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Chemsex is the interplay of substance use by men who have sex with men (MSM) in sexual contexts. The minority stress model and the identity process theory are explanatory models. In this study, we investigated whether (i) differences in certain psychosocial aspects (i.e., shame, aspects of queer identity, and sexual self-concepts) exist between chemsex users and non-users, and (ii) which factors influence an awareness of negative impacts in chemsex users. We conducted an anonymous, cross-sectional, online survey, including sociodemography, sexual history, history of substance use, validated scales for shame-proneness, aspects of queer identity, and sexual self-concepts. Our analysis comprised descriptive statistics, t-tests, Spearman's correlations, and a multiple linear regression model. We recorded a total of 3257 datasets with 107 chemsex users. Chemsex users showed higher rates for risky sexual behavior. Values for shame proneness, more negative aspects of queer identity, and sexual self-concepts were elevated in chemsex users with an awareness of negative impacts. Sexual anxiety, intravenous substance use, and having had a difficult process coming out were significant predictors of feeling negative impacts. Aspects of shame, queer identity aspects, and sexual self-concepts play an important role in the field of chemsex. Different explanatory models seem to be relevant for different subgroups of chemsex users. Chemsex users with an awareness of a problem were particularly vulnerable and distressed but had the highest motivation for change. Prevention, counseling, and care might profit from the inclusion of these aspects. Further anti-stigma campaigns and a specialization of the healthcare system are needed. Registration: DRKS00022336, date: 29th of October, 2020. [ABSTRACT FROM AUTHOR]

Non-invasive brain stimulation methods are currently being evaluated for treatment of addictive disorders. Some evidence indicates that modulating left and right prefrontal brain activity by transcranial direct current stimulation (tDCS) can reduce craving and relapse rates in tobacco addiction. Therefore, this study investigated the effects of active and sham tDCS as an add-on treatment to a standardized brief intervention for smoking cessation. This randomized, double-blind study included 36 participants (22 women and 14 men) with nicotine dependence according to ICD-10 criteria. At five visits on alternate days, participants underwent a 20-min active or sham tDCS over the left dorsolateral prefrontal cortex and subsequently participated in a 10-min brief intervention for smoking cessation. Patients were followed up after 3 months. On each treatment day and at follow-up, abstinence was assessed as the smoking status nonsmoker and craving was assessed with the German version of the Questionnaire on Smoking Urges. At each visit, the number of cigarettes smoked per day was recorded and carbon monoxide in expired air and cotinine in saliva were measured. At follow-up, a study-specific questionnaire was used to assess tobacco use. All 36 participants completed the treatment sessions, but one participant in each group was lost to follow-up. Abstinence rates were not significantly different between the groups at any of the study visits, but craving was significantly lower in the active group at tDCS session 5 compared with session 1. tDCS combined with a brief intervention may support smoking cessation, but studies need to evaluate whether longer and more intensive treatment can achieve significant, sustainable effects. [ABSTRACT FROM AUTHOR]

Heated tobacco products (HTPs) produce aerosol using a different mechanism than tobacco cigarettes, leading to lower emissions of some harmful substances, but also of nicotine as reported by some independent studies. Lower nicotine delivery could lead to compensatory puffing when product use does not sufficiently satisfy cravings. Thus, this three-arm crossover study was conducted to characterize the potential of two different HTPs to deliver nicotine and satisfy cravings compared with conventional cigarettes in users who had already switched to HTPs. Fifteen active, non-exclusive HTP users consumed the study products according to a pre-directed puffing protocol. At predetermined time points, venous blood was sampled and the subjective effects of consumption were assessed. Nicotine delivery by both HTPs was comparable, but significantly lower than that by conventional cigarettes, suggesting a lower addictive potential. Cravings were reduced by all products, with no statistically significant differences between them, despite the different nicotine deliveries. This indicated that HTPs do not necessarily need high nicotine deliveries with high addictive potential, as are characteristic of tobacco cigarettes. These results were followed up on with an ad libitum use study. [ABSTRACT FROM AUTHOR]

Objective: Tobacco control measures are relevant also in child and adolescent psychiatric institutions and their implementation in Germany will be assessed in this study., Methods: In an online survey, n=78 leading staff members responded to standardized questions assessing how smoking in patients was dealt in such institutions., Results: The majority of institutions (70-87%) had smoking bans in the psychiatric clinic buildings and premises. Depending on the type of psychiatric ward, exceptions were in place in the form of a designated smoking area (38%), smoking pavilion (19%), or when patients suffered from certain mental disorders (28%). Documentation of violations of the ban varied with the type of ward (30-79%), while in most cases violations led to consequences (84-93%) including confiscation of smoking utilities (42-63%) or a curfew (25-38%). Smoking cessation aids were reported by 78% of the institutions, most often as consultations (64%). Pharmacological treatments for smoking were provided in inpatient wards (71-83%). One in two institutions documented the result of cessation attempts (54%). Smoking-related working groups (14%) or the use of standardized diagnostic instruments (0-4%) were much less frequently reported., Discussion: We provide a first look at tobacco control policy measures in child and adolescent psychiatric institutions on a national scale. This allows us to derive future areas for tobacco control., Competing Interests: Die Durchführung der Studie erfolgte ohne finanzielle Zuwendung durch Tabakindustrie oder öffentliche/universitäre/private Drittmittelgeber. Die Autoren erklären, dass sie bezogen auf die vergangenen 3 Jahren folgende Interessenkonflikte berichten: SKP ist freiberuflicher Mitarbeiter an einer universitären Raucherambulanz und erhielt Vortragshonorare durch den Berufsverband Pneumologen Sachsen und ein Konsortium von Tagungssponsoren (AbbVie Germany, Almirall Hermal, Belano medical, Celgene, Janssen-Cilag, LEO Pharma, Lilly Germany, Novartis Pharma, Pfizer Pharma, UCB Pharma). SM ist Gesellschafter und Geschäftsführer einer Psychotherapeutischen Hochschulambulanz mit angebundener Raucherambulanz und steuert verantwortlich Studien zur Umsetzung möglicher Strategien für die breite Anwendung von Tabakentwöhnung innerhalb der Gesundheitsversorgung (Förderer: AOK PLUS, Deutsche Krebsstiftung, Sächsische Landesregierung, Spitzenverband GKV). CR ist angestellt im Deutschen Netzwerk Rauchfreier Krankenhäuser und Gesundheitseinrichtungen e.V. und erhielt Unterstützung bei der Kongressteilnahme durch den Veranstalter des Deutschen Suchtkongresses sowie Honorare für die Durchführung einer klinischen Auftragsstudie (Bundesministerium für Gesundheit). TR erhielt Vortragshonorare (Pfizer Pharma, Johnson+Johnson, Sanofi) und Zuschüsse zur Koyngressteilnahme (Pfizer Pharma, Johnson+Johnson). MT, KL, VR, MNS, AR berichten keine Interessenkonflikte., (Thieme. All rights reserved.)

Non-smoker protection and tobacco cessation Abstract. Objective: Whereas, on the one hand, employees in child and adolescent psychiatric institutions (CAP) have to enforce smoking bans among patients, on the other hand, they have a high likelihood of being smokers themselves. Little data are available on the enforcement of smoking regulations and what cessation support is offered by CAP institutions. Method: In an online survey, n = 78 senior staff members or directors of German CAP institutions (41.9 % of all addressed CAP institutions) responded to questions on smoking regulations, exceptions, and cessation support for employees. Results: The enforcement of comprehensive smoking bans is rarely reported (<20 % of CAP institutions). Employees are exempted or allowed to smoke mostly outside of the building (e. g., in designated smoking areas: 69-78 % depending on ward type). Cessation support was offered by less than half of the CAP institutions (47%). Conclusions: The data presented point toward future areas for tobacco control in CAP care, including transparent regulations, staff training, and dissemination of support for occupational smoking cessation.