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Objectives. To examine trends in young adult self-reported driving under the influence of alcohol (DUI-A), cannabis (DUI-C), and simultaneous alcohol and cannabis use (DUI-AC) in a state with legalized nonmedical cannabis use from before to during the COVID-19 pandemic. Methods. We used logistic regression and annual statewide data from the Washington Young Adult Health Survey to assess DUI behaviors from 2016 to 2021. Results. Both prepandemic yearly changes in prevalence and deviations from those trends during the pandemic years were small and not statistically significant. However, prevalence estimates were alarming: 12.0% of participants reported DUI-A, 12.5% reported DUI-C, and 2.7% reported DUI-AC. Exploratory moderation analyses indicated a relative increase in DUI-A during 2020 among 4-year college students relative to young adults not attending 4-year colleges. Conclusions. Young adults in Washington State continued to engage in risky DUI behaviors during the pandemic. College students may have increased their likelihood of DUI-A during COVID-19. Public Health Implications. Young adults, for whom vehicle crashes remain a leading cause of death, showed little change in DUI behaviors during the COVID-19 pandemic. There is continued need for young adult DUI prevention efforts. ( Am J Public Health . 2024;114(S8):S698-S701. https://doi.org/10.2105/AJPH.2024.307767).

Objective: Alcohol expectancies are beliefs people have about the likelihood of experiencing various positive or negative consequences related to alcohol use. Expectancies have most commonly been treated as traitlike characteristics of individuals, but some researchers have assessed expectancies as state-level characteristics that vary within persons across days. Previous work developed a 13-item daily alcohol expectancies measure. This study evaluated an expanded version of that measure that includes 10 additional expectancy items., Method: Participants were 2- and 4-year college students ( N = 201; 63.7% female; 55.2% White non-Hispanic; 75.1% 4-year students) randomized to the control group of a longitudinal study designed to test the efficacy of a just-in-time adaptive intervention delivered via mobile app to reduce high-risk alcohol use. Multilevel exploratory factor analysis was used to determine the factor structure at the daily and person levels. Multilevel models were used to evaluate the convergent validity of the resulting subscales., Results: Two factors, broadly representing positive and negative alcohol expectancies, were retained at the daily and person levels. Composite reliability (omega) estimates ranged from .85 to .96 and suggested that the reliability of the resulting subscales was good to strong. Associations between the daily expectancy subscales and baseline scores on an established expectancies measure provided preliminary evidence of convergent validity., Conclusions: Findings indicate that this expanded 23-item daily alcohol expectancies measure is psychometrically sound. This measure is appropriate for use in daily or just-in-time expectancy challenge interventions. It is suitable for use among 2- and 4-year college students who drink alcohol regularly and occasionally in heavy quantities and who experience alcohol-related negative consequences., Competing Interests: The authors have no conflicts of interest to report.

Objective: It is unknown whether age-related decreases in substance use (maturing out) are observed in the legalized cannabis context. This study evaluated age-related changes in past-month alcohol use frequency, cannabis use frequency, and any simultaneous alcohol and marijuana/cannabis (SAM) use among young adults who engaged in the respective substance use behavior., Method: Young adults, residing in Washington State at enrollment (N=6,509; 68.3% female; ages 18-25), provided 3-5 years of annual data in a longitudinal, cohort-sequential design from 2015 to 2019, a period after nonmedical cannabis was legalized and implemented. Multilevel growth models were conducted; post-stratification weights were applied to make the sample more similar to the Washington young adult general population in demographic characteristics., Results: Among those who reported alcohol use at 1+ timepoints, days of alcohol use increased from age 18 to approximately age 25 and then decreased until age 30. Among those who reported cannabis use at 1+ timepoints, days of cannabis use increased from age 18 until approximately age 23 and then decreased until age 30. Among those who reported SAM use at 1+ timepoints, the probability of SAM use increased from age 18 until approximately age 24 and then decreased until age 30. Age-related changes in SAM use were largely explained by concurrent changes in alcohol and cannabis use frequency., Conclusions: Maturing out was observed for alcohol, cannabis, and SAM use among those who used each respective substance, with evidence that age-related changes in SAM use were tied to alcohol and cannabis use frequency.

This paper presents a 10-channel, 120 nW/channel, reconfigurable capacitance-to-digital converter (CDC) enabling sub- μW wearable sensing applications. The proposed multi-channel architecture supports 10 channels with a shared reconfigurable 6-bit differential analog-to-digital converter (ADC). The reconfigurable nature of the CDC enables adaptive sensing range and sensing speed based on the target application. Furthermore, the architecture performs both on/off-chip parasitic correction and baseline calibration to measure the change in capacitance ( ∆C), excluding baseline and parasitic capacitances. The experimental results show the measurement range of ∆C are 5.34 pF for 1x sensitivity and 1.8 pF for 3x sensitivity respectively. The capacitive divider-based architecture excludes power-hungry operational trans-impedance amplifiers for capacitance to voltage conversion, and the architecture supports programmable channel access to activate or deactivate each channel independently. The random interrupt protection logic avoids any broken sample or data error in a sampling window. Additionally, the channel monitoring logic helps keep track of specific channel information. The measured silicon result shows a total power consumption of 1.2 μW for 1.6 kHz sampling frequency when driven by a 32 kHz clock, which is 8.6x less than prior works. The CDC is also tested with DMMP (dimethyl-methylphosphonate) gas sensor in gas chromatography (GC). Implemented in 65 nm CMOS process, the 10-channel CDC occupies 0.251 mm 2 of active area (0.0251 mm 2 /Ch).

Motor vehicle crashes are a leading cause of death for young adults (YA) in the USA, and driving under the influence of alcohol (DUIA), cannabis (DUIC), and simultaneous use of both substances (DUIAC) are prominent risk factors. Trends in YA impaired driving behaviors after opening of cannabis retail stores have been understudied. We examined YA trends in DUIA, DUIC, and DUIAC from immediately prior through 5 years following the opening of cannabis retail outlets in Washington State (2014-2019). Differences in trends were assessed across age, sex, and urbanicity. Weighted logistic regressions assessed yearly change in prevalence of DUIA, DUIC, and DUIAC from 2014 to 2019, using annual statewide data from the Washington Young Adult Health Survey (n = 12,963; ages 18-25). Moderation of trends by age, sex, and urbanicity was assessed. Prevalence of DUIA decreased overall (AOR = 0.93, 95% CI 0.90, 0.97) and among drinkers (AOR = 0.95, 95% CI 0.91, 0.99) but remained at concerning levels in 2019 (10% overall; 16% among drinkers). Overall DUIC did not change significantly (AOR = 0.99, 95% CI 0.96, 1.03; 11% by 2019) but decreased among those who used cannabis (AOR = 0.91, 95% CI 0.86, 0.96; 33% by 2019). DUIAC decreased but not significantly (overall: AOR = 0.89, 95% CI 0.78, 1.01; those who used alcohol and cannabis: AOR = 0.84, 95% CI 0.74, 1.04). Prevalence of YA DUI remained concerning. Trends may reflect some success in reducing DUI, but additional detection and prevention are needed., (© 2024. Society for Prevention Research.)

Most young adults naturally mature out of high-risk substance use patterns, but it is important to identify factors that may impede normative declines. Use of alcohol and cannabis simultaneously (i.e., simultaneous alcohol and marijuana/cannabis [SAM]) is cross-sectionally associated with alcohol and cannabis concerns, and SAM use increases acute risks at the daily level. However, less is known about long-term risks of SAM use and, specifically, how SAM use relates to maturing out of alcohol and cannabis use. Using four consecutive years of survey data from young adults who reported SAM use ( N =409; 1636 responses; aged 18-25 at baseline), we first estimated age-related changes in symptoms of alcohol and cannabis use disorder (AUD/CUD) using multilevel growth modeling. Findings supported a maturing out process, as both AUD and CUD symptom severity significantly declined across young adulthood, on average (4 % and 5 % per year respectively, with significant acceleration). Cross-level interactions tested whether participants' mean SAM use frequency across all four timepoints moderated age-related trajectories in AUD/CUD symptom severity. Significant interactions indicated that, relative to less-frequent SAM use, participants with more frequent SAM use showed less steep declines in AUD (1 % decrease per year vs. 6 % per year) and CUD symptoms (0 % decrease per year vs. 7 % per year); thus, SAM frequency was associated with slower/delayed maturing out of hazardous alcohol and cannabis use. Findings highlight that SAM use may be a correlate or risk-factor for prolonged high-risk substance use during young adulthood that relates to deviations from maturing out processes., Competing Interests: The authors have no conflicts of interest to disclose., (© 2024 The Author(s).)

This paper presents a tri-modal self-adaptive photoplethysmography (PPG) sensor interface IC for concurrently monitoring heart rate, SpO 2 , and pulse transit time, which is a critical intermediate parameter to derive blood pressure. By implementing a highly-reconfigurable analog front-end (AFE) architecture, flexible signal chain timing control, and flexible dual-LED drivers, this sensor interface provides wide operating space to support various PPG-sensing use cases. A heart-beat-locked-loop (HBLL) scheme is further extended to achieve time-multiplexed dual-input pulse transit time extraction based on two PPG sensors placed at fingertip and chest. A self-adaptive calibration scheme is proposed to automatically match the chip's operating point with the current use case, guaranteeing a sufficient signal-to-noise ratio for the user while consuming minimum system power. This paper proposes a DC offset cancellation (DCOC) approach comprised by a logarithmic transimpedance amplifier and an 8-bit SAR ADC, achieving a measured 38 nA residue error and 8.84 μA maximum input current. Fabricated in a 65nm CMOS process, the proposed tri-modal PPG sensor interface consumes 2.3-5.7 μW AFE power and 1.52 mm 2 die area with 102dB (SpO 2 mode), 110-116 dB (HR & PTT mode) dynamic range. A SpO 2 test case and a HR & PTT test case are both demonstrated in the paper, achieving 18.9 μW and 43.7 μW system power, respectively.

The COVID-19 pandemic has led to unprecedented life disruptions among young adults, including increased job insecurity and financial strain. Mental health problems and substance use have also increased during the pandemic, with young adults particularly vulnerable to experiencing these challenges. This study examines trajectories of financial distress among young adults during the pandemic and their associations with depression, anxiety, and hazardous alcohol and cannabis use. Data from 473 young adults (ages 22-29) recruited in the Northwest United States were collected from April/May 2020 to July/August 2021. Financial distress trajectories were identified using growth mixture modeling. Negative binomial models were used to examine associations between financial distress trajectories and distal outcomes of depression, anxiety, alcohol, and cannabis use. Three distinct trajectories were identified, revealing Low, Moderate, and High financial distress experiences. Individuals with "Moderate" and "High" trajectories showed significantly greater depressive and anxiety symptom scores compared with those in the "Low" financial distress trajectory group. Trajectories were not associated with subsequent levels of alcohol or cannabis use. Young adult mental health remains a priority during periods of economic downturn. Providers must be aware of the psychological challenges imposed by financial distress among young adults to address worsening mental health symptoms., (© 2023 International Association of Applied Psychology.)

Young adulthood is a developmental period during which individuals experience shifts in their social roles in various domains, which coincides with a period of time that is also high risk for lifetime peaks in alcohol use. The current study examined age-related changes in heavy episodic drinking (HED) and high-intensity drinking (HID) and associations with short-term (i.e., monthly) variation in young adults' social roles over a 2.5-year period in a community sample of young adults who reported past-year alcohol use (N = 778, baseline age range 18-23). Results showed probabilities of past-month HED and HID changed in a nonlinear fashion across ages 18-26 with greater probabilities of use at younger ages. Most participants did not report being in the same social role status every sampled month, underscoring the presence of short-term role variation. Living with parents and being in a serious romantic relationship in a given month were negatively associated with past-month HED. Living with parents in a given month was also negatively associated with past-month HID. Being a 4-year college student and being employed full-time in a given month were not significantly related to either outcome. Findings provided partial evidence that monthly statuses were associated with heavy drinking. Several avenues for future research are described in light of the findings., (© 2024 Society for Research on Adolescence.)

Objective: We examined age-varying associations between young adult simultaneous alcohol and marijuana/cannabis use (SAM) and heavy episodic drinking (HED) and positive and negative affect to inform harm reduction efforts., Methods: Young adults reporting past-year alcohol use (n = 556; ages 19-25) were recruited in a state where alcohol and nonmedical cannabis use was legal for those 21 +. Participants provided 24 repeated monthly assessments. Among those reporting past-month cannabis use on at least one survey, logistic time-varying effect models estimated (1) the age-varying prevalence of and associations between past-month SAM and HED and (2) age-varying unique associations of affect with SAM and HED., Results: There was a positive age-varying association between HED and SAM over time that was highest at age 19 (OR = 7.56), decreased until age 20.7 (OR = 3.39), increased until age 23.0 (OR = 4.85), and decreased until the association became non-significant by age 25. Negative affect was positively associated with SAM from ages 20.7 to 23.0, peaking at age 21.8 (OR = 1.36). Positive affect was positively associated with HED from ages 19.4 to 20.4 (peak OR = 1.25) and ages 22.5 to 24.5 (peak OR = 1.38). In contrast, positive affect was not uniquely associated with SAM nor negative affect with HED across ages 19-25., Conclusions: While HED and SAM were positively associated throughout young adulthood and interventions could target them in tandem, their associations with affect suggest differential etiologic processes. Preventive intervention and harm reduction efforts should attend to psychological context in which these behaviors occur., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Emerging research suggests morning cannabis use may be associated with using more cannabis and experiencing more cannabis-related consequences. This paper examined whether months when young adults reported morning cannabis use (use between 6:00AM and 12:00PM) were associated with cannabis use frequency, negative cannabis-related consequences, and changes in cannabis use disorder (CUD) symptoms., Methods: Participants were 778 young adults (M age =21.11 years, 58.5% female) enrolled in a longitudinal study on substance use and social role transitions. Eligible participants were 18-23 years old at screening and reported past-year alcohol use. Participants completed a baseline survey, 24 consecutive monthly surveys, and a follow-up survey 30 months after baseline. Aims were tested using multilevel models and multiple regression., Results: Analyses were limited to cannabis use months (N=4719; 28.9% of sampled months) and participants who reported cannabis use at least once (N=542; 69.7% of all participants). Morning use was reported in 12.3% of cannabis use months and at least once by 23.6% of participants who reported using cannabis. Relative to non-morning use months, morning use months were associated with greater cannabis use frequency and more negative consequences. However, the association between morning use and negative consequences was not statistically significant after controlling for cannabis use frequency. The percentage of cannabis use months with morning use was positively associated with increased CUD symptoms at the 30-month follow-up, relative to baseline., Conclusions: Morning cannabis use may be a useful marker of high-risk cannabis use and may contribute to the maintenance and worsening of CUD over time., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest., (Copyright © 2024. Published by Elsevier B.V.)

Morning cannabis use is associated with heavier, frequent cannabis use and more cannabis-related negative consequences, yet little empirical research has examined its predictors. Using 24 months of longitudinal data, the present study tested demographic, psychosocial, and behavioral predictors of morning cannabis use among young adults at the monthly- and person-levels. Young adults (N = 778) were part of a larger study on substance use and social role transitions; participants completed a baseline survey and up to 24 consecutive monthly surveys. Hypotheses were tested using logistic multilevel models to estimate odds ratios for any vs. no morning use in a given month. At the monthly level, social anxiety motives and cannabis use frequency on a given month were positively associated with morning cannabis use. At the person level, typical coping motives, average cannabis use frequency, and male sex were positively associated with morning cannabis use. Findings advance our understanding of individual and psychosocial predictors of morning cannabis use among young adults. Notably, social anxiety motives may represent a malleable target for intervention efforts that could reduce risky use patterns associated with morning use. Such efforts may be especially prudent for young men, as our findings indicated morning cannabis use probabilities were much higher for men than women., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Context: Public health policy can play an important role in improving public health outcomes. Accordingly, there has been an increasing emphasis by policy makers on identifying and implementing evidence-informed public health policy interventions., Program or Policy: Growth and refinement of the field of research assessing the impact of legal interventions on health outcomes, known as legal epidemiology, prompted this review of studies on the relationship between laws and health or economic outcomes., Implementation: Authors systematically searched 8 major literature databases for all English language journal articles that assessed the effect of a law on health and economic outcomes published between January 1, 2009, and September 18, 2019. This search generated 12 570 unique articles 177 of which met inclusion criteria. The team conducting the systematic review was a multidisciplinary team that included health economists and public health policy researchers, as well as public health lawyers with expertise in legal epidemiological research methods. The authors identified and assessed the types of methods used to measure the laws' health impact., Evaluation: In this review, the authors examine how legal epidemiological research methods have been described in the literature as well as trends among the studies. Overall, 3 major themes emerged from this study: (1) limited variability in the sources of the health data across the studies, (2) limited differences in the methodological approaches used to connect law to health outcomes, and (3) lack of transparency surrounding the source and quality of the legal data relied upon., Discussion: Through highlighting public health law research methodologies, this systematic review may inform researchers, practitioners, and lawmakers on how to better examine and understand the impacts of legal interventions on health and economic outcomes. Findings may serve as a source of suggested practices in conducting legal epidemiological outcomes research and identifying conceptual and method-related gaps in the literature., Competing Interests: The authors have indicated that they have no potential conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Exposure to media with alcohol-related content is a known risk for alcohol use and related harms among young people. The present study used longitudinal self-report data on exposure to media with alcohol-related content to examine age trajectories across young adulthood and to estimate associations with heavy episodic drinking (HED) and negative consequences., Method: Participants were 201 high-risk young adults enrolled in 2- and 4-year colleges (ages 18-25 at screening; 63.7% female). Repeated assessments occurred at four timepoints across a 12-month period., Results: Self-reported exposure to both positively and negatively portrayed alcohol-related media content decreased with age. Between-persons, controlling for alcohol use frequency, exposure to positive alcohol-related media content was positively associated with HED, and exposure to negative alcohol-related media content was inversely associated with HED; no within-person effects on HED were significant. For negative consequences, controlling for alcohol quantity, exposure to positive media content was associated with more negative consequences both between- and within-persons. Unexpectedly, exposure to negatively portrayed media content was positively associated with negative consequences at the within-person level., Discussion and Conclusions: Trajectories in exposure to media with alcohol-related content showed that relatively younger participants reported greater exposure, highlighting the need for policy and prevention efforts to protect this vulnerable demographic. Findings generally indicated that positive portrayals of alcohol use increase alcohol-related risks. Moreover, increased exposure to negative portrayals in a given assessment was associated with more negative consequences-potentially by normalising or glorifying high-risk drinking and consequences, though mechanistic/causal research is needed., (© 2023 Australasian Professional Society on Alcohol and other Drugs.)

This article presents a fully autonomous system-on-chip (SoC) that can be distributed along a fiber strand, capable of simultaneously harvesting energy, cooperatively scaling performance, sharing power, and booting-up with other in-fiber SoCs for ultra-low-power (ULP) sensing applications. Utilizing a custom switched capacitor energy harvesting and power management unit (EHPMU), the SoC can efficiently redistribute and reuse harvested energy along the fiber. Integrated on-chip, the ULP RISC-V digital core and temperature sensor enable energy-efficient sensing and computation at nanowatt power levels. A dedicated ripple boot-up and cooperative dynamic voltage and frequency scaling (DVFS) further optimize the operation and physical size of the system. Fabricated in 65 nm, measurement results show that the proposed SoC achieves 33 nW power consumption for the whole chip under 92 Lux lighting condition and can reduce control power down to 2.7 nW for the EHPMU. With the proposed power sharing and cooperative DVFS techniques, the SoC reduces the illuminance needed to stay alive by >7× down to 12 Lux. Integrated into a mm-scale polymer fiber, our SoC demonstrates the feasibility of fully autonomous and ULP on-body sensing systems in resource-constrained fiber environments.

Objective: Experiencing negative substance use consequences may deter future use, alter patterns of substance use (e.g., substituting one substance for another, combining substances), or point to a sustained pattern of engaging in heavy or frequent use. We used monthly data to examine relationships between negative alcohol and cannabis use consequences experienced in one month and changes in use the following month., Method: Data were from 508 individuals (59% female; ages 18-23 years at enrollment) who were surveyed monthly for 2 years and used both alcohol and cannabis during the study period. Multilevel models assessed within-person associations between monthly fluctuations in substance-related negative consequences and the next month's substance use (i.e., typical drinks per week, cannabis use frequency, and simultaneous alcohol and cannabis/marijuana [SAM] use), controlling for the prior month's substance use., Results: Positive associations were found between alcohol consequences and the following month's alcohol use and between cannabis consequences and subsequent cannabis use, although only the cannabis association was statistically significant. There was little evidence of effects of cannabis consequences on the next month's alcohol use or alcohol consequences on the next month's cannabis use. Cannabis consequences had a positive and statistically significant association with the next month's SAM use. Within-substance positive associations were strongest for physical alcohol consequences and cannabis consequences of low motivation, memory problems, and trouble breathing., Conclusions: Experiencing negative cannabis use consequences predicted more frequent cannabis use and greater chance of SAM use 1 month later. Results point to negative consequences, along with prior use, indicating risk for future use.

Background: Simultaneous alcohol and marijuana (SAM) use has been associated with greater alcohol use and consequences at the daily level, but limited research has examined SAM use in relation to marijuana use and its consequences. This study tested daily associations between SAM use and four outcomes: alcohol use (number of drinks), marijuana use (hours high), negative alcohol consequences, and negative marijuana consequences., Methods: A community sample of young adults [ages 18-25, mean (SD) = 21.61 (2.17) years] with recent alcohol and SAM use was recruited (N = 409; 50.9% female; 48.2% non-Hispanic/Latinx White). Participants completed a baseline survey and six 2-week bursts of daily surveys (81.1% of morning surveys completed) and reported on substance use and negative substance-related consequences. Multilevel modeling was used to test the main aims and to explore each specific consequence., Results: Among days with any alcohol use, SAM use days were associated with consuming more drinks and experiencing more total negative alcohol-related consequences than non-SAM use days. Among days with any marijuana use, SAM use days were associated with more hours being high than non-SAM use days. Exploratory models showed that SAM use was related to five specific alcohol-related consequences and two specific marijuana-related consequences., Conclusions: These findings build upon prior research by showing that SAM use days are linked to consuming more drinks, reporting more hours being high from marijuana, and experiencing more total alcohol-related consequences even after controlling for the number of drinks, the number of hours high, any tobacco/nicotine use, and any other substance use. SAM use was also associated with a greater likelihood of experiencing some specific consequences related to alcohol and marijuana. The findings underscore the need for additional research on SAM use and marijuana-related outcomes., (© 2023 Research Society on Alcohol.)

We examined patterns of longitudinal trajectories of loneliness during the COVID-19 pandemic using six time points (January 2020 [pre-pandemic] to March/April 2021) and whether trajectories were associated with psychological distress (depression/anxiety) and substance use (alcohol/cannabis) outcomes in Spring 2021. Participants were 644 young adults who completed online assessments. Outcomes were regressed on most-likely loneliness trajectory adjusting for pre-pandemic measures. Three loneliness trajectories varied from consistently lower to consistently higher. Pre-pandemic social support was associated with lower odds of a higher loneliness trajectory. Higher loneliness trajectories were associated with greater odds of past-month cannabis use compared to Low trajectories, but not significantly associated with depression, anxiety, or alcohol use in Spring 2021. Interventions addressing co-occurring loneliness and cannabis use are needed., (© 2023 Society for Research on Adolescence.)

Prior research suggests that higher trait negative emotion differentiation (NED; one's ability to make subtle distinctions between different negative emotional states) is associated with consuming less alcohol when experiencing high negative affect (NA) in daily life. Yet, whether these findings extend to cannabis use behaviors is unclear. The present study used intensive daily data to test whether NED moderated the relationship between NA and cannabis behaviors. A community sample of 409 young adults who used alcohol and cannabis completed a baseline survey and five 2-week bursts of online surveys across two years. Multilevel models tested cross-level interactions between trait NED (person-level) and daily NA (daily-level) predicting cannabis use, hours high, negative consequences, craving, and coping motives. In contrast to expectations, on days with higher reported NA, people with higher NED (compared to those with lower NED) had a greater likelihood of experiencing any cannabis craving, experienced more intense craving, and reported higher cannabis coping motives. NED x NA interaction was not significant for likelihood of cannabis use, hours high, or negative consequences. Post-hoc descriptive analyses suggest notable person-specific heterogeneity in these findings. Individuals with higher ability to differentiate between negative emotions reported higher coping motives and craving when experiencing higher NA. However, these associations were variable for individuals within the sample. It may be that high NED individuals crave and purposefully use cannabis to reduce NA states. Findings are inconsistent with the alcohol literature and have important implications for intervention efforts aimed at reducing coping-motivated cannabis use among young adults., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Laws regarding cannabis are rapidly changing in the USA as more states legalize nonmedical cannabis for adults aged 21 and older. Previous research has examined whether legalization has led to an increase in cannabis use as well as the use of other substances. The current study examined changes in cannabis- and alcohol-specific risk factors following legalization of nonmedical cannabis. We used 6 years of annual cross-sectional data (2014-2019) from 12,951 young adults age 18 to 25 who resided in Washington state. Risk factors examined include perceiving that use was common among same-age peers, believing use was acceptable, having easy access, and low perceived physical and psychological harm from use. Logistic regression models estimated annual rate of increase in these risk factors. All cannabis-specific risk factors increased among those aged 21+ (range of ORs for annual rate of change: 1.07-1.31) while significant increase in cannabis-related risk factors among those under age 21 was limited to perceptions of cannabis use being common (medical use: OR=1.08, 95% CI: 1.03, 1.12; nonmedical use: OR=1.13, 95% CI: 1.08, 1.18) and low perceived physical harm of occasional use (OR=1.08, 95% CI: 1.03, 1.13). Although descriptive norms for past-year use of alcohol among those aged 21+ increased (OR = 1.09, 95% CI: 1.02, 1.17), other risk factors for alcohol did not change significantly or, in the case of low perceived physical and psychological harm, decreased among both those under age 21 and those aged 21+ (range of ORs = 0.90-0.94). Given these findings show an increase in cannabis-specific risk factors since legalization was implemented, particularly among those young adults aged 21+, preventive interventions correcting risk misperceptions and related risk factors among young adults aged 21+ may prove efficacious in reducing use and resultant negative consequences., (© 2022. Society for Prevention Research.)

Background: The contexts in which young adults drink alcohol play a salient role in alcohol-related outcomes and negative consequences at an event-level, but less is known about longitudinal risks. We collected longitudinal monthly data across 2 years on (a) daytime drinking, (b) pregaming/pre-partying, and (c) playing drinking games. We then examined associations between drinking in these contexts and within-person variability in alcohol consumption, consequences, and simultaneous alcohol and marijuana (SAM) use in a given month. We also examined the extent to which drinking in these contexts predicted hazardous drinking (using Alcohol Use Disorders Identification Test (AUDIT) scores) at a distal follow-up timepoint, controlling for baseline AUDIT scores., Method: A community sample of 759 young adults (M age  = 21.1 years; 56.4% female) completed monthly surveys for 24 consecutive months and a distal 30-month follow-up. Multilevel models estimated within- and between-person associations between drinking context frequencies (daytime drinking, pregaming, drinking games) and alcohol-related outcomes (weekly consumption, consequences, SAM use). A single-level negative binomial regression tested associations between drinking context frequency averages across a two-year period and changes in AUDIT scores from baseline to a follow-up 2.5 years later., Results: Over 75% of the sample of non-abstaining young adults reported drinking in each of the three contexts at least once during the 24-month period. Within-persons, young adults reported greater consumption, more negative consequences, and increased likelihood of SAM use during months that they drank in these contexts more often than usual. Each context was associated with negative consequences, even when controlling for alcohol use frequency. More frequent daytime drinking and pregaming, but not drinking games, were associated with increases in AUDIT scores at the 30-month follow-up, suggesting that there are potential long-term risks of drinking in these contexts., Conclusions: Findings suggest that daytime drinking, pregaming, and playing drinking games are high-risk contexts in terms of month-to-month and long-term risks. Additional research is needed on the various contexts in which young adults drink alcohol and the extent to which contextual factors interact with one another to amplify/reduce risks and harms., (© 2023 Research Society on Alcohol.)

Objective: There has been concern regarding increased substance use during the COVID-19 pandemic, particularly among young adults, but much of this concern stemmed from cross-sectional or short-term data collected early in the pandemic. This study followed a young adult community cohort throughout the first 1.5 years of the pandemic to examine longer-term trends/trajectories in alcohol and cannabis use behaviors., Method: Beginning before the COVID-19 pandemic (January 2020), 656 young adults completed up to eight surveys on substance use and other behaviors, which extended through August 2021. Multilevel spline growth models estimated changes in alcohol/cannabis use in three segments: (a) from pre-pandemic to April 2020, (b) from April 2020 to September/October 2020, and (c) from September/October 2020 to July/August 2021. Abstainers were removed from the analyses, yielding subsamples for alcohol models ( n = 545; M age = 25.6 years; 59.8% female) and cannabis models ( n = 303; M age = 25.6; 61.4% female)., Results: Drinking frequency initially increased (3% per month), decreased in the second segment (4% per month), and plateaued in the final segment. Drinking quantity significantly decreased in all three segments: 4% per month in segment one, 3% per month in segment two, and 1% per month in the final segment. Cannabis frequency and quantity showed no significant changes across the first two segments, then significantly decreased in the final segment (3% and 6% per month, respectively). The significant changes for cannabis frequency/quantity were moderated by age, such that older participants had steeper decreases in the final segment., Conclusions: Findings highlight that young adult alcohol and cannabis use generally declined across the first 1.5 years of the COVID-19 pandemic, contrary to widespread concerns., Competing Interests: The authors have no conflicts of interest to disclose.

Background: Given recent historical increases in young adults frequent cannabis use and changes in cannabis policies throughout the United States, there is a need to examine high-risk patterns of use. This paper examined predictors and cannabis-related outcomes of "wake-and-bake" cannabis use, operationalized as use within 30min of waking., Methods: Participants were 409 young adults (M age =21.61 years, 50.8% female) enrolled in a longitudinal study on simultaneous alcohol and cannabis use (i.e., using alcohol and cannabis at the same time such that their effects overlap). Eligibility criteria included reporting alcohol use 3+ times and simultaneous alcohol and cannabis use 1+ times in the past month. Participants completed twice-daily surveys for six 14-day bursts across two calendar years. Aims were tested using multilevel models., Results: Analyses were limited to cannabis use days (9406 days; 33.3% of all sampled days), and thereby to participants who reported using cannabis (384 participants; 93.9% of the sample). Wake-and-bake use was reported on 11.2% of cannabis use days and at least once by 35.4% of participants who used cannabis. On wake-and-bake use days, participants were high for more hours and had greater odds of driving under the influence of cannabis, but did not experience more negative consequences, relative to non-wake-and-bake cannabis use days. Participants who reported more cannabis use disorder symptoms and those reporting higher average social anxiety motives for cannabis use reported more frequent wake-and-bake use., Conclusions: Wake-and-bake cannabis use may be a useful marker of high-risk cannabis use, including driving under the influence of cannabis., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objective: Using substances to cope with social anxiety is robustly related to negative consequences. The present study uses daily-level methods to test whether days young adults used substances to cope with social anxiety were associated with greater alcohol and cannabis use and consequences compared to use days without this motive., Method: Participants were a community sample of young adults enrolled in a study on alcohol and cannabis use, which involved a baseline survey and five 2-week bursts of online daily surveys across 2 years. Aims were tested using multilevel models among a subsample of 257 participants who reported social anxiety coping motives 1 day or more during the study period; M age = 21.8 ( SD age = 2.2), 51% female; 49% non-Hispanic/Latinx White., Results: Compared to use days without social anxiety coping motives, days with social anxiety coping motives were associated with more drinks consumed and more positive and negative alcohol consequences on alcohol-only days, more negative cannabis consequences on cannabis-only days, and heavier use, more negative cannabis consequences, and more positive consequences for both substances on co-use days. Days with social anxiety coping motives were associated with a greater likelihood of positive item-level consequences (e.g., "was more sociable") on drinking days. Baseline social anxiety symptoms did not moderate associations., Conclusions: Days young adults used substances to cope with social anxiety were high-risk days for elevated substance use and consequences, regardless of baseline social anxiety. Positive consequences attained through drinking to cope with social anxiety may be an important pathway that reinforces coping motivated use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: Simultaneous alcohol and marijuana (SAM) use is reported to be associated with heavier alcohol and marijuana use and more negative consequences, but less is known about the social, physical, and temporal contexts of SAM use., Method: Young adults ( N = 326, 51.2% male, 49.1% White non-Hispanic) who reported past-month SAM use completed up to 14 daily surveys across five bursts that assessed SAM use and negative consequences and social, physical, and temporal contexts. We used multilevel models to examine SAM use contexts' associations with alcohol/marijuana quantity and consequences., Results: The social context of alone only (vs. with others only) was associated with consuming fewer drinks. Physical contexts that included using both at home and outside the home (vs. only at home) were associated with greater alcohol and marijuana quantity and negative consequences (but not after controlling for alcohol quantity); use outside the home only (vs. only at home) was associated with more alcohol use, more alcohol consequences (but not after controlling for alcohol quantity), and fewer marijuana consequences (even after controlling for marijuana quantity). The temporal context of first engaging in SAM use before 6 P.M. (vs. after 9 P.M.) was associated with greater alcohol and marijuana quantity and more marijuana consequences (but not after controlling for number of hours high), and first engaging in SAM use between 6 and 9 P.M. was associated with more hours high., Conclusions: SAM use contexts such as using with others, using outside the home, and using earlier in the evening are typically associated with greater alcohol/marijuana quantity and consequences.

Objective: Planned and unplanned substance use have been examined as predictors of heavier alcohol and cannabis use and problems at the between-person level. However, it remains unclear whether planned versus unplanned use is riskiest at the day-level, and for whom. The present study tested whether day-level planned versus unplanned alcohol and cannabis use were associated with higher alcohol and cannabis consumption and negative consequences that day and whether two impulsive traits, lack of premeditation and positive urgency, moderated associations., Method: Young adults ( N = 409; 50.9% female) completed five bursts of daily surveys, each consisting of a morning and afternoon report across 14 consecutive days. During a baseline session, participants reported their impulsivity (UPPS-P). During afternoon surveys, participants reported their plans to use alcohol/cannabis that night. During morning surveys, participants reported number of drinks consumed/hours spent high yesterday and negative consequences experienced., Results: Planned drinking days were associated with a greater number of drinks and negative consequences, whereas planned cannabis use days were associated with more hours spent high but not negative consequences. In the drinking quantity model, there was a significant interaction for planned versus unplanned drinking by positive urgency. Planned drinking was associated with heavier alcohol consumption across levels of positive urgency; however, unplanned drinking was associated with heavier consumption for individuals with higher (vs. lower) levels of positive urgency., Conclusions: Day-level planned drinking and cannabis use are important factors to target in just-in-time interventions. However, interventions focused on planned and unplanned drinking may be particularly effective for individuals with higher levels of positive urgency. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: Pregaming, or drinking before going out, is common among college students and has been linked with greater alcohol use and experiencing more negative consequences. This study tested within- and between-person associations between pregame heavy episodic drinking (Pregame HED; 4+/5+ drinks for women/men while pregaming) and high-intensity drinking (8+/10+ drinks), negative consequences, and three risky behaviors., Method: College students at a large, public university in the Northeast United States who participated in a longitudinal measurement-burst design study completed a longer survey and up to 14 daily surveys in up to four consecutive semesters ( n days = 4,706; n persons = 547). Hypotheses were primarily tested using logistic and Poisson multilevel models., Results: Pregame HED was reported by 41% of drinkers and on 15% of drinking days and 38% of pregaming days. Students were more likely to engage in high-intensity drinking on Pregame HED days than on moderate pregaming (1-3 and 1-4 pregaming drinks for women and men, respectively) or no pregaming drinking days. Students experienced more negative consequences on Pregame HED days than moderate or no pregaming drinking days, but there was no unique daily-level association between Pregame HED and negative consequences after alcohol intake was controlled. Students were more likely to use marijuana on Pregame HED days than on moderate and no pregaming drinking days., Conclusions: Pregame HED appears to be a characteristic of extremely heavy drinking days and fundamentally different from moderate pregaming and no pregaming drinking days. Findings highlight the importance of accounting for amounts of alcohol consumed while pregaming and the notion that drinking episodes can be dynamic.

Background: Measuring marijuana use quantity in survey research is complicated due to wide variation in the types (e.g., flower, edibles) and potency of marijuana products and in the modes (e.g., smoking, dabbing) used to consume products. There is currently no gold standard marijuana use quantity measure for survey research. This study examined whether number of hours high can be used as a proxy for marijuana use quantity in survey research, particularly in intensive longitudinal designs., Methods: Participants came from a community sample of young adults participating in a longitudinal study on simultaneous alcohol and marijuana use that used a longitudinal measurement-burst design in which participants completed surveys on up to 14 consecutive days in up to five bursts across nearly two calendar years. Those who reported using marijuana on at least one sampled day were included in present analyses (N = 379; M age = 21.6; 50.7 % female). Hypotheses were tested using Poisson multilevel models and a logistic regression., Results: Within persons, mode-specific marijuana use quantity variables predicted same-day number of hours high indicating evidence of initial criterion validity. In turn, hours high predicted same-day negative marijuana-related consequences indicating evidence of proximal predictive validity. Between persons, participants' average number of hours high was positively associated with their odds of possible cannabis use disorder following the last burst demonstrating distal predictive validity., Conclusions: Number of hours high may be a parsimonious proxy for measuring marijuana use quantity (regardless of mode of use) in survey research, particularly in intensive longitudinal designs., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Motor vehicle crashes remain a leading cause of death among young adults (ages 18-25) in the United States. Many drivers implicated in these crashes are under the influence of alcohol, cannabis, or the simultaneous use of alcohol and cannabis. Extremely limited research has assessed impaired driving behaviors and their predictors at the daily level. Perceived norms and motives to use substances have empirical support suggesting they may impact impaired driving-related behavior. Novel approaches to assess these associations at the daily level are needed and may inform future intervention and prevention programs., Objective: The goal of the current study is to utilize electronic daily assessments to assess driving under the influence of alcohol, cannabis, or simultaneous use and riding with a driver impaired by these substances to assess variability and predictors of these impaired driving-related behaviors at the daily level. This present manuscript details a protocol, measures, and a plan of analyses to assess how within-person differences in perceived norms and motives to use are associated with the likelihood of engaging in impaired driving-related behaviors., Methods: Participants include young adults in Washington State who report simultaneous use in the past month and either driving under the influence of alcohol, cannabis, or simultaneous use, or riding with a driver under the influence of both substances in the past 6 months. Individuals who verify their identity and meet eligibility requirements will complete a baseline assessment after which they will be scheduled for training on the daily assessment procedure via Zoom. Next, they will be invited to complete daily surveys on Thursday, Friday, Saturday, and Sunday every other week for 6 months and a 6-month follow up assessment. Analyses will utilize multilevel models with days nested within individuals., Results: The study is currently recruiting participants. A total of 192 participants have been recruited and 100 have completed the study protocol. Data collection is expected to be completed in Fall 2022., Conclusions: This study utilizes a novel design to assess impaired driving and predictors at the daily level among young adults at high risk of impaired driving-related behaviors. Findings will provide unique data that will shape the knowledge base in the field of social science and public health substance use research and that may be helpful for future prevention and intervention efforts on impaired driving., Competing Interests: The authors have declared that no competing interests exist.

Study Objectives: To examine the effects of sleep duration on next-day alcohol and cannabis craving and use among young adults., Method: A community sample of young adults who reported recent simultaneous alcohol and cannabis use at screening (N = 409; M age  = 21.61; 50.9% female) completed twice daily surveys (morning and afternoon) for five 14-day sampling bursts (i.e., 70 days total). Daily measurements included sleep duration, alcohol and cannabis craving, and alcohol and cannabis use (i.e., number of drinks, hours high). Multilevel models enabled examining associations between sleep duration and substance use/craving at three distinct levels: daily-level, burst-level, and person-level., Results: At the day-level, sleep duration was inversely associated with craving for both alcohol and cannabis: Stronger craving was reported on mornings and afternoons after relatively shorter sleep duration. At the burst-level, sleep duration was inversely associated with morning and afternoon alcohol craving indicating stronger alcohol craving, but not cannabis craving, during two-week periods when young adults have accumulated shorter sleep duration. Pertaining to alcohol and cannabis use, no daily-level effects were found, but the burst-level effect showed that participants engaged in greater alcohol use during two-week bursts with shorter sleep duration., Conclusions: Based on a non-clinical sample of young adults reporting substance use, results suggest shorter sleep duration may be a modifiable risk factor as it pertains to substance use and cravings. Results highlight day-level effects of shorter sleep duration on substance use cravings and adverse effects of cumulative sleep deficit on alcohol use., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The rise of wearable health monitoring has largely incorporated photoplethysmography (PPG), an optical sensing modality, to determine heart rate and blood oxygen saturation metrics by reflecting light through a user's skin. Due to its optical nature, this sensing method is strongly impacted by the skin type, body mass index (BMI), and general physiological composition of the user. In the context of self-powering, there is a need for these devices to consume ultra-low power, to not be dependent on batteries and regular charging, enabling continuous monitoring. This paper presents a novel PPG sensing model for both a custom, ultra-low power (ULP) AFE and the Texas Instruments (TI) AFE4404 which is used to demonstrate the design tradeoffs between system power and SNR. The models also incorporate a novel human skin reflectance component to analyze the effect of the user's skin phototype and BMI on these tradeoffs with the goal of demonstrating inclusive, accurate ULP PPG sensing. Measured results on both devices from 23 participants are included to emphasize the limited design space for enabling self-powered, continuous monitoring wearables.

This study examined longitudinal trajectories of young adults' mental health and well-being before and throughout the first year-and-a-half of the COVID-19 pandemic. Repeated assessments of a young adult community cohort (N = 656; M age  = 25.6 years; 59.3% female) were conducted beginning prior to COVID-19 (January 2020) and extending through August 2021. Multilevel spline growth models estimated changes in three segments: (a) from pre-pandemic to April/May 2020, (b) from April/May 2020 to September 2020, and (c) from September 2020 to August 2021. Depression symptoms and loneliness increased significantly in the first segment, plateaued slightly, then decreased significantly across the final segment. Anxiety symptoms were unchanged across the first two segments, but significantly decreased in the final segment. Satisfaction with life decreased significantly across the first two segments, and then increased significantly in the final segment. Direct comparisons of pre-pandemic scores (January 2020) to the last follow-up (July or August 2021) showed a return to pre-pandemic levels of depression symptoms, loneliness, and satisfaction with life, as indicated by non-significant differences, and significantly lower anxiety symptoms, relative to pre-pandemic. Findings support concerns for young adults' mental health and well-being in the initial months of the COVID-19 pandemic, but also indicate that young adults' emotional well-being, on average, may be returning to pre-pandemic levels., (© 2022. Society for Prevention Research.)

The COVID-19 pandemic has presented young adults with novel challenges and disruptions to several life domains. The current study examined how COVID-19-related stressors (i.e., job-related, financial-related, social/relational, and illness-related stressors) relate to young adults' symptoms of depression and anxiety, and satisfaction with life (in the US). In Aim 1, we examined associations between COVID-19-related stressors and indices of mental health and well-being in the initial phase of the pandemic (April/May 2020) while accounting for participants' pre-pandemic levels of these outcomes in January of 2020 (N = 519; M age  = 25.4; 62.8% women). Social/relational stressors were most strongly associated with increased symptoms of anxiety/depression, and financial stressors were most strongly associated with decreased satisfaction with life. Extending this research longitudinally (Aim 2), we sampled young adults bi-monthly across a year-long period (September 2020 to August 2021). Multilevel models revealed within-person associations between each stressor domain and mental health/well-being; young adults reported more symptoms of depression/anxiety and lower satisfaction with life in months that stressors were relatively more salient. Interactions between stressors and time revealed associations were generally stronger in earlier months and decreased linearly across the pandemic. Taken together, longitudinal evidence indicates that COVID-19-related stressors, especially social/relational stressors, have direct and time-varying associations with mental health and well-being., (© 2022 The International Association of Applied Psychology.)

Background: Alcohol and marijuana are commonly used by young adults, and use of both substances, particularly at the same time, is prevalent among this population. Understanding the prevalence, patterns, correlates, and consequences of simultaneous alcohol and marijuana (SAM) use is important to inform interventions. However, this literature is complicated by myriad terms used to describe SAM use, including use with overlapping effects and same-day co-use., Objectives: This scoping review identifies and describes the peer-reviewed literature focused on SAM use by young adults and distinguishes simultaneous use from same-day co-use of alcohol and marijuana. This review also provides a narrative summary of the prevalence of SAM use, patterns of SAM and other substance use, psychosocial correlates, and consequences of SAM use., Eligibility Criteria: This review is limited to papers written in English and published in peer-reviewed journals between January 2000 and August 2021. It includes papers assessing simultaneous use or same-day co-use of alcohol and marijuana among young adults ages 18 to 30. Review papers, qualitative interviews, experimental lab studies, policy work, toxicology or medical reports, and papers focused on neurological outcomes are excluded., Sources of Evidence: PubMed, PsycINFO, and Web of Science databases were searched. Databases were selected and the search strategy developed in consultation with an information specialist., Charting Methods: A data charting form was utilized to specify which information would be extracted from included papers. Eight categories of data were extracted: (1) research questions and hypotheses; (2) sample characteristics; (3) study procedures; (4) definition of SAM use; (5) prevalence of SAM use; (6) patterns of SAM and other substance use; (7) psychosocial correlates of SAM use; and (8) consequences of SAM use., Results: A total of 1,282 papers were identified through initial search terms. Through double-blind title/abstract screening and full-text review, the review was narrowed to 74 papers that met review inclusion criteria. Review of these papers demonstrated that SAM use was prevalent among young adults, particularly among those who reported heavier quantities and more frequent use of alcohol and marijuana. Enhancement-related motives for use were consistently positively associated with SAM use. SAM use was associated with greater perceived positive and negative consequences of alcohol and/or marijuana use. Inconsistencies in prevalence, patterns, correlates, and consequences were found between studies, which may be due to large variations in measurement of SAM use, populations studied, methodological design (e.g., cross-sectional vs. intensive longitudinal), and the covariates included in models., Conclusions: The literature on simultaneous use and same-day co-use of alcohol and marijuana has expanded rapidly. Of the 74 included papers (61 on SAM use; 13 on same-day co-use), 60 papers (47 on SAM use; 13 on same-day co-use) were published within the last 5 years. Future research focusing on the ways in which SAM use confers acute risk, above and beyond the risks associated with separate consumption of alcohol and marijuana, is needed for understanding potential targets for intervention., Competing Interests: Disclosures The authors declare no competing financial or nonfinancial interests.

Young adults' subjective feelings of alcohol's effects are a key predictor of engagement in risky behavior such as deciding whether to drive after drinking. To best inform prevention messaging and tailor intervention techniques that target high-risk drinking, it is critical that our measurement best captures subjective feelings. Standard sliding scales (0-100 rating of, "how drunk do you feel?") may have some challenges with distinguishing between levels of subjective responses to alcohol. The current daily diary study compared the utility of the standard sliding scale to a newly developed sliding scale that uses contemporary, crowd-sourced language from young adults as evenly spaced anchors (slightly buzzed, tipsy/"happy," drunk, and wasted) along a continuum of subjective effects of alcohol. Participants were 154 young adult substance users (58% women) who completed up to 14 consecutive daily reports of their substance use behavior. The four-anchored sliding scale performed similarly well as the standard scale in predicting alcohol use outcomes while showing the advantages of recording higher mean values/standard deviations and demonstrating that participants used the anchors to denote varying degrees of subjective effects. Findings suggest that the four-anchored subjective alcohol effects sliding scale is a viable alternative to the standard scale. By providing evenly spaced anchors that reflect incremental differences in language young adults use to describe their subjective states, the proposed scale may provide a guide for participants to indicate how they feel after drinking and may better capture variability in alcohol's effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective: As cannabis products are becoming increasingly available and young adults are increasingly using vaporizers to consume cannabis, there is a need to understand how this population is using different modes of administration and the extent to which specific modes are associated with differential cannabis use outcomes. Toward this end, the current study characterized predictors of cannabis mode of administration and examined how consumption levels and subjective intoxication vary as a function of mode of administration in daily life., Method: Participants were 106 young adult cannabis and heavy alcohol users (51% female) who completed up to 14 daily diaries ( n = 1,405 person days). Each day, participants reported whether they used any cannabis and, if any, which mode(s) were used, number of hits used per mode, overall subjective intoxication, and the socio-environmental context in which they used cannabis., Results: Across all cannabis use days, Bong-Only and Vape-Only days were the most common, followed by Multimode, Joint-, Pipe-, and Blunt-Only days. Participants reporting a greater proportion of cannabis use days were more likely to report Bong-Only and Multimode days than Vape-Only days. Compared to Vape-Only days, participants reported fewer hits on Bong-Only days and more hits on Blunt-Only, Pipe-Only, and Multimode days. Participants felt more intoxicated on Bong-Only days than Vape-Only days., Conclusions: Mode-specific associations with cannabis consumption and subjective intoxication levels suggest assessing modes of administration may be a meaningful way to guide individual and public health intervention efforts. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective It is not well understood whether heavy drinking interferes with academics on specific days or if this relationship simply reflects between-student differences. Participants: N  = 736 college students completed 14 consecutive daily assessments during 7 semesters. Methods: Days were classified as non-drinking, moderate drinking, heavy episodic drinking only (HED-only), or high-intensity drinking (HID) days. Multilevel models tested associations between drinking level and academic behaviors. Results: Students were more likely to skip class after engaging in HED-only or HID the previous day. On weekdays, students spent more time on schoolwork when they did not drink the previous day and spent less time on schoolwork when they engaged in HED-only and HID the previous day. On weekends, students spent less time on schoolwork after HED-only days. Conclusions: Heavy drinking is associated with lower academic effort the next day, highlighting the need for college programs targeting heavy alcohol use prevention and daily decision making.

Introduction: Heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke are the 5 leading causes of death in the U.S. The objective of this review is to examine the economic value of prevention interventions addressing these 5 conditions., Methods: Tufts Medical Center Cost-Effectiveness Analysis Registry data were queried from 2010 to 2018 for interventions that addressed any of the 5 conditions in the U.S. Results were stratified by condition, prevention stage, type of intervention, study sponsorship, and study perspective. The analyses were conducted in 2020, and all costs were reported in 2019 dollars., Results: In total, 549 cost-effectiveness analysis studies examined interventions addressing these 5 conditions in the U.S. Tertiary prevention interventions were assessed in 61.4%, whereas primary prevention was assessed in 8.6% of the studies. Primary prevention studies were predominantly funded by government, whereas industry sources funded more tertiary prevention studies, especially those dealing with pharmaceutical interventions. The median incremental cost-effectiveness ratio for the 5 conditions combined was $68,500 per quality-adjusted life year. Median incremental cost-effectiveness ratios were lowest for primary prevention and highest for tertiary prevention., Discussion: Primary prevention may be more cost effective than secondary and tertiary prevention interventions; however, research investments in primary prevention interventions, especially by industry, lag in comparison. These findings help to highlight the gaps in the cost-effectiveness analysis literature related to the 5 leading causes of death and identify understudied interventions and prevention stages for each condition., (Published by Elsevier Inc.)

Introduction: Subjective ratings of cannabis effects are important predictors of use-related consequences. However, psychometric research is fairly limited, particularly for measures to capture variability in daily life when diverse modes of cannabis administration and co-substance use are common., Methods: This study evaluated the predictive utility of a revised item to assess perceived cannabis effects and examined modes of cannabis administration and alcohol and nicotine co-use as moderators. Participants were 106 young adults (18-25 years; 51% female) who completed up to 14 consecutive daily reports of substance use (n = 1405 person-days). Two measures of subjective effects were examined: a standard item (0-100 rating of "how high do you feel?") and a revised item that uses four crowd-sourced anchor points ranging from relaxed (0), calm/chill (33), high (67), and stoned/baked (100). The items shared substantial variance (Pseudo-R 2 = 59.5%), however, the revised item showed greater within-person variability (77.0% vs. 68.8%) and stronger day-level associations with consumption levels (Pseudo-R 2 = 25.0% vs. 16.7%)., Results: The cannabis consumption-subjective effects link was weaker on blunt-only days compared to vape-only days. Subjective cannabis effects were higher on nicotine co-use days after controlling for cannabis consumption; neither alcohol nor nicotine co-use moderated the cannabis consumption-subjective effects link., Discussion: The revised subjective cannabis effects item is a viable alternative to the standard item among young adults who engage in simultaneous alcohol and cannabis use., Conclusions: Future research focused on characterizing the variability in cannabis effects is needed., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objective: Alcohol use motives may characterize types of drinking that have unique associations with cannabis use and illuminate psychological processes underlying cannabis use. This study examined how alcohol use motives, both on average across two years and in a particular month, were associated with any and frequent cannabis use. Method: A young adult community sample (n = 486; 54% female, age 18-23 at enrollment) who used alcohol and cannabis in the year prior to study enrollment provided two years of monthly data. Multilevel logistic regression models predicting any and frequent (10+ occasions) past-month cannabis use estimated both between- and within-person effects of alcohol use motives, controlling for frequency of alcohol use and demographic covariates. Results: Alcohol use frequency was positively associated with any cannabis use at the between- and within-person levels and frequent cannabis use at the within-person level. Across two years, individuals who had higher average coping drinking motives and lower average social and conformity drinking motives were more likely to use cannabis frequently. Further, between-person variation in social motives was negatively associated with any cannabis use. Within-person, months with greater enhancement and social motives were associated with higher probability of any cannabis use. Conclusions: Using alcohol for coping reasons, rather than other-focused social reasons, indicated greater risk for frequent cannabis use, although drinking for social and enhancement reasons in a particular month signaled slightly increased short-term probability of any cannabis use. Assessment of alcohol motives may help guide targeting and timing of prevention related to cannabis use.

Background: Pre-gaming, or drinking before going out, is common among young adults and associated with heavier drinking and negative consequences. However, findings have been mixed as to whether a unique, day-level association between pre-gaming and negative consequences exists independent of alcohol intake. It is also unknown whether young adults experience more positive consequences of alcohol use on days they engage in pre-gaming. This study tested day-level associations between pre-gaming and positive and negative consequences, controlling for same-day alcohol intake, as well as whether these associations were moderated by person- and day-level variables., Methods: Participants were 148 young adult heavy drinkers (M age  = 20.30, SD age  = 1.45, 57.4% female) who reported past-month simultaneous alcohol and marijuana use. For up to 14 consecutive days, participants completed electronic surveys asking about their drinking behaviors and consequences the previous day., Results: Prior to adjusting for alcohol intake, Poisson multilevel models showed that participants reported more negative and positive consequences on days they pre-gamed and those who reported pre-gaming more often throughout the study also experienced more negative and positive consequences overall. After controlling for alcohol intake, a positive, day-level association between pre-gaming and positive consequences remained. There was no evidence of moderation of study associations by person- or day-level variables., Conclusion: The unique association between pre-gaming and positive consequences may help explain why pre-gaming is linked with heavy drinking and other risky behaviors as positive consequences have been shown to reinforce such behaviors. Findings suggest pre-gaming may be a useful intervention point for alcohol reduction programs., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Young adults are prolific media users and tend to use substances, such as alcohol, more than people of other ages. Despite much research on young adults' exposure to alcohol advertisements and portrayals of alcohol use in the media, much is still unknown about the nuances of young adults' exposure to and engagement with alcohol-related media content. The present paper examined how college students' media exposure differed for messages portraying positive and negative alcohol effects, how exposure to alcohol-related content differed across media sources, which themes of alcoholrelated content were seen most, and whether exposure to alcohol-related content was associated with hazardous/harmful drinking. Method: Participants (N=500) were two- and four-year college students (Mage=20.90, SDage=1.70, 63.2% female) recruited for a longitudinal study examining the efficacy of a mobile app intervention for high-risk drinking college students. The data used here comes from the baseline survey. Results: Participants reported the greatest exposure to alcohol-related messages in movies/TV/on-demand streaming shows followed by in social media, and they reported greater exposure to messages portraying positive than negative effects of alcohol. Findings from linear regressions indicated that exposure to messages portraying positive or negative effects of alcohol generally did not predict hazardous/harmful drinking. Conclusion: This sample of high-risk college student drinkers reported seeing alcohol-related content through a variety of media sources, with most content portraying alcohol in a positive light. Future research should assess the effects that messages of different types and from different sources have on use, expectancies, norms, and other outcomes.

Background: Day drinking, or drinking during the daytime, is a term used colloquially in the media and among college students based on anecdotal evidence. Drinking at tailgate parties, generally thought to be a type of day drinking, tends to be particularly heavy and to achieve levels comparable to drinking on holidays and special occasions. The objective of this study was to assess how many and how often students day drink and whether day drinking days (i.e., days drinking began before 4:00 p.m.) were associated with heavy drinking, legal intoxication, negative alcohol-related consequences, and three risky substance use behaviors., Methods: We conducted a longitudinal daily diary study of college students who were followed for their first seven semesters of college. The analytic sample includes 7,633 drinking days nested with 619 student drinkers. We used logistic and Poisson multilevel models to test associations between day drinking days and substance use outcomes and negative consequences., Results: Approximately 50% of drinkers drank durinng the day at least once, and day drinking occurred on 9% of drinking days. Greek organization participants reported significantly more day drinking days than non-participants. Day drinking days were characterized by heavy drinking as evidenced by strong, positive associations between day drinking and drinking to heavy episodic drinking (HED) and high-intensity drinking (HID) thresholds on a given day. In contrast, students were less likely to reach legal intoxication and experienced fewer negative alcohol-related consequences on day drinking days than days on which drinking began in the evening or nighttime. Students who reported day drinking more often throughout the study also reported having more days of drinking at the HED and HID thresholds and playing drinking games and mixed alcohol with energy drinks more frequently., Conclusions: Day drinking was common among this sample of college students. Findings suggest that day drinking days may be characterized by heavy drinking and may be a behavior most typically engaged in by heavy drinkers, including members of Greek organizations., (© 2021 by the Research Society on Alcoholism.)

Not all computing problems are created equal. The inherent complexity of processing certain classes of problems using digital computers has inspired the exploration of alternate computing paradigms. Coupled oscillators exhibiting rich spatio-temporal dynamics have been proposed for solving hard optimization problems. However, the physical implementation of such systems has been constrained to small prototypes. Consequently, the computational properties of this paradigm remain inadequately explored. Here, we demonstrate an integrated circuit of thirty oscillators with highly reconfigurable coupling to compute optimal/near-optimal solutions to the archetypally hard Maximum Independent Set problem with over 90% accuracy. This platform uniquely enables us to characterize the dynamical and computational properties of this hardware approach. We show that the Maximum Independent Set is more challenging to compute in sparser graphs than in denser ones. Finally, using simulations we evaluate the scalability of the proposed approach. Our work marks an important step towards enabling application-specific analog computing platforms to solve computationally hard problems.

Improving system lifetime and robustness is a key to advancing self-powered platforms for real world applications. A complete self-powered, battery-less, wearable platform requires a microwatt-power system-on-chip (SoC), operating reliably within this budget, capable of surviving long periods without charging, and recovering from power loss to its previous state. To meet these requirements, we designed a wireless sensing heterogeneous system-in-package (SiP) containing an ultra-low power (ULP) SoC, a non-volatile boot memory (NVM), and a 2.4 GHz frequency shift key (FSK) radio, all integrated with custom ULP interfaces. The SoC includes a fully integrated energy harvesting platform power manager (EH-PPM) to power the SiP and other commercial sensors. The EH-PPM is designed for small loads and powers the SoC and peripherals while drawing very low operating current. The SoC also includes a digital system data-flow for sensing applications, an analog front end for ECG signal acquisition, and a cold-boot management system (CBMS) for boot and recovery from the NVM. The CBMS enables integration of the SoC with the ULP NVM to create a wearable formfactor, self-powered system capable of recovery from power loss. The SoC also includes a radio interface tightly integrated with a compression accelerator to efficiently communicate with the FSK transmitter and reduce the FSK's transmission time. This tight integration between accelerators on the SoC and peripherals is another feature that reduces the system's power consumption by reducing the code size and number of memory accesses required to perform an operation. The SoC consumes 507 nW average power while running free-fall detection, 519 nW average power while measuring ambient temperature, and 1.02 μW during continuous ECG monitoring and post-processing.

College drinking and its negative consequences remain a major public health concern. Yet, many prevention efforts targeting college drinkers are expensive, are difficult to implement, use indicated approaches targeting only high-risk drinkers, and/or are only marginally effective. An alternative strategy taken explicitly or implicitly by many colleges is campus-led alcohol-free programming which provides students with attractive leisure alternatives to drinking on weekend nights. This study aimed to extend work by Patrick et al. (Prevention Science, 11, 155-162, 2010), who found that students drank less on weekend nights they attended LateNight Penn State (LNPS) activities during their first semester of college. Here, daily diary and longitudinal data on college students' daily lives and risk behaviors were collected from 730 students on 19,506 person-days across seven semesters at a large university in the Northeastern United States. Generalized linear mixed models were used to estimate alcohol and illegal substance use on weekend days as a function of LNPS attendance, gender, legal drinking status (≥ 21 years), and day of the weekend. Across college, students who attended LNPS used alcohol and illegal substances less in general and less on days they participated compared to themselves on days they did not participate. Legal drinking status moderated the association between LNPS attendance and alcohol and illegal substance use such that levels of use were lowest for students under 21 years old on weekend days they attended LNPS. Our findings provide support for campus-led alcohol-free programming as a potential harm reduction strategy on college campuses.

Introduction and Aims: High-intensity drinking (HID), or consuming 8+ (10+) drinks in one sitting for women (men), is associated with significant harm. We compared the likelihood of individuals using protective behavioural strategies (PBS) on days with varying levels of drinking (HID, heavy episodic-only drinking [4-7/5-9 drinks for women/men], moderate drinking [1-3/1-4 drinks])., Design and Methods: We used an intensive repeated measures longitudinal design with four 14-day measurement bursts across 2 years (N = 258 university students [50.0% female, average age of 19.95 (SD = 0.41) years] who provided 3176 daily drinking reports). Each drinking day, participants reported the amount of alcohol consumed and whether they used PBS., Results: Multilevel models indicated that, relative to heavy episodic drinking-only days, students were more likely to use strategies of avoiding drinking too quickly on moderate drinking days (odds ratio = 1.90, confidence interval 1.50-2.40) but less likely on HID days (odds ratio = 0.38, confidence interval 0.29-0.48). Relative to heavy episodic drinking-only days, students were less likely to use strategies to protect themselves from serious harm on moderate days (odds ratio = 0.53, confidence interval 0.41-0.67) and equally likely on HID days (odds ratio = 0.84, confidence interval 0.93-1.41)., Discussion and Conclusions: Despite elevated risk for alcohol-related harms when drinking most heavily, PBS may be under-utilised on higher-risk drinking occasions. In light of prior work supporting the effectiveness of PBS at reducing harms on HID days, increasing PBS should be emphasised in future prevention and intervention efforts., (© 2019 Australasian Professional Society on Alcohol and other Drugs.)

Youth who suffer from psychiatric disorders are at high risk for negative outcomes, including aggression and substance abuse. Although many youth with psychiatric disorders have endured harsh parenting and/or child maltreatment (CM), differential associations between these experiential factors have yet to be fully explored. Sleep problems have also been implicated in psychiatric disorders and are consistently associated with CM. The overlap and unique contributions of CM and sleep problems to the mental health of youth remains unclear; longitudinal studies from late childhood into adolescence, when psychiatric illnesses frequently onset, are rare. The current longitudinal study examined associations of CM, harsh parenting, and sleep problems with symptoms of four psychiatric disorders: Conduct Disorder, Attention Deficit Hyperactivity Disorder, Anxiety, and Depression. Early adolescent youth with no history of substance use ( N = 529) were sampled from a working class, medium-sized city in northern Kentucky, and an extensive battery of tests were administered to youth and a parent. CM was more strongly and consistently related to psychiatric disorder symptoms at baseline than was harsh parenting. Reports of harsh parenting were more strongly associated with externalizing symptoms than internalizing symptoms. Sleep problems were also positively associated with psychiatric disorder symptoms at baseline, but did not exacerbate the effects of CM or harsh parenting on symptom counts. Longitudinally, harsh parenting was more predictive of change in psychiatric symptoms two to three years later than was CM. The potential significance of childhood adversity and sleep problems for prevention of later mental health problems are discussed., Competing Interests: Conflict of Interest: B. H. Calhoun declares that he has no conflict of interest. T. A. Ridenour declares that he has no conflict of interest. D. H. Fishbein declares that she has no conflict of interest.

Heavy episodic drinking (HED) is prevalent among college students and associated with harms. However, many students engage in "high-intensity drinking" (HID) by drinking at thresholds beyond HED. HID relative to HED-only is associated with elevated risk for acute and severe negative consequences. When used, protective behavioral strategies (PBS) are shown to help drinkers limit their drinking and lower their odds of experiencing consequences. This study assessed whether PBS use was associated with reduced consequences on occasions college students engaged in HID relative to HED-only. Data were from a longitudinal measurement-burst design (14-day bursts across 4 semesters) from 256 college students who engaged in HID on at least 1 reported day, yielding 2,352 daily drinking reports. Participants reported the number of standard drinks consumed on each day and, on days with 1+ drinks, whether they used PBS and experienced a variety of negative drinking-related consequences. Three-level multilevel models revealed that on days when students used manner of drinking PBS there was a weaker association between HID and passing out from drinking. On days students used serious harm reduction PBS there was a weaker association of HID with having no one sober enough to drive and experiencing regretted sexual behaviors. Use of some PBS may help college students reduce harms on HID occasions relative to HED-only occasions. Interventions should promote use of planning strategies to minimize harm, especially on HID occasions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).