocial interventions with substance use disorders seem to underappreciate that the use of different control-group types yields different effect estimates. Most reviews have not distinguished between different control-group designs and therefore have provided a confused picture regarding absolute and relative treatment efficacy. A systematic approach to treating different control-group designs in research reviews is necessary for meaningful estimates of treatment efficacy. [ABSTRACT FROM AUTHOR]

Aims To assess the association between doctors' smoking status and the use of the '5 As' of smoking cessation. Methods A systematic search of 11 databases covering English and Spanish language publications since 1996 was undertaken. Studies were included if they reported doctors' smoking status (current, former or never smoker) and rates of practising any of the 5 As of smoking cessation ( Ask; Advise; Assess; Assist; and Arrange). Frequencies and proportions were extracted from individual papers and risk ratios ( RR) were calculated. A random-effects meta-analysis model was used to assess the effect of the doctor's personal smoking history. Covariate effects were explored using meta-regression for three pre-specified study characteristics: doctors' role, smoking prevalence of the sample and study quality. Results Twenty studies were included in this systematic review. The RR of always asking patients about their smoking was not associated significantly with doctors' smoking status [ RR = 0.98; 95% confidence interval ( CI) = 0.94-1.02; P = 0.378; I2 = 0.00%; 10 studies]. Meta-analysis suggested that doctors who were current smokers had a 17% increased risk of not advising their patients to quit compared with never-smokers ( RR = 0.83; 95% CI = 0.77-0.90; P < 0.000; I2 = 82.14%; 14 studies). However, high levels of heterogeneity were found that were not explained by the meta-regression. Regarding assisting patients to quit, never smokers were more likely to counsel than current smokers ( RR = 0.92; 95% CI = 0.85-0.99; P = 0.036; I2 = 0.00%; three studies) but less likely to make a referral ( RR = 1.40; 95% CI = 1.09-1.79; P = 0.009; I2 = 0.00%; five studies). No statistically significant differences were found in arranging future contact by smoking status ( RR = 0.80; 95% CI = 0.52-1.23; P = 0.315; I2 = 47.03%; four studies). Conclusions Smoking status of doctors may affect their delivery of smoking cessation treatments to patients, with smokers being less likely than non-smokers or ex-smokers to advise and counsel their patients to quit but more likely to refer them to smoking cessation programmes. [ABSTRACT FROM AUTHOR]

Aims The Cochrane Collaboration is an international not-for profit organization which produces and disseminates systematic reviews. This paper is the second in a series of annual updates of Cochrane reviews on tobacco addiction interventions, covering new and updated reviews from 2013. Methods In 2013, the Group published two new reviews and updated 11 others. This update summarizes and comments on these reviews as well as on a review of psychosocial interventions for smoking cessation in pregnant women, and presents pooled results from reviews of cessation interventions. Results New reviews in 2013 found: low-quality evidence that behavioural interventions with mood management components could significantly increase long-term quit rates in people with current [risk ratio (RR) = 1.47, 95% confidence interval (CI) = 1.13–1.92) and past (RR = 1.41, 95% CI = 1.13–1.77] depression; evidence from network meta-analysis that varenicline and combined forms of nicotine replacement therapy (NRT) are associated with higher quit rates than bupropion or single-form NRT (varenicline versus single-form NRT odds ratio (OR) = 1.57, 95% credibility interval (CredI) = 1.29–1.91; versus bupropion OR = 1.59, 95% CredI = 1.29–1.96); and no evidence of a significant increase in serious adverse events in trial participants randomized to varenicline or bupropion when compared to placebo controls. New evidence emerging from updated reviews suggests that counselling interventions can increase quit rates in pregnant women and that school-based smoking programmes with social competence curricula can lead to a significant reduction in uptake of smoking at more than a year. Updated reviews also suggested that naltrexone, selective serotonin re-uptake inhibitors and St John’s wort do not have a significant effect on long-term smoking cessation. Conclusions Cochrane systematic review evidence from 2013 suggests that adding mood management to behavioural support may improve cessation outcomes in smokers with current or past depression and strengthens evidence for previous conclusions, including the safety of varenicline and bupropion and the benefits of behavioural support for smoking cessation in pregnancy. [ABSTRACT FROM AUTHOR]

Background and Aims Unrecorded alcohol constitutes about 30% of all alcohol consumed globally. The aims of this systematic review were to determine the epidemiology (occurrence, types, prevalence) of unrecorded alcohol consumption in different countries/regions, analyse the chemical composition of unrecorded alcohol and examine health outcomes caused by the consumption of unrecorded alcohol, based on either epidemiology or toxicology. Methods A systematic search for, and qualitative analysis of, papers with empirical results on the different categories of unrecorded alcohol, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses ( PRISMA) guidelines. Results Unrecorded alcohol was widespread in all regions of the world. Artisanal fermented beverages and spirits were the most common categories of unrecorded alcohol globally, and were available on all continents. In India, industrially produced spirits (country spirits) were most prevalent. In Russia and countries of the former Soviet Union, surrogate alcohols complemented artisanal spirits. Cross-border shopping was the most prevalent method of obtaining unrecorded alcohol in parts of Europe. Ethanol was the most harmful ingredient of unrecorded alcohol, and health consequences due to other ingredients found in unrecorded alcohol were scarce. However, as unrecorded alcohol is usually the least expensive form of alcohol available in many countries, it may contribute to higher rates of chronic and irregular heavy drinking. Conclusions Very large amounts of alcohol are produced globally that go unrecorded. The primary harm from this kind of alcohol arises from the fact that it is typically much cheaper than licit alcohol. [ABSTRACT FROM AUTHOR]