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Objective: We examined the frequency and intensity of tobacco use and thoughts about abstinence among young adults in the United States as a function of their use of marijuana. We hypothesized that heavier marijuana use would be associated with heavier tobacco use and fewer attempts to quit smoking, and we explored relationships between marijuana use and ratings of intentions and thoughts related to quitting tobacco. Method: This was a cross-sectional survey consisting of online recruitment and anonymous self-report. Participants were English literate, were between the ages of 18 and 25 years, and reported past-month tobacco use. More than half (53%) had smoked marijuana in the past 30 days. Tobacco use (quantity/frequency, Heavy Smoking Index, past-year quit attempt), thoughts about tobacco use (outcome expectancies, desire, self-efficacy, difficulty of quitting, abstinence goal, pros and cons, stage of change), alcohol use, and other drug use were assessed. Results: Compared with those who smoked only tobacco, co-users were younger and had smoked for fewer years; had higher house hold income; were more likely to be male, multiethnic, and nondaily smokers; and reported greater alcohol and other drug use. The variable of days using marijuana in the past 30 days was associated with multiple measures of tobacco use intensity/frequency. Only one association was significant between marijuana use and tobacco-related cognitions: Co-users had a lower likelihood of planning to quit tobacco for good (odds ratio = 0.75, 95% CI [0.58, 0.98]). Conclusions: Findings support the association between tobacco and marijuana use among young people but speak to the importance of addressing tobacco cognitions in young adult smokers regardless of level of marijuana use. (J. Stud. Alcohol Drugs, 74,301-310, 2013) [ABSTRACT FROM AUTHOR]

Objective: The extent to which problem drinkers transition into and out of problem drinking was examined using Markov modeling. Method: Study participants (N= 1,350) were randomly sampled from one county's general population and from consecutive admissions to public and private alcohol treatment programs in the same county, and they were assessed at 1-, 3-, 5-, and 7-year follow-ups. At baseline, all met the criteria for problem drinking. Individuals were classified as "problem drinkers" if they reported at least two of three criteria (heavy episodic drinking, social consequences, dependence symptoms according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) during the prior 12 months. Results: Although all possible patterns were observed, a latent Markov model with heterogeneous transitions and five patterns fit the data. The sampling frame and baseline alcohol severity related to pattern. Conclusions: The data indicate that, although they do change over time, problem drinkers on the whole are more likely either to remain problem drinkers or to cease to be problem drinkers than they are to move into and out of problem-drinking status. Once they transition out of problem drinking, they are more likely to remain nonproblem drinkers. [ABSTRACT FROM AUTHOR]

Objective: Although the effect of alcohol assessment in medical settings has received attention, the longitudinal study of such efforts has been restricted to studying a single assessment/intervention dose. Such interventions can be recurrent and have effects on subsequent problem drinking. Method: A sample of problem drinkers in the general population (n = 672) and with admissions to chemical-dependency programs (n = 926) was interviewed at baseline and 1, 3, 5, and 7 years later. At each wave, respondents were asked about their drinking, their medical visits, and the intensity of the medical contact (whether during the visit they were asked about their drinking and, if so, whether they received or were referred to alcohol treatment). Results: Rates of problem drinking declined over time, from 48% at the 1-year follow up to 38% at the 7-year follow-up. Problem drinkers were more likely at each wave to receive or be referred to treatment. Alcohol and drug severity increased with more intensive medical-contact types over time. Predicting subsequent problem drinking status from prior intensity of medical contact, odds of problem drinking at subsequent waves decreased with time, age, and prior drug severity while increasing with volume and alcohol severity. Odds of problem drinking were lower among prior problem drinkers receiving assessment and treatmentlreferral, compared with the assessed-only group. Examined separately, this effect was found only for those drinkers with lower volumes (average < 0.5 drinks/day). Conclusions: Alcohol assessment may be effective in reducing problem drinking but may be most effective among the non-heaviest drinkers. [ABSTRACT FROM AUTHOR]

Objective: Much of what we know about the course of alcohol consumption in problem and dependent drinkers comes from studies of in-treatment populations. Less is known about the natural course of alcohol consumption among such drinkers in the general population and what predicts how much they drink.Method: This study examined alcohol consumption over the course of 11 years in a randomly selected sample of 672 problem and dependent drinkers from a single, heterogeneous U.S. county.Results: Alcohol consumption declined and leveled off over time but did not decrease to the average general U.S. population level. Several indicators of ongoing problems with drinking are associated with high levels of drinking over time: having a heavy-drinking network, receiving suggestions to do something about one's drinking, and going to treatment. Factors associated with less drinking include having contact with community agencies and going to Alcoholics Anonymous (AA).Conclusions: Results suggest that problem and dependent drinkers continue to drink at an elevated level over the course of years. Gatekeepers, family members, and policymakers should encourage and facilitate contact with social service agencies and with AA for problem drinkers. Suggestions from others to do something about one's drinking and seeking specialty care occur more often in those with more severe problems and do not appear to be linked to less drinking over time. [ABSTRACT FROM AUTHOR]