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This study aimed to: (a) explore differences in the prevalence of nomophobia and smartphone addiction (SA) from pre- to during COVID-19; (b) identify students' self-reported changes in smartphone reliance and screen time during COVID-19; and (c) examine whether self-perceived changes in smartphone usage predicted nomophobia and SA scores. Scores on the Nomophobia Questionnaire and Smartphone Addiction Scale between two surveys administered at two timepoints were compared: Sample 1 (September 2019–January 2020; N = 878) and Sample 2 (May-June 2020; N = 258). No significant differences were found between samples on nomophobia or SA. Nearly all of Sample 2 reported using some type of app more, using their smartphone a little more, and about the same perceived smartphone reliance during COVID-19. Increased screen time, smartphone reliance, and social media significantly predicted nomophobia and SA. COVID-19 does not appear to have exacerbated the prevalence of nomophobia or SA. [ABSTRACT FROM AUTHOR]

The present review aimed to synthesize the empirical evidence regarding the association between problematic pornography use (PPU) and mental health. A comprehensive literature search using keywords and subject headings was performed with three electronic databases, resulting in 20 studies that met the inclusion criteria. The patterns of association between PPU and mental health were examined, and the limitations of these studies were discussed. The overall findings suggest the relationship between PPU and mental health outcomes is not clear-cut, and it is often mediated by other factors such as loneliness, anxiety, and self-esteem. Further studies are required to evaluate the prevalence of PPU and both risk and protective factors which are associated with exposure to online pornography. Most studies relied on homogenous samples which have limited the generalizability of findings. The use of representative samples, including both males and females with different sexual orientations and from diverse cultural and ethnic backgrounds, would strengthen our understanding of PPU and go further to expound on its controversies. Clinical recommendations and future directions are also discussed. [ABSTRACT FROM AUTHOR]

Background: Previous research has shown that nostalgia for the pre-addicted self can motivate people living with addiction to engage in behavior change. Objective: Herein, we explored nostalgia for the addictive behavior—labeled addiction-related nostalgia (ARN)—among people in recovery from engaging in addictive behavior. We tested the novel idea that ARN is positively associated with ambivalence about recovery. We also hypothesized that ARN may counteract the positive influence of optimism on individuals' commitment to recovery. Results: In two studies involving individuals in recovery from a gambling (Study 1; N=301) or alcohol use disorder (Study 2; N=604), ARN was linked to increased ambivalence about recovery, while optimism was associated with decreased ambivalence. As expected, the interaction between optimism and ARN revealed that nostalgia either eliminated (Study 1) or reduced (Study 2) the negative relation between optimism and ambivalence. Conclusions: These findings underscore the challenges posed by ARN in the recovery process and emphasize the importance of interventions that address and mitigate its impact while considering the moderating role of optimism. [ABSTRACT FROM AUTHOR]

Substance use disorders (SUDs) affect over 35 million individuals worldwide and are associated with significant harms. Residential treatment is an essential component of Canada's approach to combating SUDs, offering highly intensive and specialized acute services. Historically, residential treatment facilities have quantified the success of their program(s) solely based on program completion. However, there has been a recent movement toward empirically evaluating programs using standardized measures of distress. The purpose of this study was to evaluate whether the inpatient residential program for SUDs at Edgewood Treatment Centre is effective in providing substantive improvement of a range of addiction and mental health symptoms. The current study assessed both addiction related and psychological outcomes. Specifically, we examined whether patients improved on various measures of functional impairment, addiction-related symptoms, traumatic stress, and psychological distress, following completion of the 7-week inpatient addiction program. Findings suggested that there were significant improvements in emotion regulation, and decreases in substance dependence, substance cravings, anxiety, depressive symptoms, and traumatic stress between admission and discharge. [ABSTRACT FROM AUTHOR]

Religion and spirituality (RS) are integral to counseling and health but their incorporation into the curricula of these professions is still lacking. Limited literature is available on how to effectively teach such courses. This article presents a promising experiential, interactive model for an RS course designed for undergraduate students pursuing careers in addictions counseling, therapeutic recreation, and public health. An online course conducted during the COVID-19 pandemic adopted a social constructivist framework that encompassed four key components in its design and delivery: assessing prior knowledge, creating cognitive dissonance, applying new knowledge with feedback, reflecting on learning. Students' feedback in the course indicated their broadened understanding of the plurality of RS orientations and their acquisition of foundational skills with an increased confidence in bringing RS conversations into their practice. This article provides a conceptual and practical framework for educators to develop an RS course for a diverse representation of students and encourages further evaluation of the proposed model to assess its impact on learning outcomes. [ABSTRACT FROM AUTHOR]

In the area of addiction, Canada has been in a public health crisis since 2016. Addiction takes a toll on an individual's self-worth and identity. In this narrative literature review, the distinct nature of spirituality was addressed. Next, individualized conceptualizations of spirituality were outlined. Subsequently, the importance of fellowship in addiction recovery was detailed. Next, the significance of being of service was presented. Meaningful and authentic spirituality were discussed in the context of recovery identity. Lastly, spirituality as a personal journey is described. A narrative literature review of 70 manuscripts published between 1999 and 2021 was undertaken to determine multiple approaches to treating addiction recovery in the context of spiritual development. An understanding of spirituality can inform counsellors regarding spiritual development in addiction recovery. Implications for counselling include a roadmap to support clients developing an individualized spiritual connection and operating as a functional system. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives Work addiction is not contingent on personality alone; it is also impacted by social contextual factors. Work addiction influences the perceived quality of care and intention to remain in healthcare sector. The current study seeks to understand the role of ethical climate as a potential organisational lever to reduce such addiction, especially among newcomers. Design We contacted a sample of Canadian healthcare organisations to collect quantitative data using an online questionnaire from November 2021 to February 2022. All constructs (ethical climate, work addiction, perceived quality of care, intention to quit the profession) were measured using validated psychometric scales. 860 respondents provided complete questionnaires. We analysed the data using structural equation modelling and regression analysis. Results Work addiction mediated the indirect relationship between ethical climate and the intention to quit the profession (β=-0.053; 95% CI (-0.083 to -0.029); p<0.001) and with quality of care (β=0.049; 95% CI (0.028, 0.077); p<0.001). For each increase of 1 SD of ethical climate, the total effects regarding the variations in the outcomes were more important at low rather than high levels of tenure for work addiction (-11%, -2%), perceived quality of care (23%, 11%) and intention to quit the profession (-30%, -23%), respectively. Conclusion Ethical climate in healthcare organisations has a significant and beneficial relationship with healthcare workers' (HCWs) work addiction behaviours. In turn, this relationship is related to greater perceived quality of care and higher intention to remain, especially for HCWs with lower tenure. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The objective of this study was to describe the clinical course and outcomes in children with technology dependence (TD) hospitalized with SARS-CoV-2 infection. Methods: Seventeen pediatric hospitals (15 Canadian and one each in Iran and Costa Rica) included children up to 17 years of age admitted February 1, 2020, through May 31, 2021, with detection of SARS-CoV-2. For those with TD, data were collected on demographics, clinical course and outcome. Results: Of 691 children entered in the database, 42 (6%) had TD of which 22 had feeding tube dependence only, 9 were on supplemental oxygen only, 3 had feeding tube dependence and were on supplemental oxygen, 2 had a tracheostomy but were not ventilated, 4 were on non-invasive ventilation, and 2 were on mechanical ventilation prior to admission. Three of 42 had incidental SARS-CoV-2 infection. Two with end-stage underlying conditions were transitioned to comfort care and died. Sixteen (43%) of the remaining 37 cases required increased respiratory support from baseline due to COVID-19 while 21 (57%) did not. All survivors were discharged home. Conclusion: Children with TD appear to have an increased risk of COVID-19 hospitalization. However, in the absence of end-stage chronic conditions, all survived to discharge. [ABSTRACT FROM AUTHOR]

Background: The goal of the Edmonton Classification System for Cancer Pain (ECS-CP) is to create an international classification system for cancer pain. Previous studies reinforce the need for standardized training to ensure consistency across assessors. There is no universally accepted classification for neuropathic pain. Objectives: Our primary objective was to describe the prevalence of ECS-CP features in a diverse sample of advanced cancer patients, using assessors with standardized training. The secondary objectives were to: (1) determine the prevalence of neuropathic pain using the Neuropathic Pain Special Interest Group (NeuPSIG) criteria and (2) examine the relationship between specific predictors: ECS-CP features, age, Palliative Performance Scale, Morphine Equivalent Daily Dose (MEDD), setting, and pain intensity; and neuropathic pain. Methods: A total of 1050 adult patients with advanced cancer were recruited from 11 Canadian sites. A clinician completed the ECS-CP and NeuPSIG criteria, and collected additional information including demographics and pain intensity (now). All assessors received standardized training. Results: Of 1050 evaluable patients, 910 (87%) had cancer pain: nociceptive (n = 626; 68.8%); neuropathic (n = 227; 24.9%); incident (n = 329; 36.2%); psychological distress (n = 209; 23%); addictive behavior (n = 51; 5.6%); and normal cognition (n = 639; 70.2%). The frequencies of ECS-CP features and pain intensity scores varied across sites and settings, with more acute settings having higher frequencies of complex pain features. The overall frequency of neuropathic pain was 24.9%, ranging from 11% (hospices) to 34.2% (palliative outpatient clinic) across settings. Multivariate logistic regression analysis revealed that age <60 years, MEDD ≥19 mg, pain intensity ≥7/10, and incident pain were significant independent predictors of neuropathic pain (p < 0.05). Conclusion: The ECS-CP was able to detect salient pain features across settings. Furthermore, the frequencies of neuropathic pain utilizing the NeuPSIG criteria fits within the lower-end of literature estimates (13%–40%). Further research is warranted to validate the NeuPSIG criteria in cancer pain. [ABSTRACT FROM AUTHOR]

For Canadian families experiencing social vulnerability, challenges of living with low income, parental mental illness, addiction, and/or lack of social support are frequently intergenerational. US two-generation programs demonstrate positive effects on child and parent well-being; Canadian two-generation programs are rare, with CUPS (formerly Calgary Urban Project Society) the Canadian exemplar. In this cross-sectional, concurrent, triangulation mixed methods study, we used Maslow's Hierarchy as a framework. We explored experiences of parents and adolescents at CUPS through written answers on questionnaires (39 parents and 55 adolescents), measuring attitudes toward child maltreatment (44 parent/adolescent dyads), and ACE scores (48 parent/adolescent dyads). Experiences encompassed movement toward resiliency and intergenerational shifts in risk for child maltreatment, including use of corporal punishment, and lower ACE scores in adolescents than parents. Effective early childhood interventions for families experiencing vulnerability must focus on intergenerational approaches, emphasize social support systems, breaking cycles of adversity, and lifelong movement toward resiliency. [ABSTRACT FROM AUTHOR]

Background: The purpose of the study was to examine the incidence of exercise dependence amongst varsity - level university athletes. Method: Physical activity behavior patterns were measured amongst 62 participants (31 male and 31 female) from a mid - size University in Canada for the purpose of identifying problematic exercise through a questionnaire - based survey utilizing the Exercise Addiction Inventory (EAI). Results: Total scores were tabulated to indicate the number of varsity athletes scoring either "at-risk", "symptomatic" or "asymptomatic" of exercise addiction, and percentages were determined for each of the EAI categories. 72.5% scored "symptomatic" while 19.5% recorded "at - risk" and 8% attained an "asymptomatic" result on the questionnaire. Interestingly, females rated "at - risk" three times higher than males whereas "asymptomatic" scores were four times greater amongst males on the EAI scale. Conclusion: While the EAI can identify individuals at risk from problematic exercise, a limitation is that high scores are not necessarily indicative of exercise addiction due to some people interpreting questions differently than they were intended. In addition, underlying causes such as anxiety, depression, difficulties with relationships or coping with personal hardship can be at the root of exercise addiction. Notwithstanding, individuals who score in the "at - risk" category of the EAI might still best be advised to seek counselling as activity should be pursed so that it enhances one's life through sustainable long - term physical, psychological and social health versus exercising for deriving a sense of physical and psychological fulfillment. [ABSTRACT FROM AUTHOR]

Clinical trials drive the development of medicine. However, little is known about the current status of clinical trials on addiction. This study aimed to provide a comprehensive analysis of registered addiction-related trials from ClinicalTrials.gov. We examined all addiction-related trials registered on ClinicalTrials.gov up to March 23, 2020. Statistical analysis was performed by using SPSS 25.0, and a two-sided p <.05 was considered statistically significant. 370 eligible trials were identified. Over half of trials were completed, while only 13.8% of trials reported results. Sample sizes varied a lot with a median number of 84 per trial. Universities were the primary sponsor for 164 (44.3%) trials, followed by hospitals (96, 26.0%). Compared to trials without results, more trials with results were sponsored by universities (62.7% vs. 41.4%, p =.003), and conducted in United States/Canada (90.2% vs. 48.3%, p <.001). Most interventional trials were randomized with a parallel assignment, and 56.3% were blinded. Thirty one (41.3%) observational trials were cohort studies and 12 (16.0%) were case-only studies. Interventional trials were more likely to be funded by the US Government, while more observational trials were supported by industries. Trials funded by the US Government were more likely to be completed than those funded by other sources (p =.009). Most registered trials on ClinicalTrials.gov about addiction were interventional trials with purpose for treatment. Most interventional trials were randomized, parallel, and masked. Our analysis highlighted the need for improvement in completing study results on the ClinicalTrials.gov. [ABSTRACT FROM AUTHOR]

Deficit models of care for clients experiencing social vulnerability have become increasingly unsustainable; and there is a shift towards models of care that promote and protect resiliency for lifelong health. We defined clients as socially vulnerable if they were living with poverty, mental health problems and addictions, disability, and social isolation. Scales to measure outcomes of resiliency‐focused programming have limited reliability and have not been validated with vulnerable populations. The aim of this study was to develop and conduct preliminary psychometric assessment of two measures: CUPS (formerly Calgary Urban Project Society) Resiliency Interview Schedule (RIS) and Resiliency Questionnaire (RQ) for adults experiencing social vulnerability. To engage clients who were seeking integrated services at a social services agency, we developed the RIS and accessed data collected between April 2017 and December 2018. In a structured intake interview, the client and staff prioritised goals and identified resiliency in three domains: (a) economic, (b) social‐emotional, and (c) health. On average, clients (N = 545) who completed the CUPS‐RIS were 45.9 years old (SD = 12.62). For the CUPS‐RIS, Cronbach's alphas at intake and outcome assessments were 0.80. Exploratory factor analysis demonstrated a four‐factor solution with two unexpected results: executive functioning/self‐regulation loaded with mental and physical health, and client education failed to load on any factor. We found significant improvements between client intake and outcome measurement points on eight of 12 sub‐domains. As a brief self‐report measure of resiliency, we developed the CUPS‐RQ and accessed data collected between November 2018 and May 2019. Clients (N = 29) who completed the CUPS‐RQ concurrently with the Resilience Research Centre‐Adult Resilience Measure (RRC‐ARM) were, on average, 42.46 years old (SD = 12.87). The CUPS‐RQ was correlated with RRC‐ARM, r = 0.819. In preliminary psychometric assessment, the CUPS‐RIS and CUPS‐RQ demonstrated satisfactory reliability and validity and show promise as measures of resiliency for agencies serving clients experiencing social vulnerability. [ABSTRACT FROM AUTHOR]

Background: Emerging adulthood is associated with heavy drinking. Despite overall heavy use, studies show considerable heterogeneity in emerging adult drinking habits. Lau-Barraco and colleagues (2016 b) identified three subtypes (high, moderate, low) of emerging adult heavy drinkers based on patterns of use across common drinking situations. Heavy situational drinkers had more alcohol problems, mental health symptoms, and coping/conformity motives for alcohol use. Objective: Our goal was to replicate and extend the aforementioned study, expecting to find the same subgroups, then examining whether certain risk factors predicted subgroup membership. Methods/Results: Undergraduates (N = 497) completed online self-report measures and a latent profile analysis (LPA) found support for three similar subtypes; low, "moderate" (higher endorsement of pleasant emotion/social pressure situations, relative to the low group), and high. Univariate ANOVAs, followed by pairwise comparisons, found that heavy situational drinkers scored highest on measures of alcohol problems, problem gambling, drug use, depression, and anxiety compared to the other two groups, and consistent with previous findings. Conclusions: This study showed that emerging adults who drink heavily across various situations are likely to engage in other addictive behaviors and struggle with mental health symptoms. Identifying one's personal risk factors and their riskiest drinking situations is critical for developing targeted intervention programs and increasing the understanding of the heterogeneous nature of drinking behaviors in emerging adults in Canada. [ABSTRACT FROM AUTHOR]

Background and aims: To improve evidence‐based addiction care in acute care settings, many hospitals across North America are developing an inpatient addiction medicine consultation service (AMCS). St Paul's Hospital in Vancouver, Canada houses a large interdisciplinary AMCS. This study aimed to: (1) describe the current model of clinical care and its evolution over time; (2) evaluate requests for an AMCS consultation over time; (3) highlight the established clinical training opportunities and educational curriculum and (4) provide some lessons learned. Design, setting and participants: A retrospective observational analysis in an urban, academic hospital in Vancouver, Canada with a large interdisciplinary AMCS, studied from 2013 to 2018, among individuals who presented to hospital and had a substance use disorder. Measurements Data were collected using the hospital's electronic medical records. The primary outcome was number of AMCS consultations over time. Findings In 2014 the hospital's AMCS was restructured into an academic, interdisciplinary consultation service. A 228% increase in the number of consultations was observed between 2013 (1 year prior to restructuring) and 2018 (1373 versus 4507, respectively; P = 0.027). More than half of AMCS consultations originated from the emergency department, with this number increasing over time (55% in 2013 versus 74% in 2018). Referred patients were predominantly male (> 60% in all 5 years) between the ages of 45 and 65 years. Reasons for consultation remained consistent and included: opioids (33%), stimulants (30%), alcohol (23%) and cannabis use (8%). Conclusions: After St Paul's Hospital in Vancouver, Canada was restructured in 2014 to a large, interdisciplinary addiction medicine consultation service (AMCS), the AMCS saw a 228% increase in the number of consultation requests with more than half of requests originating from the emergency department. Approximately two‐thirds of consultation requests were for opioid or stimulant use. [ABSTRACT FROM AUTHOR]

The stigma of addiction in Muslim communities is a significant barrier to accessing mental health services. The objective of this study was to evaluate the impact of a newly developed spiritually-adapted addictions psychoeducational program with adult Muslims in the mosque setting. Ninety-three individuals were recruited from nine different mosques within Toronto, Canada. Ninety-minute seminars were presented. This study used a convergent mixed method design. There was a significant increase in the participants' self-reported knowledge (t = 3.6; p < 0.001), a more positive attitude on two scales (t = 3.7; p < 0.001 and t = 2.9; p = 0.005) and an increase in willingness to seek help from a medical doctor and mental health professional (t = 4.4; p < 0.001 and t = 2.2; p = 0.03, respectively) post-seminar as compared to baseline. Qualitative data confirmed these changes. Evidence-informed spiritually-adapted outreach program in the mosque setting can help reduce addiction related stigma in Muslim communities. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to provide an updated profile of gambling and problem gambling in Canada and to examine how the rates and pattern of participation compare to 2002. Method: An assessment of gambling and problem gambling was included in the 2018 Canadian Community Health Survey and administered to 24,982 individuals aged 15 and older. The present analyses selected for adults (18+). Results: A total of 66.2% of people reported engaging in some type of gambling in 2018, primarily lottery and/or raffle tickets, the only type in which the majority of Canadians participate. There are some significant interprovincial differences, with perhaps the most important one being the higher rate of electronic gambling machine (EGM) participation in Manitoba and Saskatchewan. The overall pattern of gambling in 2018 is very similar to 2002, although participation is generally much lower in 2018, particularly for EGMs and bingo. Only 0.6% of the population were identified as problem gamblers in 2018, with an additional 2.7% being at-risk gamblers. There is no significant interprovincial variation in problem gambling rates. The interprovincial pattern of problem gambling in 2018 is also very similar to what was found in 2002 with the main difference being a 45% decrease in the overall prevalence of problem gambling. Conclusions: Gambling and problem gambling have both decreased in Canada from 2002 to 2018 although the provincial patterns are quite similar between the 2 time periods. Several mechanisms have likely collectively contributed to these declines. Decreases have also been reported in several other Western countries in recent years and have occurred despite the expansion of legal gambling opportunities, suggesting a degree of inoculation or adaptation in large parts of the population. [ABSTRACT FROM AUTHOR]

The Brief Screener for Substance and Behavioral Addictions (SSBAs) was developed to assess a common addiction construct across four substances (alcohol, tobacco, cannabis, and cocaine), and six behaviors (gambling, shopping, videogaming, eating, sexual activity, and working) using a lay epidemiology perspective. This paper extends our previous work by examining the predictive utility of the SSBA to identify self-attributed addiction problems. Participants (N = 6,000) were recruited in Canada using quota sampling methods. Receiver Operating Characteristics (ROCs) analyses were conducted, and thresholds established for each target behavior's subscale to predict self-attributed problems with these substances and behaviors. For each substance and behavior, regression models compared overall classification accuracy and model fit when lay epidemiologic indicators assessed using the SSBA were compared with validated screening measures to predict selfattributed problems. ROC analyses indicted moderate to high diagnostic accuracy (Area under the curves (AUCs) 0.73–0.94) across SSBA subscales. Thresholds for identifying self-attributed problems were 3 for six of the subscales (alcohol, tobacco, cannabis, cocaine, shopping, and gaming), and 2 for the remaining four behaviors (gambling, eating, sexual activity, and working). Compared to other instruments assessing addiction problems, models using the SSBA provided equivalent or better model fit, and overall had higher classification accuracy in the prediction of self-attributed problems. The SSBA is a viable screening tool for problematic engagement across ten potentially addictive behaviors. Where longer screening tools are not appropriate, the SSBA may be used to identify individuals who would benefit from further assessment. [ABSTRACT FROM AUTHOR]

Tilt is a very common term in online poker players' vocabulary, it describes a state where the player is no longer able to make rational decisions because they are overwhelmed by strong emotions. This study aims to explore the relation existing between the frequency of Tilt episodes, the player's perception of these episodes and excessive gambling in online poker. The sample is composed of 291 adult French-speaking online poker players. All participants completed an online self-assessment questionnaire. The results of the classification analysis showed that the sample could be divided into three groups. The first group, named ''players in control'' included low excessive gambling tendencies with low perceived and measured Tilt frequencies. The two other groups showed high measured tilt levels, with perceived tilt levels that were different from the measured levels. Furthermore, these two groups present a moderate usage risk of developing an excessive gambling tendency in a money-based game of chance. These results show the existence of a relation between the player's capacity to perceive tilt and the online poker player's behavior. [ABSTRACT FROM AUTHOR]

We examined the prevalence of hypersexuality in two combined Canadian adult community samples totalling 1,857 respondents (female n = 960, male n = 835, other n = 60, missing n = 2). Participants were recruited from social media to complete an online sexual behaviour survey that included two measures of compulsive sexual behaviour disorder— the Sexual Compulsivity Scale (SCS) and Hypersexual Behaviour Inventory (HBI)—as well as sexual behaviour and interest items. Respondents also reported their total sexual outlets (TSO)—defined by number of orgasms experienced weekly—as a third potential indicator of hypersexuality. Canadian men and women reported multiple sexual outlets per week that tended to be higher than previous reports. Men tended to report a larger number and higher frequency of various sexual behaviour than women, including higher rates of compulsive sexual behaviour disorder, which varied depending on the measure employed. Implications for establishing sexuality norms and conceptualizing hypersexuality and compulsive sexual behaviour disorder are discussed. [ABSTRACT FROM AUTHOR]

Aims: To determine whether a simple combination of level of smoking and level of vaping results in a useful typology for characterizing smoking and vaping behaviours. Methods: Cross‐sectional data from adults (≥ 18 years) in the 2016 wave 1 ITC Four Country Smoking and Vaping Survey in the United States (n = 2291), England (n = 3591), Australia (n = 1376) and Canada (n = 2784) were used. Participants who either smoked, vaped or concurrently used both at least monthly were included and divided into eight groups based on use frequency of each product (daily, non‐daily, no current use). This resulted in four concurrent use groups (predominant smokers, dual daily users, predominant vapers and concurrent non‐daily users). These groups were compared with each other and with the four exclusive use groups, on socio‐demographics, nicotine dependence, beliefs and attitudes about both products, and quit‐related measures using data weighted to reference population surveys in each country. Results: Of the sample, 10.8% were concurrent users, with daily smokers vaping non‐daily (predominant smokers), constituting 51.6% of this group. All eight categories differed from other categories on at least some measures. Concurrent daily nicotine users reported higher levels of indicators of nicotine dependence, and generally more positive attitudes toward both smoking and vaping than concurrent non‐daily users. Among daily nicotine users, compared with exclusive daily smokers, reports of interest in quitting were higher in all concurrent use groups. Dual daily users had the most positive attitudes about smoking overall, and saw it as the least denormalized, and at the same time were equally interested in quitting as other concurrent users and were most likely to report intending to continue vaping. Conclusions: In Australia, Canada, England and the United States in 2016, daily nicotine users differed considerably from non‐daily nicotine users. Among daily nicotine users, dual daily users (those who smoke and vape concurrently) should be treated as a distinct grouping when studying relationships between smoking and vaping. The eight‐level typology characterizing concurrent and exclusive use of smoking and vaping should be considered when studying both products. [ABSTRACT FROM AUTHOR]

Daily fantasy sports (DFS), a rapidly growing industry, allows players to create fantasy teams of real-life players and potentially win cash prizes, derived from entry fees. Some stakeholders have expressed concern that DFS's accelerated nature and other features might promote excessive play and related harm. We conducted the first descriptive summary of actual DFS play using records from a cohort of subscribers to a dominant operator, DraftKings. Participants (N = 10,385) initially entered paid National Football League (NFL) contests. Across all participants, players entered a median of two contests per entry day and typically submitted a single entry for each contest they entered. Players paid a median of $87 in entry fees throughout the 2014 NFL season and experienced an overall median net loss of $30.7. However, we identified heavily involved sub-groups of players based on number of contests entered, total entry fees, and net loss. These top 1% groups were less likely to restrict themselves to NFL games, exhibited greater time involvement, but also won a greater percentage of the contests they entered than typical players. Our observations of typical and heavily involved players tend to mirror those generated in previous Internet sports gambling research. [ABSTRACT FROM AUTHOR]

The Children's Saving Inventory (CSI) was introduced in 2011 and is the first parent-rated questionnaire specifically designed to measure the severity of hoarding symptoms in youth. To date, however, no replication studies of the CSI have been published. Additionally, the total CSI score includes several items measuring acquisition, a behavioural dimension that has since been excluded from DSM-5's hoarding disorder criteria. Given these limitations, the primary goal of the present study was to test a modified, DSM-5-consistent, total score of the CSI. Because a confirmatory factor analysis did not support the 2011 four-factor model of the CSI, we reviewed the original CSI and excluded all acquisition items. An exploratory factor analysis yielded a strong three-factor solution (difficulty discarding, Clutter, and distress/impairment) with good reliability and validity for a 15-item version of the CSI. Overall, our results support the use of the 15-item CSI in youth with OCD. [ABSTRACT FROM AUTHOR]

• Assessing addictive behaviours comprehensively and efficiently is a challenge. • A new tool was developed to measure both substance and behavioral addictions. • The new tool (SSBA-G) demonstrated excellent internal and temporal reliability. • The SSBA-G also demonstrated good convergent and divergent validity. • The SSBA-G is a sound and efficient measure of addiction-related impairment. Assessing addictive behaviours comprehensively and efficiently is a challenge in both research and clinical practice. Consequently, we tested the psychometric properties of the Generalized Screener for Substance and Behavioural Addictions (SSBA-G), a novel, brief screening tool measuring functional impairment resulting from both substance and behavioural addictions. The SSBA-G was developed from the Screener for Substance and Behavioural Addictions (Schluter et al., 2018) and tested in four samples including university students in Canada (n = 481) and the US (n = 164) as well as community adults in Canada (n = 301), and Hungary (n = 79). Confirmatory factor analysis supported the hypothesized bifactor model of the SSBA-G. Receiver-operation characteristic analyses revealed high differentiation accuracy (AUC=0.86–.95), as well as identical ideal cut points across the Substance Addiction (SSBA-G-S) and Behavioural Addiction (SSBA-G-B) Subscales. Results indicated good-to-excellent sensitivity and moderate-to-good specificity. The SSBA-G demonstrated excellent internal consistency and test-retest reliability as well as promising concurrent validity in relation to the original SSBA and additional questions regarding addiction-related impairment. The SSBA-G also showed good convergent and divergent validity with indicators of general mental health. These results indicate that the SSBA-G is a psychometrically sound and efficient measure of addiction-related impairment across substances and excessive behaviours. [ABSTRACT FROM AUTHOR]

Voluntary self-exclusion (VSE) programs enable problem gamblers to engage in a break from casino-based gambling. The current study analyzed the effects of a VSE program in British Columbia, Canada on problem gambling symptoms and the comparative reductions in problem gambling symptoms when participants abstained from gambling, continued to participate in non-casino based gambling, or attempted to violate their exclusion contract. 269 participants completed two telephone interviews over a 6-month period. Participants were administered the Problem Gambling Severity Index (PGSI). Substantial reductions in PGSI scores were observed after 6 months. Program violators had significantly smaller PGSI Difference Scores by Time 2 compared to those who continued to gamble outside of the casino and those who completely abstained from all gambling. There were no significant differences between those who gambled informally and those who abstained. A multiple regression identified that while access to counselling and length of enrollment also contributed to the reduction in PGSI scores, violation attempts were most strongly associated with smaller reductions in symptoms of problem gambling. These results imply that some gamblers can successfully engage in non-casino based forms of gambling and still experience reductions in symptoms of problem gambling. Future analyses will explore characteristics associated with group membership that may help to identify which participants can successfully engage in non-casino based gambling without re-triggering symptoms of problem gambling. [ABSTRACT FROM AUTHOR]

This analysis of gambling habits of Canadian university students (ages 18-25) dovetails two recent developments in the field of gambling studies. First, the popularity of latent class analysis to identify heterogeneous classes of gambling patterns in different populations; second, the validation of the Gambling Motives Questionnaire (with financial motives) among university students-specifically to understand both how and why emerging adults gamble. Our results support a four-class model of gambling activity patterns, consisting of female-preponderant casual and chance-based gambling groups, and male-preponderant skill-based and extensive gambling groups. Each class shows a specific combination of motives, underscoring the necessity for nuanced responses to problem gambling among emerging adults. More specifically, gambling for the skill-based group appears primarily to be a source of thrill and a way to cope; for the chance-based group, gambling appears but one symptom of a set of wider issues involving depression, anxiety, substance use, and low self-esteem; while extensive gamblers seem to seek excitement, sociality, and coping, in that order. Only the chance-based group was significantly more likely than casual gamblers to be motivated by financial reasons. Situating our analysis in the literature, we suggest that interventions for the predominantly male subtypes should address gambling directly (e.g. re-focusing excitement seeking into other activities, instilling more productive coping mechanisms) while interventions for predominantly female subtypes should address low self-esteem in conjunction with depression, substance abuse, and problematic levels of gambling. We conclude future research should focus on links between self-esteem, depression, substance abuse, and financial motives for gambling among female emerging adults. [ABSTRACT FROM AUTHOR]

Abstract: Background and aims: There is currently no well‐validated measure that assesses a broad spectrum of substance‐related and behavioural addictions in general populations. This study aimed to develop a brief self‐attribution Screener for Substance and Behavioural Addictions (SSBA) to screen for four substances and six behaviours, and to compare its performance with established individual‐behaviour screening instruments. Design: A small, psychometrically optimal set of items to assess self‐attributed indicators of addiction across alcohol, tobacco, cannabis, cocaine, gambling, shopping, videogaming, overeating, sexual activity and overworking were identified from a broader pool that was developed using a lay epidemiology qualitative approach. The suitability of the four‐item single‐factor solution was tested for each behaviour and scores were compared with those obtained from the sample using individual‐behaviour screening instruments. Setting and Participants: Participants (n = 6000), broadly representative of the Canadian English‐speaking adult population, were recruited through the Ipsos Reid Canadian Online Panel. Measurements: Participants completed an item pool of 15 indicators of addiction for each target behaviour and a validation instrument for one randomly assigned behaviour. Findings: A set of four items identified using principal component and confirmatory factor analyses demonstrated good fit and excellent internal consistency (α = 0.87–0.95) across behaviours, and good convergent validity (rs = 0.44–0.8) with extant instruments measuring similar constructs, with only one exception (r = 0.26). Conclusions: The proposed Screener for Substance and Behavioural Addiction is a reliable and valid measure assessing the lay public's self‐attributed indicators of addiction across 10 substances and behaviours. [ABSTRACT FROM AUTHOR]

Available evidence suggests that self-help treatments may reduce problem gambling severity but inconsistencies of results across clinical trials leave the extent of their benefits unclear. Moreover, no self-help treatment has yet been validated within a French Canadian setting. The current study therefore assesses the efficacy of a French language self-help treatment including three motivational telephone interviews spread over an 11-week period and a cognitive-behavioral self-help workbook. At-risk and pathological gamblers were randomly assigned to the treatment group (n = 31) or the waiting list (n = 31). Relative to the waiting list, the treatment group showed a statistically significant reduction in the number of DSM-5 gambling disorder criteria met, gambling habits, and gambling consequences at Week 11. Perceived self-efficacy and life satisfaction also significantly improved after 11 weeks for the treatment group, but not for the waiting list group. At Week 11, 13% of participants had dropped out of the study. All significant changes reported for the treatment group were maintained throughout 1, 6 and 12-month follow-ups. Results support the efficacy of the self-help treatment to reduce problem gambling severity, gambling behaviour and to improve overall functioning among a sample of French Canadian problem gamblers over short, medium and long term. Findings from this study lend support to the appropriateness of self-help treatments for problem gamblers and help clarify inconsistencies found in the literature. The low dropout rate is discussed with respect to the advantages of the self-help format. Clinical and methodological implications of the results are put forth. [ABSTRACT FROM AUTHOR]

Objectives: The first goal of this study was to empirically identify, among university students, groups with varying levels of risk based on indicators of gambling and substance use. The second goal was to compare the identified groups on various demographic characteristics. Methods: The study comprised of 2139 full-time undergraduate students, representative of university students in Montreal, Canada. A 3-step latent class logistic regression analysis was performed to identify groups and compare them on demographic characteristics. Results: The statistical fit indices of the latent class analysis revealed a four-class solution. Class 1 (30.1% of the sample) included non-gamblers with low probabilities of substance use. Class 2 (11.2% of the sample) grouped non-gamblers with high-risk patterns of consumption. Class 3 (36.42% of the sample) included gamblers who are low-risk substance users, and individuals in Class 4 (22.25% of the sample) reported risky patterns of gambling and substance-using behaviors. Results of the logistic regression suggested that gender, being born in Canada, and working full- or part-time are significant predictors of class membership. Participants in both groups labeled at-risk (with and without gambling) were also more likely to report psychological distress and to live outside the family environment. Conclusions: This study raises important questions regarding the choice of preventive models and feeds into the long-standing debate around universal versus high-risk approaches. [ABSTRACT FROM AUTHOR]

The current study examined the role of bisexual-specific distal stressors (i.e. anti-bisexual discrimination from heterosexuals and from lesbians and gay men) and proximal stressors (i.e. internalized binegativity and anticipated discrimination) in sexual compulsivity among bisexual men. Sexual compulsivity disproportionately affects gay and bisexual men and confers risk of sexually transmitted infections, including HIV. A total of 942 bisexual male adults, recruited primarily from three large cities in the United States and Canada, completed online self-report surveys. Results revealed that discrimination from lesbians and gay men (but not from heterosexuals) was associated with both internalized binegativity and anticipated discrimination. Internalized binegativity and anticipated discrimination, in turn, were associated with increased sexual compulsivity. Moreover, there was a significant indirect effect of discrimination from heterosexuals and from lesbians and gay men on sexual compulsivity through anticipated discrimination. There was also a significant indirect effect of discrimination from lesbians and gay men on sexual compulsivity through internalized binegativity. Results suggest that these bisexual-specific distal and proximal minority stressors are important risk factors for sexual compulsivity. As such, treatment providers are encouraged to address these underlying risk factors in treating sexual compulsivity among bisexual men. [ABSTRACT FROM PUBLISHER]

Background:With the development of new gambling technology, and increased internet accessibility, online gambling has rapidly emerged as a new gambling market. Governments in numerous jurisdictions have moved to legalize online gambling, yet little is known about the impact of online gambling availability particularly for adolescents. To date, few studies have identified the characteristics of adolescent online gamblers and even fewer have looked at whether these characteristics differ from land-based adolescent gamblers. This study examined socio-demographic and factors associated with online gambling for adolescents and compared this to land-based gamblers to examine whether the profile of online gamblers are unique. Method:Data for the current study comes from the 2012–2013 Youth Gambling Survey (YGS) (n = 10 035) and consists of students in Grades 9 to 12 from three Canadian provinces: Newfoundland and Labrador, Ontario, and Saskatchewan. Results:Compared to adolescents who did not have a gambling problem, those who had low to moderate (OR = 2.21,p < .001) or high problem gambling severity (OR = 13.60,p < .001) were significantly more likely to gamble online. Adolescents who played free games were also significantly more likely to gamble online (OR = 2.75,p < .001). Females were significantly less likely to gamble online compared to males (OR = 0.31,p < .001). Other than gender, problem gambling severity and playing free games, when compared to land-based adolescent gamblers, the profile of online gamblers are not that different. Conclusions:Current prevention efforts for adolescents should focus on gambling across modalities. [ABSTRACT FROM PUBLISHER]

Exercise addiction has sparked a growing interest in the scientific and clinical literature, yet this behavioral addiction has mainly been investigated quantitatively, from a positivistic perspective. This article explores the subjective and embodied dimensions of exercise addiction, broadening current conceptions of this emerging, still unofficial mental health category. Building on carnal sociology, and through a thematic analysis of mobile interviews conducted with 17 self-proclaimed "exercise addicts" from Canada, this article examines the interrelations between the embodiment of exercise addiction and the normative social elements at stake in the shaping of the category, providing insights on how exercise is experienced as an addiction. Results show that most participants describe this addiction as "soft" and "positive", highlighting the virtues of exercising. However, their bodily accounts also reveal a suffering body, bringing forth the vices related to excessive exercising. Participants also put in relation the quantifiable and the sensible body, revealing the porous boundaries of this construct: exercise addiction can sometimes be regulatory in certain contexts and counternormative in others. Thus, it appears that "exercise addicts" enact various contemporary normative requirements, which vary from asceticism and body-ideals but also to the phenomenon of social and temporal acceleration. We argue that exercise addiction questions how certain behaviors, deemed potentially problematic, illustrate the tensions and complex articulations between embodying and resisting social normativity. • Exercice addiction (EA) has paradoxical effects on health and well-being. • The phenomena involves both suffering and thriving experiences. • Such behavioral addictions are inextricably tied to embodied experiences. • EA exemplifies the tensions between embodying and resisting social norms. • Mobile interviews offer innovative techniques to research embodied experiences. [ABSTRACT FROM AUTHOR]

Background: Prescription opioid (PO) injection and poly-drug use have been associated with hepatitis C virus (HCV) infection among people who inject drugs (PWID). Poly-drug use is often a barrier to key HCV preventive programmes including opioid agonist treatment. The contribution of specific drug combinations to high HCV incidence in poly-drug users has not been assessed previously. Addressing this knowledge gap could enhance HCV treatment and prevention efforts. We examined the association between specific drugs and number of drugs used in addition to injected POs, and HCV seroconversion.Methods: PWID participating in a cohort study in Montréal (HEPCO), HCV-seronegative at baseline and followed between 2004 and 2013, were included. Data were collected by interview-administered questionnaires. Blood samples were tested for HCV new infections at each 3-6 month follow-up visit. Time-varying Cox regression models were utilized.Results: Of 356 participants (81.5% males; mean age: 34.7 years), 123 (34.6%) reported injected POs in the past month at baseline. In univariate analyses, recent use of the following drugs was associated with HCV seroconversion: injected POs, injected cocaine, injected heroin, non-injected tranquilisers, and smoked crack/cocaine. The relative excess risk of HCV seroconversion due to interaction (RER1HR) was the highest for co-use of injected POs with the following substances: injected cocaine (RER1HR=3.44), smoked crack/cocaine (RER1HR=1.27), and non-injected tranquilisers (RER1HR=0.8). In addition, a significant linear trend (p<0.001) towards higher risk was observed with increasing the number of these three drugs used in combination with injected POs.Conclusion: Specific drugs and number of drugs used in addition to injected POs play a modulating role in the risk of HCV primary infection. Poly-drug use among people who inject POs has to be addressed in order to improve harm reduction programmes and reduce HCV transmission in this high-risk population. [ABSTRACT FROM AUTHOR]

Background: Until the early 2000s, people who inject drugs (PWID) in Québec had mainly been injecting powder cocaine and heroin. Since then, ethnographic studies have shown that the drug market has diversified, with crack and prescription opioids (PO) becoming increasingly available. This could have led to changes in drug use practices among PWID. The objectives of our study were to examine annual trends in injection of different drugs, crack smoking and frequent injection (FI), as well as relationships between injected drugs and FI.Methods: PWID are participants in the ongoing Québec SurvUDI surveillance system. PWID (past 6 months) were recruited in 2 urban and 6 semi-urban/rural sites. Each visit included a structured interview addressing drug use behaviours. Analyses were carried out using GEE methods. For trend analyses (2003-2014) on drugs and FI (number of injections≥upper quartile, previous month), the first annual interview was selected for PWID with multiple participations per year. Analyses on associations between FI and types of injected drugs were based on all interviews (2004-2014).Results: Crack/cocaine and heroin injection declined significantly, with prevalence ratios (PR) per year of 0.983 [95% confidence interval (CI): 0.980-0.986] and 0.979 (95% CI: 0.969-0.990), while PO injection [PR=1.052 (1.045-1.059)], crack smoking [PR=1.006 (1.001-1.012)], and FI (≥120 injections, previous month) significantly increased [PR=1.015 (1.004-1.026)]. Compared to PWID who injected crack/cocaine±other drugs, the proportion of PWID reporting FI was higher among those who injected PO+heroin/speedball, crack/cocaine or other drugs (adjusted PR 2.29; 95% CI: 2.07-2.53) or PO only (aPR 1.72; 95%CI: 1.47-2.01).Conclusions: Changes that have occurred in the drug market are reflected in PWID's practices. The high frequency of injection observed among PO injectors is of particular concern. Drug market variations are a challenge for health authorities responsible for harm reduction programs. [ABSTRACT FROM AUTHOR]

Objective: The American Psychiatric Association (APA) identified Internet gaming disorder as a new potential psychiatric disorder and has recognized that little is known about the prevalence, validity, or cross-cultural robustness of proposed Internet gaming disorder criteria. In response to this gap in our understanding, the present study, a first for this research topic, estimated the period prevalence of this new potential psychiatric disorder using APA guidance, examined the validity of its proposed indicators, evaluated reliability cross-culturally and across genders, compared it to gold-standard research on gambling addiction and problem gaming, and estimated its impact on physical, social, and mental health.Method: Four survey studies (N=18,932) with large international cohorts employed an open-science methodology wherein the analysis plans for confirmatory hypotheses were registered prior to data collection.Results: Among those who played games, more than 2 out of 3 did not report any symptoms of Internet gaming disorder, and findings showed that a very small proportion of the general population (between 0.3% and 1.0%) might qualify for a potential acute diagnosis of Internet gaming disorder. Comparison to gambling disorder revealed that Internet-based games may be significantly less addictive than gambling and similarly dysregulating as electronic games more generally.Conclusions: The evidence linking Internet gaming disorder to game engagement was strong, but links to physical, social, and mental health outcomes were decidedly mixed. [ABSTRACT FROM AUTHOR]

Background and Objective: Complete tobacco bans in mental health facilities are thought to have the potential for adverse consequences. We evaluated staff and patient attitudes and adverse events associated with implementing Canada's largest, multi-site academic psychiatric hospital tobacco ban.Methods: A total of 1,173 staff and 422 patients completed an anonymous attitudes survey at prior to implementation (baseline), and 4-6 months and 10-12 months post-implementation. The tobacco-free initiative was implemented in a phased approach, allowing the prospective measurement of changes in attitudes and adverse outcomes such as agitation over a 1-year period.Results: We observed positive changes in staff and patient attitudes toward the tobacco-free policy for both staff and patients. Moreover, there was also a statistically significant decrease in patient agitation F (2, 99) = 3.25, p = .04, but no change F (2, 21) = 1.09, p = .35 in fire-related incidents.Discussion and Conclusions: We observed positive changes in staff and patients attitudes and significant decrease in patient agitation during the first year of this tobacco-free hospital initiative.Scientific Significance: During the first year of this tobacco-free psychiatric hospital policy, implementation of a tobacco-free environment in a large mental health and addictions setting was feasible and perceived as desirable by the majority of staff and patients surveyed and a decrease in incidents related to patient agitation was also observed. Further well-controlled studies with longer study durations are warranted. (Am J Addict 2017;26:183-191). [ABSTRACT FROM AUTHOR]

As older adults continue to make up a greater proportion of the Canadian population, it becomes more important to understand the implications that their leisure activities have for their physical and mental health. Gambling, in particular, is a form of leisure that is becoming more widely available and has important implications for the mental health and financial well-being of older adults. This study examines a large sample (2103) of casino-going Ontarian adults over the age of 55 and identifies those features of their gambling participation that are associated with problem gambling. Logistic regression analysis is used to analyze the data. Focusing on types of gambling participated in and motivations for visiting the casino, this study finds that several forms of gambling and motivations to gamble are associated with greater risk of problem gambling. It also finds that some motivations are associated with lower risk of problem gambling. The findings of this study have implications related to gambling availability within an aging population. [ABSTRACT FROM AUTHOR]

Objectives: It is common practice to individualize smoking cessation pharmacotherapy based on clinical judgment and patient response. However, little has been documented about the use and outcomes of smoking cessation pharmacotherapy in real-world settings. This study examines factors associated with using smoking cessation pharmacotherapy and related outcomes among smokers with psychiatric and/or substance use disorders who completed an intensive tobacco treatment program within mental health and addiction services settings in Vancouver, Canada.Methods: A retrospective analysis was used to examine combined program participation data (N= 889) from two tobacco treatment programs (i.e., the Tobacco Dependence Clinic and the Butt Out group) between September 2007 and July 2013. Changes in smoking cessation pharmacotherapy from the initial to final treatment and seven-day point prevalence of smoking abstinence (verified by expired carbon monoxide) were assessed at the end of treatment.Results: During treatment, 60% of participants remained on the initial pharmacotherapy plan, 30% received adjunctive treatment, and 10% had treatment plans that were switched. Those whose pharmacotherapy was switched had higher cigarette consumption and nicotine dependence at baseline and were less likely to have a psychiatric disorder history. When comparing between pharmacotherapy groups, individuals who switched medications were less likely to achieve abstinence at the end of treatment as compared to those whose medication treatment plans remained the same or who received adjunctive treatment (unchanged = 36.8%, adjunctive = 38.1% vs. switched = 20.9%, χ2= 9.59,df= 2,p= .008). In multivariate regression analysis, switching pharmacotherapy was associated with lower smoking cessation (OR= .33, 95% CI [.17, .63]) and significantly mediated the effectiveness of pharmacotherapy. As there were differences in medication switching rates at the clinical level, there were limitations in assessing the impact of mental illness or substance use disorder variables.Conclusions: At least 40% of individuals may have their smoking cessation pharmacotherapy plan changed during treatment. Switching pharmacotherapy may indicate a subgroup of smokers characterized by greater challenges in smoking cessation. Our findings may enhance algorithms for using smoking cessation pharmacotherapy in clinical practice and provide directions for future research in treating tobacco use disorder among individuals with mental health and substance use disorders. [ABSTRACT FROM PUBLISHER]

Introduction: Cannabis use frequently co-occurs with gambling, and evidence indicates that both acute and chronic cannabis use may influence gambling behavior. The primary aim of the present study was to further contribute to the literature on this relationship by examining data collected from a Canadian national study of gambling.Methods: Respondents consisted of 10,054 Canadian gamblers recruited from Leger Opinion's (LEO) online panel. In this study, gamblers who used cannabis were compared with non-users across a number of gambling as well as demographic and mental health variables.Results: Of the total sample, 25.4 % reported past 12-month cannabis use. Among the 2,553 cannabis-users, 21.3 % reported daily use, and 69.9 % reported using once a month or more. A total of 56.2 % indicated they had used cannabis while gambling in the past 12 months. Bivariate analysis found significant differences between cannabis use and non-use on numerous demographic, mental health, and gambling-related variables. Individuals with greater problem gambling severity scores, more hours gambling, and a larger range of gambling activities were more likely to endorse using cannabis. Hierarchical logistic regression revealed that tobacco use, and having experienced significant child abuse were predictors of cannabis use. Non-use of cannabis was associated with older age, less engagement in online gambling, and being less likely to consume alcohol.Conclusion: The present findings both corroborate previous studies and expand upon the relationship between cannabis and gambling. [ABSTRACT FROM AUTHOR]

Gaming disorder (i.e., gaming addiction) is a relatively common mental health disorder with a worldwide prevalence rate of 3.05%. In the present research, we examined whether emotion dysregulation mediates the relation between adverse childhood experiences and problematic gaming in two samples of current video game players. The first sample consisted of 1,262 students recruited from five universities across Canada. The second sample comprised 417 community adults residing in Canada. Both samples of participants completed an online survey which included measures of adverse childhood experiences, problematic gaming, and emotion dysregulation. A total of 45.64% (n = 576) in the university sample and 49.76% (n = 205) in the community sample met the threshold for problematic gaming. In the student sample, adverse childhood experiences were positively associated with problematic gaming. In contrast, there was no significant association between adverse childhood experiences and problematic gaming in the community sample. In both samples, adverse childhood experiences were positively associated with emotion dysregulation, and emotion dysregulation was positively associated with problematic gaming. Importantly for the present research, emotion dysregulation mediated the relationship between adverse childhood experiences and problematic gaming in both the university and community sample. Although adverse childhood experiences are distal and static risk factors for problematic gaming, emotion dysregulation is a more proximal and modifiable risk factor. The results suggest that increasing adaptive emotion regulation skills may decrease the risk of problematic gaming among individuals who have experienced an adverse childhood experience. [ABSTRACT FROM AUTHOR]

This paper summarizes the degree to which different forms of legal gambling contribute to Problem and Pathological Gambling (PPG) in Canada. Legal gambling activities were compared using meta-analysis of publicly available data concerning Canada's legal gambling industry. The majority of revenues in the decade spanning 2002-2012 were drawn from Video Lottery Terminals and casino slot machines. Population surveys indicated that three quarters of Canadians reported some form of past-year gambling participation, but most did not play Electronic Gambling Machines. Annual revenues divided by estimated numbers of participants in various gambling activities showed that Video Lottery players spent more money on average than did participants in other forms of gambling. The relative risk of PPG was higher among Video Lottery players than it was for other common forms of gambling. Results from a community study of frequent Video Lottery players showed that the risk of frequent players reporting symptoms of PPG was elevated if they reported playing weekly, spending $50 or more per session, or playing for more than an hour per session. These studies provide converging evidence that Video Lottery is more hazardous to consumers than other forms of gambling that are commonly practised in Canada. [ABSTRACT FROM AUTHOR]

Background and Objectives: Despite the high prevalence of prescription opioid (PO) misuse, little is known about the phenomenon of seeking POs for nonmedical use among high-risk populations, such as people who inject drugs (PWID). We therefore sought to examine the prevalence and correlates of seeking POs from a physician for nonmedical use among PWID in Vancouver, Canada.Methods: Cross-sectional data from two open prospective cohort studies of PWID in Vancouver were collected between June 2013 and May 2014 (n = 1252). Multivariable logistic regression was used to identify factors associated with seeking POs from physicians for nonmedical use.Results: Of 1252 participants, 458 individuals (36.6%) reported ever trying to get a PO prescription from a physician for nonmedical use and, of these, 343 (74.9%, comprising 27.4% of the total sample) reported ever being successful. Variables independently and positively associated with PO-seeking behavior included older age (adjusted odds ratio [AOR] = 1.02), Caucasian ethnicity (AOR = 1.38), having ever overdosed (AOR = 1.32), having ever participated in methadone maintenance therapy (AOR = 1.90), having ever dealt drugs (AOR = 1.65), and having ever been refused a prescription for pain medication (AOR = 2.02) (all p < .05).Discussion and Conclusions: We observed that PO-seeking behavior was common among this sample of PWID and associated with several markers of higher intensity drug use.Scientific Significance: Our findings highlight the need to identify evidence-based public health and clinical strategies to mitigate PO misuse among PWID without compromising care for PWID with legitimate medical concerns. (Am J Addict 2016;25:275-282). [ABSTRACT FROM AUTHOR]

Concepts of addiction differ across time and place. This article is based on an international research project currently exploring this variation and change in concepts of addiction, in particular in the field of alcohol and other drug (AOD) use. Taking AOD policy in Australia and Canada as its empirical focus, and in-depth interviews with policy makers, service providers and advocates in each country as its key method (N=60), the article compares the addiction concepts articulated by professionals working in each setting. Drawing on Bruno Latour's theoretical work on the body and his proposal for a better science based on the 'articulation of differences', it explores the accounts of addiction offered across the Australian and Canadian project sites, identifying a shared dynamic in all: the juggling of difference and unity in discussions of the nature of addiction, its composite parts and how best to respond to it. The article maps two simultaneous trajectories in the data - one moving towards difference in participants' insistence on the multitude and diversity of factors that make up addiction problems and solutions, and the other towards unity in their tendency to return to narrow disease models of addiction in uncomfortable, sometimes dissonant, strategic choices. As I will argue, the AOD professionals interviewed for my project operate in two modes treated as distinct in Latour's proposal: in turning to reifying disease labels of addiction they take for granted, and work within, a 'universe of essences', but in articulating the multiplicity and diversity of addiction, they grope towards a vision of a 'multiverse of habits'. The article concludes by addressing this tension directly, scrutinising its practical implications for the development of policy and delivery of services in the future, asking how new thinking, and therefore new opportunities, might be allowed to emerge. [ABSTRACT FROM AUTHOR]

Background: Preventing injection drug use among vulnerable youth is critical for reducing serious drug-related harms. Addiction treatment is one evidence-based intervention to decrease problematic substance use; however, youth frequently report being unable to access treatment services and the impact of this on drug use trajectories remains largely unexplored. This study examines the relationship between being unable to access addiction treatment and injection initiation among street-involved youth.Methods: Data were derived from the At-Risk Youth Study (ARYS), a prospective cohort of street-involved youth aged 14-26 who use illicit drugs, from September 2005 to May 2014. An extended Cox model with time-dependent variables was used to identify factors independently associated with injection initiation.Results: Among 462 participants who were injection naïve at baseline, 97 (21 %) initiated injection drug use over study follow-up and 129 (28 %) reported trying but being unable to access addiction treatment in the previous 6 months at some point during the study period. The most frequently reported reason for being unable to access treatment was being put on a wait list. In a multivariable Cox regression analysis, being unable to access addiction treatment remained independently associated with a more rapid rate of injection initiation (Adjusted Hazard Ratio =2.02; 95 % Confidence Interval: 1.12-3.62), after adjusting for potential confounders.Conclusion: Inability to access addiction treatment was common among our sample and associated with injection initiation. Findings highlight the need for easily accessible, evidence-based addiction treatment for high-risk youth as a means to prevent injection initiation and subsequent serious drug-related harms. [ABSTRACT FROM AUTHOR]

The legislation of health warning labels on cigarette packaging is a major focus for tobacco control internationally and is a key component of the World Health Organization’s Framework Convention on Tobacco Control. This population-level intervention is broadly supported as a vital measure for warning people about the health consequences of smoking. However, some components of this approach warrant close critical inspection. Through a qualitative content analysis of the imagery used on health warning labels from 4 countries, we consider how this imagery depicts people that smoke. By critically analyzing this aspect of the visual culture of tobacco control, we argue that this imagery has the potential for unintended consequences, and obscures the social and embodied contexts in which smoking is experienced. [ABSTRACT FROM AUTHOR]