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Objectives. We examined the roles of gender and poverty in cigarette use and nicotine dependence among adults in the United States. Methods. Our data were drawn from the 2001-2002 National Epidemiological Survey of Alcoholism and Related Conditions, a nationally representative sample of US adults 18 years and older. Results. The overall rate of cigarette use declined between 1964 and 2002. Nicotine dependence does not appear to have declined overall, and there is evidence that nicotine dependence has increased among women in recent cohorts. The odds of nicotine dependence among cigarette users appear to have increased significantly in recent cohorts. Conclusions. Despite recent declines in cigarette use, the prevalence of nicotine dependence has increased among some groups and has remained steady overall, which may be hampering public health initiatives to reduce cigarette use. Efforts to study or curb cigarette use should therefore take nicotine dependence into account. (doi:10.2105/AJPH.2007.127886)

Objectives. We sought to study the association between adverse events occurring in childhood and adolescence and lifetime alcohol dependence in a representative sample of American adults. Methods. With data from the National Epidemiologic Survey on Alcohol and Related Conditions, we conducted logistic regression multivariate analyses to examine the impact of adverse events occurring in childhood (aged Results. Adverse childhood events were associated with familial alcoholism and with early and binge drinking, and therefore, we controlled for these potential confounders. Experiencing 2 or more adverse childhood events, compared with none, significantly increased the risk for alcohol dependence, even after we controlled for sociodemographic variables and disorder-specific potential confounders not considered in the extant literature (adjusted odds ratio = 1.37; 95% confidence interval = 1.06, 1.77). Conclusions. Individuals who experienced 2 or more adverse childhood events are at increased risk for lifetime alcohol dependence. A better understanding of the factors underlying the risk for alcohol dependence is important for developing better prevention and early intervention measures. (Am J Public Health. 2009;99:258-263. doi:10.2105/AJPH.2008.139006)

Objective: Among the general population, co-use of opioids and sedatives is associated with greater risk of overdose compared with opioid use alone. National Football League (NFL) retirees experience higher rates of opioid use than the general population, although little is known about their co-use with sedatives. The aim of this study was to examine the prevalence and risk factors of opioid and sedative co-use among NFL retirees. Design: Retrospective cohort study. Setting: Professional American football. Participants: NFL retirees (N = 644). Independent Variables: Self-reported concussions, pain intensity, heavy alcohol use, physical and mental health impairment, disability status. Main Outcome Measure: Any past 30-day co-use of opioids and sedatives. Results: Approximately 4.9% of the sample reported past 30-day co-use of opioids and sedatives, although nearly 30% of retirees using opioids also used sedatives. Greater pain was associated with co-use of opioids and sedatives (adjusted odds ratios [aOR] = 1.58; 95% confidence interval [CI] = 1.23-1.98), although retirees with moderate/severe mental health impairment (vs none/mild; aOR = 2.47; 95% CI = 1.04-5.91) and disability (vs no disability; aOR = 1.35; 95% CI = 1.05-1.73) demonstrated greater odds of co-use compared with retirees not using either substance. Conclusions: Given the high rate of sedative use among participants also using opioids, NFL retirees may be susceptible to the negative health consequences associated with co-use. Interventions focused on improving pain and mental health may be especially effective for reducing co-use of these substances among NFL retirees. [ABSTRACT FROM AUTHOR]

Objectives. We examined the effects of exposure to or interpersonal loss resulting from a terrorist attack on posttraumatic stress and alcohol consumption after we controlled for psychiatric history assessed before the attack. Methods. At baseline (1991-1992) and at 1- and 10-year follow-ups, an adult community sample of drinkers living approximately 12 mi (19.2 km) from the World Trade Center were evaluated for alcohol dependence and major depression. Of this group, 82.2% were assessed regarding the impact of the September 11, 2001, attacks, including proximity to the World Trade Center, interpersonal loss, posttraumatic stress, and alcohol consumption. Results. In regression models, interpersonal loss and past major depression, but not proximity to the World Trade Center, predicted posttraumatic stress symptoms. Proximity and past alcohol dependence, but not interpersonal loss, predicted high levels of post--September 11 alcohol consumption. Past alcohol dependence did not modify the proximity-drinking relationship, and past major depression did not modify the loss--posttraumatic stress relationship. Conclusions. Participants' responses to September 11 were specific to their type of exposure and not predetermined by their psychiatric history. A better understanding of responses to traumatic events should assist more-effective prevention and intervention efforts.

Objectives. We investigated the consequences of exposure to acts of terrorism among Israeli adolescents. We examined Whether exposure to terrorism predicted adolescents' use of cigarettes, alcohol (including binge drinking), and cannabis after we controlled for posttraumatic stress and depressive symptoms and background variables. Methods. Anonymous self-administered questionnaires were given to a random sample of 960 10th and 11th grade students (51.6% boys, 48.4% girls) in a large city in northern Israel. Results. Close physical exposure to acts of terrorism predicted higher levels of alcohol consumption (including binge drinking among drinkers) and cannabis use. These relationships remained even after we controlled for posttraumatic stress and depressive symptoms. Conclusions. In addition to posttraumatic stress symptoms, negative consequences of terrorism exposure among adolescents included substance abuse. The similarity between our findings among Israeli adolescents and previous findings among US adults suggests cross-cultural generalizability. Given the risks for later problems from early-onset substance abuse, the consequences of terrorism exposure among adolescents merit greater research and clinical attention. (Am J Public Health. 2007;97:1852-1858. doi:10.2105/AJPH.2006.090514)

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2005.04.001 Byline: Kenneth M. Carpenter (a), Xinhua Liu (b), Deborah S. Hasin (c) Keywords: Alcohol dependence; Type I-Type II; Subtype Abstract: The Type A-Type B multidimensional classification model has been useful for identifying a subgroup of alcohol dependent drinkers with more severe psychosocial problems and a poor prognosis. Evidence suggests its dimensions may be useful for identifying problem drinkers in the general population at risk for developing alcohol dependence. To date, the model has not yet been investigated for this purpose. The present study investigated the Type A/Type B distinction in a community sample of problem drinkers as well as its predictive validity among problem drinkers with no history of alcohol dependence. Author Affiliation: (a) Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, 1051 Riverside Drive, Box 120, New York, NY 10032, United States (b) Joseph L. Mailman School of Public Health, Columbia University, New York State Psychiatric Institute, United States (c) Joseph L. Mailman School of Public Health and College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, United States

Objectives. We examined risk factors for long-term homelessness among newly homeless men and women who were admitted to New York City shelters in 2001 and 2002. Methods. Interviews were conducted with 377 study participants upon entry into the shelter and at 6-month intervals for 18 months. Standardized assessments of psychiatric diagnosis, systoms, and coping skills; social and family history; and service use were analyzed. Kaplan-Meier survival analysis and Cox regression were used to examine the association between baseline assessments and duration of homelessness. Results. Eighty-one percent of participants returned to community housing during the follow-up period; the meridian duration of homelessness was 190 days. Kaplan-Meier survival analysis showed that a shorter duration of homelessness was associated with younger age, current or recent employment, earned income, good coping skills, adequate family support, absence of a substance abuse treatment history, and absence of an arrest history. Cox regression showed that older age group (P Conclusions. Identification of risk factors for long-term homelessness can guide efforts to reduce lengths of stay in homeless shelters and to develop new preventive interventinos. (Am J Public Health. 2005;95: 1753-1759. doi: 10.2105/AJPH. 2005.063321)

This article examines the relationship between motivation to change and treatment effectiveness in substance abuse treatment programs. The authors, employing the DSM-IV hierarchical diagnostic scale to determine levels of abuse severity, maintain alcohol use severity has a direct positive effect on motivation to change at treatment entry, however, alcohol and cocaine use severity is not related to motivation to change during treatment utilization.

This article examines the psychometric properties of an assessment instrument designed to measure the severity of substance abuse disorders in relation to diagnoses from the World Health Organization's International Classification of Disease. Findings indicate that this assessment is both a valid and reliable measure of chemical dependency and diagnostic severity.