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The alcohol purchase task (APT), which presents a scenario and asks participants how many drinks they would purchase and consume at different prices, generates indices of alcohol reward value that have shown robust associations with alcohol-related outcomes in numerous studies. The aim was to test its prospective validity at 4-year follow-up. Prospective cohort study. General population sample of young Swiss men. A total of 4594 Swiss young men (median age = 21, 25th - 75th quartiles = 20.5 - 21.5) completed baseline questionnaires; among those, 4214 (91.7%) were successfully followed-up 4 years later. Alcohol reward value parameters (i.e. intensity, the planned consumption when drinks are free; breakpoint, the price at which consumption would be suppressed; O max , the maximum alcohol expenditure; P max , the price associated with O max ; and elasticity, the relative change in alcohol consumption as a function of the relative change in price) were derived from the APT at baseline and used to predict self-reported weekly drinking amount, monthly binge drinking, alcohol-related consequences and DSM-5 alcohol use disorder criteria. Regression analyses, adjusting for the baseline alcohol measure, age, linguistic region and socio-economic indicators showed that intensity, breakpoint, O max and elasticity significantly predicted all tested outcomes in the expected direction (e.g. standardized incidence rate ratio [95% confidence interval] = 1.11 [1.07-1.15], 1.07 [1.03-1.10], 1.08 [1.04-1.11], and 0.92 [0.89-0.95], respectively, for weekly drinking amount, all P < 0.001). P max did not significantly predict any outcomes. Non-adjusted correlations, baseline adjusted regression and ancillary analyses using (1) latent alcohol variables, (2) multiple imputation for missing data and (3) replications in training and testing subsamples to evaluate predictive accuracy provided consistent findings. The alcohol purchase task demand curve measures of alcohol reward value are useful in characterizing alcohol-related risk in young men and have long-term predictive utility.

The association between alcohol use and sensation seeking is well known. Less is known about whether longitudinal changes in alcohol use are associated with changes in sensation seeking and in which direction influence might flow. 5125 men aged 20.0 years old at baseline and 25.4 years old at follow-up responded to the Brief Sensation Seeking Questionnaire, which measures four subscales of experience seeking, boredom susceptibility, thrill- and adventure-seeking, and disinhibition. Alcohol use was measured using volume (drinks per week) and binge drinking (about 60 g or more per occasion). Associations were calculated using cross-lagged panel models and two-wave latent change score models. Correlations between the latent change scores for alcohol use and the sensation-seeking subscales were all positive, being largest for disinhibition (rgt; 0.3) and much smaller (r ~ 0.1) for the others. Disinhibition was the dominant effect over the entire sensation-seeking scale. Cross-lagged paths were (except for thrill- and adventure-seeking) bidirectional and mostly higher from alcohol use to sensation seeking (e.g., path

To investigate the risk factors for and the consequences (ie, substance use disorders (SUD), depression, personality traits) of traumatic brain injury (TBI) in young Swiss men.This is a three-wave cohort study. Risk factors were measured at baseline (2010-2012) and at follow-up 1 (FU1; 2012-2014), while the consequences and TBI were measured at follow-up 2 (FU2; 2016-2018).Switzerland.All participants at FU2 (Mage=25.43, SD=1.25) of the Cohort Study on Substance Use Risk Factors (N=4881 young Swiss men after listwise deletion).The outcomes measured were TBI, SUD (ie, alcohol, nicotine, cannabis, other illicit drugs), depression and personality traits (ie, sensation seeking, anxiety-neuroticism, sociability, aggression-hostility) at FU2. The predictors were previous TBI (lifetime TBI but not in the past 12 months at FU2), SUD, personality traits and sociodemographics (highest level of achieved education, age, linguistic region) measured at FU1.At FU2, 3919 (80.3%) participants reported to never have had TBI, 102 (2.1%) have had TBI in the last 12 months (TBI new cases), and 860 (17.6%) have had TBI during their lifetime but not in the 12 months preceding FU2 (previous TBI). Low educational attainment (OR=3.93, 95% CI 2.10 to 7.36), depression (OR=2.87, 95% CI 1.35 to 6.11), nicotine dependence (OR=1.72, 95% CI 1.09 to 2.71), high sociability (OR=1.18, 95% CI 1.07 to 1.30), high aggression-hostility (OR=1.15, 95% CI 1.06 to 1.26) and high sensation seeking (OR=1.33, 95% CI 1.04 to 1.68) at FU1 were significantly associated with TBI new cases at FU2. Previous TBI was significantly associated with nicotine dependence (OR=1.46, 95% CI 1.16 to 1.83), depression (OR=2.16, 95% CI 1.56 to 2.99) and aggression-hostility (B=0.14, 95% CI0.00 to 0.28) at FU2.Low educational attainment and depression are the most significant risk factors associated with increased odds of future TBI, while depression, nicotine dependence and high aggression-hostility are the main consequences of previous TBI. TBI should be considered an underlying factor in the treatment of depression, SUD or unfavourable personality profiles.

Screening and brief interventions are among the evidence-based recommended practices to reduce the negative impact of substance use on the population. The digitization of these interventions makes it possible to disseminate them widely and to circumvent some of the barriers to the implementation of face-to-face interventions. Current evidence shows that electronic screening and brief interventions are effective in reducing alcohol and tobacco consumption. For other substances and for gambling, current evidence is more limited but promising and additional research is needed. These interventions can represent an alternative to face-to-face interventions.Le dépistage et les interventions brèves font partie des interventions basées sur les preuves recommandées pour réduire l’impact négatif de la consommation de substances sur la population. La digitalisation de ces interventions permet de les diffuser largement et de contourner certaines barrières à l’implémentation des interventions en face à face. Les données actuelles montrent que le dépistage et l’intervention brève digitale sont efficaces sur la réduction de la consommation d’alcool et de tabac. Pour les autres substances et pour les jeux d’argent, les données sont plus limitées mais prometteuses et la recherche doit se poursuivre dans ce domaine. Ces interventions peuvent représenter une alternative aux interventions en face à face.

Video gaming is a popular activity among young people. Time spent with gaming was found to be only moderately associated with gaming disorder. However, patterns of binge gaming (playing more than 5 h consecutively) were rarely considered in research on gaming. This study explores how binge gaming frequency is related with gaming disorder and mental health.The sample came from the Cohort study on substance use risk factors (C-SURF) and comprised 5,358 young men aged 28.26 years (SD = 1.27). ANCOVA was conducted to estimate the association between binge gaming frequency (gaming at least 5 h consecutively) and gaming disorder (measured with the Game Addiction Scale) as well as indicators of mental health.A total of 33.3% of the sample engaged in binge gaming at least once in the previous year, and 6.1% at least weekly. Frequency of binge gaming was associated with gaming disorder score in a linear dose-response relationship (linear trend = 2.30 [2.14, 2.46]) even if adjusted for time spent gaming (linear trend = 1.24 [1.03, 1.45). More frequent binge gaming was associated with lower life satisfaction and sleep quality, and with more major depression and social anxiety disorder symptoms.Binge gaming patterns, especially daily or almost daily binge gaming, are important to consider with regard to gaming disorder and mental health. Asking about binge gaming may be a promising screening question for gaming related problems. Encouraging regular breaks from gaming may be a valuable prevention strategy to reduce negative outcomes of gaming.

This four-wave longitudinal study aimed to examine the associations between retrospectively perceived parenting profiles in adolescence and the development of alcohol use disorder (AUD) throughout emerging adulthood. The cohort consisted of 190 young Swiss men who completed retrospective reports of parenting at baseline and a short AUD self-report screening tool at four measurement times (mean age at baseline = 20.18; Time 1: 21.52; Time 2: 25.61; Time 3: 26.99). Latent profile analysis revealed three parenting profiles in adolescence based on retrospective measures of parenting styles and practices: Optimal (the highest levels of involvement, structure and knowledge; 69%), Uninformed (high levels of involvement, moderate levels of structure and the lowest levels of knowledge; 17%), Low Support (the lowest levels of involvement, moderate levels of structure and knowledge; 14%). Using latent growth curve analysis, we found that young men in the Low Support profile experienced a greater increase in AUD severity compared with those in the Uninformed and Optimal profiles. Young men in the Uninformed profile reported higher levels of AUD severity at baseline than those in the Optimal profile. These findings highlight the associations between retrospectively perceived parenting profiles during adolescence and the development of AUD during emerging adulthood.

Background: Attention deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and sensation seeking (SS) have been consistently related to a higher risk of substance use (SU) and substance use disorder (SUD). Objectives: To investigate the relationship between ADHD and prevalence rates in males at age 20 and age 25, the initiation of SU and SUD after age 20, and the escalation of SU from age 20 to age 25, and to explore the role of CD and SS in the relation of ADHD with SU and SUD initiation and escalation. Method: Data were obtained as part of the Cohort Study on Substance Use Risk Factors (C-SURF), which focused on young Swiss men aged 20 years at baseline and 25 years at follow-up. Results: Participants who screened positive for ADHD at baseline exhibited a higher rate of SU and SUD than participants who screened negative. The presence of ADHD symptoms at age 20 predicted initiation of all SU between age 20 and age 25, except for alcohol and smoking. After controlling for self-reported CD and SS, ADHD still predicted this late initiation of use of hallucinogens, meth-/amphetamines, and ecstasy/MDMA; non-medical use of ADHD medication and sedatives, and alcohol use disorder (AUD). No escalation of weekly drinking and smoking or annual cannabis use was observed from age 20 to age 25. Conclusion: Screened-positive ADHD is an independent predictor of late SU and AUD, along with self-reported CD and SS. From a public health perspective, identifying ADHD is not only important in childhood and adolescence but also in early adulthood to guide specific interventions to lower risks of drug use initiation and the development of AUD in early adulthood.

Addiction medicine is influenced by societal changes and the environment has an impact on addictive behaviors and how they are experienced. The COVID-19 pandemic has had an impact on addictive behaviors, some of which could be favorable, and others highlight vulnerabilities to be considered by clinicians. Recent legislative changes open possibilities to limit the negative impact of electronic lotteries. In a context favorable to a better acceptance of people of LGBTQIA+ diversity, research and training in addiction medicine also have a role to play. In view of advances in understanding the harmful effects of alcohol, it is necessary to adapt the perception of the risk, in order not to provoke the incomprehension in the population.La médecine des addictions est liée aux enjeux sociétaux actuels, et l’environnement joue un rôle important sur les comportements addictifs et comment ils sont vécus. La pandémie de Covid-19 a eu un impact sur les comportements addictifs, dont certains pourraient être positifs et d’autres mettent en lumière des vulnérabilités à prendre en compte en clinique. Les récents changements législatifs ouvrent des possibilités pour limiter l’impact négatif des loteries électroniques. Dans le contexte favorable à une meilleure acceptation des personnes issues de la diversité LGBTQIA+ (lesbienne, gay, bisexuel·le, transgenre, queer, intersexe et asexuel·le ou aromantique), la recherche et la formation en médecine des addictions ont aussi un rôle à jouer. Au vu des avancées dans la connaissance des effets nocifs de l’alcool, il est nécessaire d’adapter la perception du risque, afin de ne pas susciter l’incompréhension de la population.

BACKGROUND AND AIMS Short screenings for alcohol use disorder (AUD) are crucial for public health purposes, but current self-reported measures have several pitfalls and may be unreliable. The main aim of our study was to provide empirical evidence on the psychometric performance of self-reports currently used. Our research questions were: Compared with a gold standard clinical interview, how accurate are 1) self-reported AUD, 2) self-reported alcohol use over time, and 3) biomarkers of alcohol use among Swiss men? Finally, we aimed to identify an alternative screening tool. DESIGN A single-center study with a cross-sectional design and a stratified sample selection. SETTING Lausanne University Hospital (Switzerland) from October 2017 through June 2018. PARTICIPANTS We selected participants from the French-speaking participants of the ongoing Cohort Study on Substance Use and Risk Factors (n=233). The sample included young men aged on average 27.0 years. MEASUREMENTS We used the Diagnostic Interview for Genetic Studies as the gold standard for DSM-5 AUD. The self-reported measures included 11 criteria for AUD, nine alcohol-related consequences, and previous twelve months' alcohol use. We also assessed biomarkers of chronic excessive drinking (ethyl glucuronide and phosphatidylethanol). FINDINGS None of the self-reported measures/biomarkers taken alone displayed both sensitivity and specificity close to 100% with respect to the gold standard (e.g., self-reported AUD: sensitivity=92.3%, specificity=45.8%). The best model combined eight self-reported criteria of AUD and four alcohol-related consequences. Using a cut-off of three, this screening tool yielded acceptable sensitivity (83.3%) and specificity (78.7%). CONCLUSIONS Neither self-reported alcohol use disorder (AUD) nor heavy alcohol use appear to be adequate to screen for AUD among young men from the Swiss population. The best screening alternative for AUD among young Swiss men appears to be a combination of eight symptoms of AUD and four alcohol-related consequences.

Background and aims: Intense use of smartphones is associated with mental health problems and low well-being. However, little is known about the mental health and well-being of non- and low-level users. This study investigated the possibly non-linear associations between time spent using a smartphone, including non-users, and mental health and well-being among young adults. Methods: Between 2016 and 2018, 5315 young Swiss men (M = 25.45 years old, SD = 1.25) completed a questionnaire assessing smartphone use, daily time spent using a smartphone, mental health and well-being (i.e. depression, social anxiety, attention deficit hyperactivity disorder, life satisfaction, stress) and potential confounding variables (social capital, personality, education). The associations of smartphone use and time spent using a smartphone (linear and quadratic associations) with mental health and well-being were tested using regression models. Results: Non-users (4.3%) reported worse mental health and well-being than smartphone users on all outcomes. Time spent using a smartphone was linearly associated with higher rates of social anxiety, depression, attention deficit hyperactivity disorder and lower levels of life satisfaction. The association with stress was non-linear, with significant linear and quadratic coefficients of time spent using a smartphone. Associations were partially attributable to confounding variables (i.e. social capital, personality, and education). Conclusions: Non-users and intense users of smartphones have lower levels of mental health and well-being than low-level users. Although society and mental health professionals are deeply concerned about the potentially negative consequences of the ever-increasing use of smartphones, the present study suggested that not using a smartphone may also indicate problems.

This article has been published in Swiss Medical Weekly: https://doi.org/10.4414/smw.2021.w30028 The COVID-19 pandemic caused many disturbances to daily life worldwide and may also have significantly affected people’s psychological well-being. The present study aimed to describe the psychological impact of the crisis on our sample of young Swiss men and to examine differences due to their linguistic region, experiencing COVID-19 symptoms and living arrangements.MethodBased on an ongoing cohort study, we assessed a general-population sample of young Swiss men (n = 2345; average 29 years old) shortly before (from April 2019) and early on during the COVID-19 crisis (between 13 May and 8 June 2020). This was a unique opportunity to estimate the crisis’ psychological impact in form of depression, perceived stress and sleep quality (assessed before and during COVID-19), and any crisis-induced fears, isolation or psychological trauma. Associations of psychological impact with living arrangements, experiencing COVID-19 symptoms and linguistic region (German-speaking vs French-speaking) were investigated using linear regression models. FindingsBy the time participants responded to our questionnaire, less than 1% had been tested positive for COVID-19, 2.6% had been tested negative, and 14.7% had had some COVID-19 symptoms but had not been tested. About 8.2% of the sample reported at least some symptoms of psychological trauma (≥ 24 points on the Impact of Event Scale). On average, participants reported higher levels of fear for others (43.6% at least moderate) and economical fear (12.7% at least moderate) than fear for themselves (5.8% at least moderate). Those living alone and those who reported having COVID-19 symptoms themselves, or knowing someone with symptoms, reported higher overall psychological impact in the form of depression, perceived stress, sleep quality, psychological trauma, fear and isolation. Associations with linguistic region varied by outcome, with higher levels of depression and fear in French-speaking regions and higher levels of perceived stress and isolation in German-speaking regions. InterpretationThe crisis had a considerable impact on the psychological well-being of our sample of young Swiss men, and some groups were more affected than others: those living alone and those who had shown COVID-19 symptoms themselves; or had known someone with symptoms, may have felt a greater psychological impact from the crisis. Supporting those at a higher risk of psychological consequences in such crises, whether through structural measures or via individual support, should be an important aspect of crisis management and could help reduce the overall impact of the current pandemic on Switzerland’s population.

Social determinants are closely related to addiction, both as a cause and a consequence of substance use and other addictive behaviors. The present paper examines prosocialness (i.e. the tendency to help, empathize, and care for others) among a population of young males. We compared prosocialness across different types of addiction and examined whether prosocialness varied according to the presence of multiple addictions. A sample of 5,675 young males, aged 19-29 years old (Mean = 21.4; Median = 21), completed a questionnaire that included screening tools to identify addictive behaviors with regards to alcohol, nicotine, cannabis, gambling, and gaming. The questionnaire also included a scale to measure prosocialness. Compared to a no-addiction control group, the subgroups of young men suffering from behavioral addictions (i.e., gambling and gaming) reported the lowest levels of prosocialness. Respondents with an alcohol addiction also showed lower prosocialness compared to no-addiction controls. By contrast, no significant differences in prosocialness were found between respondents with nicotine disorder or cannabis disorder and the no-addiction controls. Furthermore, the number of addictions had no clear, observable effects on prosocialness. Significant differences were found between the no-addiction control group and the groups reporting one or more addictions, but not between the separate groups reporting one, two, and three or more addictions. A better understanding of the social dimension affecting young males with addiction, particularly gambling and gaming addictions, may be useful for their prevention and treatment.

BACKGROUND AND AIMS Alcohol-induced blackout (AIB) is a common alcohol-related adverse event occurring during teenage years. Although research provides evidence that AIB predicts acute negative consequences, less is known about the associations of AIB with chronic consequences, such as alcohol dependence (AD). This study estimated the associations between an experience of AIB at age 20 and the incidence, maintenance and severity of AD at age 25 among Swiss men. DESIGN Prospective cohort study with 5.5 years separating baseline and follow-up. SETTING Switzerland. PARTICIPANTS Swiss male drinkers (n = 5469, age 20 at baseline) drawn from the Cohort Study on Substance Use Risk Factors (C-SURF). MEASUREMENTS Self-report questionnaires assessing AIB, AD, alcohol (drinking volume, binge drinking), cigarette and cannabis use, several risk factors (sensation-seeking, family history of problematic alcohol use, age of first alcohol intoxication) and socio-demographic variables. FINDINGS Generalized estimating equation models with and without adjustment for risk factors, including alcohol use and socio-demographics, showed that AIB at age 20 significantly predicted the incidence of AD at age 25 in men without AD at age 20 [odds ratio (OR) = 2.52, 95% confidence interval (CI), unadjusted = 2.04, 3.11, P

Background: General population surveys using self-reported measures show alcohol use disorder (AUD) to be most prevalent in young adulthood, but this may be due to misinterpretations of AUD criteria among inexperienced drinkers. The present study investigated changes in prevalence of criteria during emerging adulthood. Methods: 4924 young Swiss men were followed across three waves (age at wave 1 (w1): 20; w2: 21; w3: 25 years). We measured AUD according to the 11 DSM-5 criteria and estimated Item Response Theory models for each wave and differential item functioning across waves, related to the cohort growing older. Results: Endorsement of several AUD criteria varied considerably as a function of age in a period of only five years: Five criteria showed differential item functioning between waves 1 and 3 (i.e. between the age of 20 and 25), including the three most frequently endorsed criteria. Prevalence of tolerance (w1, 57.8%; w3, 29.6%) decreased in relation to the AUD score (Mantel–Haenszel OR = 0.26), whereas the use of alcohol larger/longer than intended (w1, 73.7%; w3, 84.8%; OR = 1.93) and hazardous use (w1, 62.7%; w3, 68.4%; OR = 1.31) increased, resulting in an unchanged mean AUD score and prevalence, but changing combinations of criteria to qualify AUD. Conclusions: Considerable differential item functioning over five years among several of the most endorsed AUD criteria suggests shifts in the interpretation of DSM-5 criteria during emerging adulthood. Self-reported measures of DSM-5 AUD criteria may require reformulation to account for young people’s different perceptions and to yield comparable diagnoses over time and across age groups.

BACKGROUND AND AIMS Cannabis use disorder (CUD) is frequent in adolescence and often goes into remission towards adulthood. This study aimed to estimate trajectories of CUD severity (CUDS) in Swiss men aged from 20 to 25 years and to identify prospective predictors of these trajectories. DESIGN Latent class growth analysis of self-reported CUDS in a cohort study with three data collection waves. SETTING A general population sample of young Swiss men. PARTICIPANTS A total of 5987 Swiss men assessed longitudinally at the mean ages of 20, 21.5 and 25 years. MEASUREMENTS Latent CUDS in the last 12 months was measured at each wave with the Cannabis Use Disorders Identification Test-Revised (CUDIT-R). Predictors of CUDS trajectories, measured at age 20, were from six domains: factors related to cannabis use, family, peers, other substance use, mental health and personality. FINDINGS We distinguished four CUDS trajectories: stable-low (88.2%), decreasing (5.2%), stable-high (2.6%) and increasing (4.0%). Predictors were generally associated with higher odds of membership in the decreasing and stable-high trajectory (versus the stable-low), and to a lesser degree with higher odds of membership in the increasing trajectory. Bivariate predictors of persistent high CUDS (stable-high versus decreasing trajectory) were major depression severity [odds ratio (OR) = 1.19, 95% confidence interval (CI) = 1.01, 1.40], attention deficit hyperactivity disorder severity (OR = 1.25, 95% CI = 1.04, 1.51), antisocial personality disorder severity (OR = 1.18, 95 % CI = 1.04, 1.34), relationship with parents (OR = 0.74, 95% CI = 0.63, 0.88), number of friends with drug problems (OR = 1.33, 95% CI = 1.11, 1.60) and the personality dimensions neuroticism-anxiety (OR = 1.35, 95% CI = 1.11, 1.65) and sociability (OR = 0.78, 95% CI = 0.62, 0.97). CONCLUSIONS Factors associated with persistent cannabis use disorder in young Swiss men include cannabis use, cannabis use disorder severity, mental health problem severity, relationship with parents (before the age of 18), peers with drug problems and the personality dimensions neuroticism-anxiety and sociability at or before age 20. Effect sizes may be small, and predictors are mainly associated with persistence via higher severity at age 20 years.

Background Information about correlates of cannabis vaping in Europe is scarce. Methods In a cohort of 1613 Swiss young males currently using cannabis, we used logistic regression, adjusting for age, linguistic region and education to assess the association between sensation seeking, substance use and sociodemographic variables with cannabis vaping. Results Mean age was 25.38 years, 60.4% had post-secondary education and 57.3% lived in French-speaking cantons; 26.3% met criteria for nicotine dependence, 16.0% met criteria for alcohol use disorder and 34.9% used illicit drugs other than cannabis; 27.4% used cannabis at least twice a week and 27.8% met criteria for cannabis use disorder (CUD). Ninety-four participants (5.8%) reported cannabis vaping (of them 87.4% reported infrequent cannabis vaping). In the adjusted analysis, using joints with no tobacco {adjusted odds ratio (aOR) [95% confidence interval (CI)] = 1.45 (1.02–1.76)}, water pipe with [aOR (95% CI) = 1.70 (1.29–2.24)] and without tobacco [aOR (95% CI) = 2.15 (1.60–2.87)], cannabis mixed with food [aOR (95% CI) = 1.61 (1.29–2.02)], using cannabis >2 times a week [aOR (95% CI) = 3.73 (2.40–5.81)], meeting criteria for CUD [aOR (95% CI) = 4.19 (2.70–6.50)], using illicit drugs other than cannabis [aOR (95% CI) = 1.88 (1.23–2.87)], weekly number of alcohol drinks [aOR (95% CI) = 1.01 (1.00–1.03)] and living in the German-speaking area of Switzerland [aOR (95% CI) = 2.70 (1.71–4.25)] were associated with higher odds of cannabis vaping; post-secondary schooling [aOR (95% CI) = 0.37 (0.16–0.86)] and vocational training [aOR (95% CI) = 0.41 (0.17–0.99)] (as opposed to primary schooling) were associated with lower odds of cannabis vaping. Conclusion Cannabis vaping might be a marker of riskier behaviours among cannabis users.

This paper was published in PLOS ONE, the final version can be found here: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0255050 AimsThe COVID-19 pandemic affected daily life worldwide. In addition to its tangible physical impacts, it may also have affected those who had been especially vulnerable already before the crisis and those who experienced substantial changes to their work situation during it. The present study aimed to investigate whether the psychological impact of the COVID-19 crisis varied with regards to young Swiss men’s pre-crisis level of education and socioeconomic status and to changes in their work situation due to it. MethodsA cohort of 2345 young Swiss men (mean age = 29) completed survey-based assessments shortly before (April 2019 to February 2020) and early on during the COVID-19 crisis (May to June 2020). Outcomes measured were psychological outcomes before and during the COVID-19 crisis (depression, perceived stress and sleep quality), and the fear, isolation and psychological trauma induced by it. We investigated associations between these outcomes and their predictors: pre-crisis socioeconomic status (relative financial status and difficulty paying bills) and level of education, changes in work situation during the crisis (job loss, partial unemployment, working from home, change in workload) and working in contact with potentially infected people, both inside and outside the healthcare sector. ResultsCOVID-19 changed the employment status of about 21% of participants (job loss, partial unemployment or lost money if self-employed). More than 40% worked predominantly from home during the crisis. Participants with a lower socioeconomic status experienced higher psychological impact (depression, perceived stress, sleep quality, psychological trauma, fear and isolation) due to the COVID-19 crisis. A higher impact was also felt by participants who lost their job due to the COVID-19 crisis, the partially unemployed, those with an increased workload or those who worked mainly from home. Overall, working in contact with potentially infected people was not associated with psychological impact.ConclusionsEven in a country like Switzerland, with relatively high social security benefits and universal healthcare, the COVID-19 crisis had a considerable psychological impact, especially among those with a lower socioeconomic status and those who experienced deteriorations in their work situation due to the COVID-19 crisis. Supporting these populations during the crisis may help to prevent an amplification of inequalities in mental health and social status. Such support could help to lower the overall impact of the crisis on the mental well-being of Switzerland’s population.

BackgroundRandomised controlled trials have shown some benefits to using e-cigarettes (ECs) to facilitate smoking reduction and cessation, but real-world observational studies have rarely confirmed this. The present study looked at EC use and smoking during a four-year longitudinal study of young men. It compares general population findings with a subgroup of individuals with a good prognosis for quitting smoking. MethodsThe smoking habits of 5353 young men at t1 (average 21.3 years old) were defined as either never-smoker, ex-smoker, initiates, relapsed smoker or persistent smoker. At follow-up (t2), smoking status was analysed using logistic regression, differences in the number of cigarettes smoked by persistent t1/t2 smokers were analysed using mixed linear models and the number of quit attempts was analysed using negative binomial models. ResultsAt the general population level, EC use had no beneficial effects on reducing or ceasing smoking. Non-smokers (never- and ex-) and smokers at t1 were more likely to be smokers at t2 if they had begun to use ECs (e.g. among persistent smokers OR=4.56, 95% CI [2.75, 7.58]), but not-significantly so if they had already used ECs at t1. Among smokers at t1, almost daily EC use at t1 was associated with a non-significant reduction in smoking at t2 (OR=0.74, 95% CI [0.33, 1.65]), but occasional EC use significantly increased smoking at t2 (OR=3.05, 95% CI [2.29, 4.06]). Both daily and occasional EC use increased smoking at t2 among t1 non-smokers. T2 smokers made more attempts to quit when using ECs at t2 (IRR=1.53, 95% CI [1.26, 1.85]). Beneficial effects were found among a subgroup of EC users with a good prognosis for quitting (using nicotine liquids and at least 2nd generation ECs, motivation to quit and daily EC use at t2, but not t1). ConclusionSome smokers may have benefitted from using ECs, but they were few. At the general population level, ECs are not predominantly used in a way, which might optimise reducing or ceasing smoking. Therefore, the public health effect on the general population of using ECs may be questionable, as may policy measures to facilitate EC use.

Background and aims It is well documented that individuals with a minority sexual orientation face greater risks of problematic substance use (e.g. heavy episodic drinking, alcohol use disorder) and mental health problems. Far less is known about how that risk varies within this population and their risk of behavioural addictions. This study estimated the risks of problematic substance use, behavioural addiction and poor mental health across the spectrum of sexual orientation. Sample and method A sample of young Swiss men (N = 5294; mean age = 25.5, SD = 1.25; representative of 21 of Switzerland’s 26 cantons) completed a self-reporting questionnaire on sexual orientation (attraction, 5-point scale) and criterion variables: problematic substance use (e.g. alcohol, cigarettes, cannabis and other illegal drugs), behavioural addictions (gambling, gaming, cybersex, internet, smartphone, work, exercise) and indicators of mental health (e.g. depression, stress). Curvilinear associations between sexual orientation (heterosexual, mostly-heterosexual, bisexual, mostly-homosexual or homosexual individuals) and criterion variables were explored using fractional polynomial regressions. Results Although there were differences across criterion variables, in general, the highest risks of problematic substance use, behavioural addictions and mental health problems were estimated for mostly-heterosexual, bisexual or mostly-homosexual men, followed by homosexual men, and with heterosexual men facing the lowest risk. Discussion and conclusion Aggregating the spectrum of sexual orientations into two or three distinct groups blurs important internal group differences. Outcome-specific explanations beyond minority stress and biphobia are necessary to understand the pathways between sexual orientation and risky behaviours. Considering sexual orientation is important to provide targeted healthcare prevention and interventions.

Objective: It is well known that certain personality traits are associated with alcohol use. Because less is known about it, we wished to investigate whether changes in alcohol use were longitudinally associated with changes in personality and in which direction the influence or causation might flow. Methods: Data came from the self-reported questionnaire answers of 5,125 young men at two time points during the Cohort study on Substance Use Risk Factors (C-SURF). Their average ages were 20.0 and 25.4 years old at the first and second wave assessments, respectively. Four personality traits were measured: (a) aggression–hostility; (b) sociability; (c) neuroticism–anxiety; and (d) sensation seeking. Alcohol use was measured by volume (drinks per week) and binge drinking (about 60+ grams per occasion). Cross-lagged panel models and two-wave latent change score models were used. Results: Aggression–hostility, sensation seeking, and sociability were significantly and positively cross-sectionally associated with both alcohol use variables. Drinking volume and these three personality traits bidirectionally predicted each other. Binge drinking was bidirectionally associated with sensation-seeking only, whereas aggression–hostility and sociability only predicted binge drinking, but not vice versa. Changes in alcohol use were significantly positively associated with changes in aggression–hostility, sensation seeking, and sociability. Associations reached small Cohen's effect sizes for sociability and sensation seeking, but not for aggression–hostility. Associations with neuroticism–anxiety were mostly not significant. Conclusion: The direction of effects confirmed findings from other studies, and the association between changes in personality and alcohol use support the idea that prevention programs should simultaneously target both.

Background:Recent theories suggest that behavioural addictions and substance use disorders may be the result of the same underlying vulnerability. The present study investigates profiles of family background, personality and mental health factors and their associations with seven behavioural addictions (to the internet, gaming, smartphones, internet sex, gambling, exercise and work) and three substance use disorder scales (for alcohol, cannabis and tobacco).Methods:The sample consisted of 5287 young Swiss men (mean age = 25.42) from the Cohort Study on Substance Use Risk Factors (C-SURF). A latent profile analysis was performed on family background, personality and mental health factors. The derived profiles were compared with regards to means and prevalence rates of the behavioural addiction and substance use disorder scales.Results:Seven latent profiles were identified, ranging from profiles with a positive family background, favourable personality patterns and low values on mental health scales to profiles with a negative family background, unfavourable personality pattern and high values on mental health scales. Addiction scale means, corresponding prevalence rates and the number of concurrent addictions were highest in profiles with high values on mental health scales and a personality pattern dominated by neuroticism. Overall, behavioural addictions and substance use disorders showed similar patterns across latent profiles.Conclusion:Patterns of family background, personality and mental health factors were associated with different levels of vulnerability to addictions. Behavioural addictions and substance use disorders may thus be the result of the same underlying vulnerabilities.

Transition into adulthood is a risky period for young people with attention deficit-hyperactivity disorder (ADHD), but empirical studies on this topic are scarce. This study investigated the association between the level of ADHD symptoms and transition into adulthood. Data were collected in the Cohort Study of Substance Use and Risk Factors among a representative sample of young Swiss men (n = 4681) over three waves. Measures included the level of ADHD symptoms and emerging adulthood assessed with the Inventory of the Dimensions of Emerging Adulthood and indicators of successful transition into adulthood. The level of ADHD symptoms was associated with a lower success in the transition into adulthood. Young people with high level of ADHD symptoms had a reduced increase in indicators of successful transition over time. Inattention symptoms were more strongly associated with emerging adulthood measures in comparison with hyperactive symptoms. The level of ADHD symptoms may delay the transition into adulthood, especially inattentive symptoms. Providing tailored interventions to emerging adults with ADHD symptoms may decrease the substantial impairments adults with ADHD experience in life.

AIM To estimate the long-term efficacy of an internet-based brief intervention (IBI) in decreasing alcohol use among men on (1) number of drinks/week and (2) monthly or more binge drinking prevalence. In addition, overall changes in alcohol use were assessed. DESIGN Participants in a cohort study were recruited in a two parallel-group randomized controlled trial of an IBI versus no-intervention control condition, showing a positive intervention effect at 6 months. As part of the regular cohort assessments, participants were re-assessed 47 months after the initial trial, offering an opportunity to determine long-term efficacy. SETTING Young Swiss men from the general population. PARTICIPANTS Of 737 randomized trial participants with unhealthy alcohol use (> 14 drinks/week or ≥ 6 drinks/occasion at least monthly, or Alcohol Use Disorders Identification Test (AUDIT) ≥ 8), 626 completed a cohort assessment at mean ± standard deviation (SD) = 47.4 ± 2.6) months after their randomized trial baseline assessment. INTERVENTION IBI included normative and personalized feedback on alcohol use, risk indicators, information about alcohol and health and recommendations; controls: assessment only. MEASUREMENTS Self-reported number of drinks/week and monthly or more binge drinking prevalence. FINDINGS Comparisons at follow-up were adjusted for baseline drinking. Missing values were replaced with the last observation carried forward. There was no evidence of differences between the IBI and control group on either the number of drinks/week [IBI: 10.8 (14.2); control: 10.7 (14.1), P = 0.8] or monthly or more binge drinking prevalence (IBI: 65.1%; control: 63.5%, P = 0.5). Although there was no evidence of overall change from baseline in number of drinks/week [9.8 (7.9) at baseline, 10.8 (14.1) at 47 months, P = 0.051], there was evidence that monthly or more binge drinking prevalence had decreased during the follow-up time (84.9% at baseline, 64.3% at 47 months, P