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British Journal of Addiction

Impact factor: 4.577 5-Year impact factor: 4.948 Print ISSN: 0965-2140 Online ISSN: 1360-0443 Publisher: Wiley Blackwell (Blackwell Publishing)

Subjects: Psychiatry, Substance Abuse

Most recent papers:

  • Using cognitive modelling to investigate the psychological processes of the Go/NoGo discrimination task in male abstinent heroin misusers.
    Chi‐Wen Liang, Roy Yi‐Xiu Zhong, Yun‐Chen Chung, Chun‐Hung Pan, Muh‐Yong Yen, Chung‐Ping Cheng, Wen‐Yau Hsu.
    Addiction. May 29, 2014
    Aims To use cognitive modelling to investigate psychological processes underlying decision‐making in male abstinent heroin misusers (AHMs). Design A case–control study design. Setting A drug misuse treatment centre in Taiwan. Participants Eighty‐eight male AHMs and 48 male controls. Measurements Four parameters representing the attention to wins, learning rate, response sensitivity and incentive of heroin‐related stimuli from the modified Go/NoGo discrimination task. Findings A modified cue‐dependent learning (CD) model with four parameters representing attention to wins, learning rate, response sensitivity and incentive of heroin‐related stimuli had a lower value of the sum of Bayesian information criterion (showing a better fit) than the original CD model (9555.50 versus 11 192.22, P < 0.001). The AHM group had a higher value of the heroin‐incentive parameter than the control group (0.26 versus −1.66, P < 0.05). The attention to wins and heroin‐incentive parameters were associated positively with total commission rate and negatively with total omission rate in the AHM group (P < 0.001). Conclusions Male abstinent heroin misusers appear to be more influenced by heroin‐related stimuli during decision‐making than males with no history of heroin misuse.
    May 29, 2014   doi: 10.1111/add.12591   open full text
  • Spatial differences and temporal changes in illicit drug use in Europe quantified by wastewater analysis.
    Christoph Ort, Alexander L. N. Nuijs, Jean‐Daniel Berset, Lubertus Bijlsma, Sara Castiglioni, Adrian Covaci, Pim Voogt, Erik Emke, Despo Fatta‐Kassinos, Paul Griffiths, Félix Hernández, Iria González‐Mariño, Roman Grabic, Barbara Kasprzyk‐Hordern, Nicola Mastroianni, Axel Meierjohann, Thomas Nefau, Marcus Östman, Yolanda Pico, Ines Racamonde, Malcolm Reid, Jaroslav Slobodnik, Senka Terzic, Nikolaos Thomaidis, Kevin V. Thomas.
    Addiction. May 27, 2014
    Aims To perform wastewater analyses to assess spatial differences and temporal changes of illicit drug use in a large European population. Design Analyses of raw wastewater over a 1‐week period in 2012 and 2013. Setting and Participants Catchment areas of wastewater treatment plants (WWTPs) across Europe, as follows: 2012: 25 WWTPs in 11 countries (23 cities, total population 11.50 million); 2013: 47 WWTPs in 21 countries (42 cities, total population 24.74 million). Measurements Excretion products of five illicit drugs (cocaine, amphetamine, ecstasy, methamphetamine, cannabis) were quantified in wastewater samples using methods based on liquid chromatography coupled to mass spectrometry. Findings Spatial differences were assessed and confirmed to vary greatly across European metropolitan areas. In general, results were in agreement with traditional surveillance data, where available. While temporal changes were substantial in individual cities and years (P ranging from insignificant to <10−3), overall means were relatively stable. The overall mean of methamphetamine was an exception (apparent decline in 2012), as it was influenced mainly by four cities. Conclusions Wastewater analysis performed across Europe provides complementary evidence on illicit drug consumption and generally concurs with traditional surveillance data. Wastewater analysis can measure total illicit drug use more quickly and regularly than is the current norm for national surveys, and creates estimates where such data does not exist.
    May 27, 2014   doi: 10.1111/add.12570   open full text
  • Does Every US Smoker Bear the Same Cigarette Tax?
    Xin Xu, Ann Malarcher, Alissa O′Halloran, Judy Kruger.
    Addiction. May 27, 2014
    Aims To evaluate state cigarette excise tax pass‐through rates for selected price‐minimizing strategies. Design Multivariate regression analysis of current smokers from a stratified, national, dual‐frame telephone survey. Setting United States. Participants A total of 16,542 adult current smokers aged 18 years or older. Measurements Cigarette per pack prices paid with and without coupons were obtained for pack versus carton purchase, use of generic brands versus premium brands, and purchase from Indian reservations versus outside Indian reservations. Findings The average per pack prices paid differed substantially by price‐minimizing strategy. Smokers who used any type of price‐minimizing strategies paid substantially less than those who did not use these strategies (p<0.05). Premium brand users who purchased by pack in places outside Indian reservations paid the entire amount of the excise tax together with an additional premium of 7–10 cents per pack for every $1 increase in excise tax (pass‐through rate of 1.07–1.10, p<0.05). In contrast, carton purchasers, generic brand users, or those who were likely to made their purchases on Indian reservations paid only 30–83 cents per pack for every $1 tax increase (pass‐through rate of 0.30–0.83, p<0.05). Conclusions Many smokers in the US are able to avoid the full impact of state excise tax on cost of smoking by buying cartons, using generic brands and buying from Indian reservations.
    May 27, 2014   doi: 10.1111/add.12630   open full text
  • Varenicline efficacy and safety among methadone maintained smokers: A randomized placebo‐controlled trial.
    Shadi Nahvi, Yuming Ning, Kate S. Segal, Kimber P. Richter, Julia H. Arnsten.
    Addiction. May 27, 2014
    Aims To test the efficacy and safety of varenicline as an aid to smoking cessation in methadone maintained smokers. Design Multicenter, randomized, double‐blind, placebo‐controlled trial with random assignment to 12 weeks of varenicline 1 mg twice daily (n=57) or matched placebo (n=55), with in‐person and telephone counseling. Setting Urban methadone programmes in the Bronx, New York City, New York, USA. Participants Methadone maintenance patients, smoking ≥5 cigarettes/day, interested in quitting, stable in methadone treatment, without current axis I psychiatric disorders, suicidal ideation, or recent suicide attempts. Measurements Seven‐day point prevalence abstinence verified by expired carbon monoxide (CO) < 8 p.p.m at week 12 (primary outcome); CO‐verified abstinence, cigarettes/day, incident axis I psychiatric illness, suicidal ideation or serious adverse events (SAEs) at weeks 2, 4, 8, 12 or 24 (secondary outcomes). Findings Baseline demographic, smoking and clinical factors were similar between groups. Retention at 24 weeks was 90%. Subjects receiving varenicline were more likely than those receiving placebo to achieve abstinence (10.5% v 0%, p = .03; effect size 10.5%, 95% CI 4.4 – 19.3%) and to reduce smoking (median 5 v 2 cigarettes/day, p<.001) at 12 weeks. These effects were not maintained after drug treatment ceased. Incident psychiatric illness (OR = 0.84, 95% CI 0.16, 4.4) and suicidality (OR = 0.88, 95% CI 0.2, 5.2) were not different between groups. There were no psychiatric or cardiac SAEs. Conclusions Varenicline can aid short‐term smoking abstinence in methadone maintained smokers.
    May 27, 2014   doi: 10.1111/add.12631   open full text
  • Effects of depressive symptoms on antecedents of lapses during a smoking cessation attempt: an ecological momentary assessment study.
    Jeannette Brodbeck, Monica S. Bachmann, Anna Brown, Hans Joerg Znoj.
    Addiction. May 22, 2014
    Aims To investigate pathways through which momentary negative affect and depressive symptoms affect risk of lapse during smoking cessation attempts. Design Ecological momentary assessment was carried out during 2 weeks after an unassisted smoking cessation attempt. A 3‐month follow‐up measured smoking frequency. Setting Data were collected via mobile devices in German‐speaking Switzerland. Participants A total of 242 individuals (age 20–40, 67% men) reported 7112 observations. Measurements Online surveys assessed baseline depressive symptoms and nicotine dependence. Real‐time data on negative affect, physical withdrawal symptoms, urge to smoke, abstinence‐related self‐efficacy and lapses. Findings A two‐level structural equation model suggested that on the situational level, negative affect increased the urge to smoke and decreased self‐efficacy (β = 0.20; β = −0.12, respectively), but had no direct effect on lapse risk. A higher urge to smoke (β = 0.09) and lower self‐efficacy (β = −0.11) were confirmed as situational antecedents of lapses. Depressive symptoms at baseline were a strong predictor of a person's average negative affect (β = 0.35, all P < 0.001). However, the baseline characteristics influenced smoking frequency 3 months later only indirectly, through influences of average states on the number of lapses during the quit attempt. Conclusions Controlling for nicotine dependence, higher depressive symptoms at baseline were associated strongly with a worse longer‐term outcome. Negative affect experienced during the quit attempt was the only pathway through which the baseline depressive symptoms were associated with a reduced self‐efficacy and increased urges to smoke, all leading to the increased probability of lapses.
    May 22, 2014   doi: 10.1111/add.12563   open full text
  • Youth tobacco use type and associations with substance use disorders.
    Patricia A. Cavazos‐Rehg, Melissa J. Krauss, Edward L. Spitznagel, Richard A. Grucza, Laura Jean Bierut.
    Addiction. May 22, 2014
    Aims To examine the associations between youth poly‐tobacco use and substance use disorders. Design Analysis of data from the 2007–11 US National Survey on Drug Use and Health. Setting Randomly selected, household‐dwelling adolescents from the non‐institutionalized, civilian population of the United States. Participants A total of 91 152 adolescents (aged 12–17 years). Methods Logistic regression models were used to examine the associations between type of tobacco user (non‐user, users of alternative tobacco products only, users of cigarettes only and users of cigarettes plus alternative tobacco products) with past year alcohol, marijuana or other illicit drug use disorders, adjusting for demographic and social variables. Findings Compared with non‐users of tobacco, the greatest risk for substance use disorders was among users of cigarettes plus alternative tobacco products [alcohol disorder adjusted odds ratio (aOR) = 18.3, 95% confidence interval (CI) = 16.2–20.6; marijuana disorder aOR = 37.2, 95% CI = 32.5–42.7; other drug disorder aOR = 18.4, 95% CI = 15.4–21.8], followed by users of cigarettes only (alcohol disorder aOR = 9.6, 95% CI = 8.8–10.6; marijuana disorder aOR = 20.4, 95% CI = 18.1–23.0; other drug disorder aOR = 9.4, 95% CI = 7.8–11.4), then users of alternative tobacco products only (alcohol disorder aOR = 8.1, 95% CI = 6.7–9.6; marijuana disorder aOR = 9.2, 95% CI = 7.5–11.4; other drug disorder aOR = 3.2, 95% CI = 2.4–4.3). Conclusions Tobacco use in adolescence is associated with higher rates of substance use disorders across all tobacco users, especially among those who use cigarettes plus other tobacco products.
    May 22, 2014   doi: 10.1111/add.12567   open full text
  • Reciprocal Associations Between Cigarette Consumption and DSM‐IV Nicotine Dependence Criteria in Adolescent Smokers.
    Mei‐Chen Hu, Pamela C. Griesler, Melanie M. Wall, Denise B. Kandel.
    Addiction. May 20, 2014
    Aims To examine the interrelationships between cigarette consumption and DSM‐IV nicotine dependence (ND) criteria from smoking onset in adolescence up to seven years later, adjusting for alcohol consumption and DSM‐IV alcohol dependence (AD) criteria. Design A cohort drawn from grades 6‐10 in an urban school system was interviewed five times at 6‐month intervals (Waves 1‐5) and 4.5 years later (Wave 6). A parent was interviewed three times. Setting Chicago, Illinois. Participants Recent smokers (n=409). Measurements Structured household interviews ascertained number of cigarettes smoked, DSM‐IV ND symptoms, drinks consumed, DSM‐IV AD symptoms, and selected covariates. Analysis Reciprocal prospective associations between number of cigarettes smoked and ND criteria, controlling for time‐varying alcohol consumption and dependence criteria, were examined with cross‐lagged models. Findings Reciprocal associations between number of cigarettes smoked and ND criteria were both significant. Cigarette consumption had stronger associations with later ND (β=0.25, 95% CI=0.17‐0.32) than dependence had with later cigarette consumption (β=0.09, 95% CI=0.01‐0.16). Alcohol and cigarette consumption influenced each other; AD scores were associated with later ND scores but not the reverse. Reports of pleasant initial experiences from smoking were positively associated with cigarette consumption and ND the first year after smoking onset; later smoking onset was negatively associated with cigarette consumption the seventh year after onset; parental ND predicted cigarette consumption and ND throughout. Conclusions In adolescent smokers, higher cigarette consumption predicts later severity of DSM‐IV nicotine dependence more than the reverse. Smoking and drinking also influence each other mutually over time.
    May 20, 2014   doi: 10.1111/add.12619   open full text
  • Early age of alcohol initiation is not the cause of alcohol use disorders in adulthood, but is a major indicator of genetic risk. A population‐based twin study.
    Eivind Ystrom, Kenneth S. Kendler, Ted Reichborn‐Kjennerud.
    Addiction. May 20, 2014
    Background and aims An early age of alcohol initiation (AAI) is associated with and has been hypothesized to be a cause of alcohol use disorders (AUD) in adulthood. Results from twin studies, however, indicate that AAI is an indicator of risk for AUD. We aimed to test a causal hypothesis vs. a risk indicator hypothesis for the relationship between early AAI and AUD. Design A population‐based twin study using biometric twin modelling. Setting Norway. Participants A population‐based sample of 1336 Norwegian twins. Measurements Lifetime DSM‐IV AUDs were assessed by structured clinical interview, and AAI by questionnaire. Findings The risk indicator model in which the association between AAI and AUD was explained by common vulnerability was the best fit to the data. The heritability was 37% (95%CI 21%, 53%) for AAI and 62% (95%CI 51%, 73%) for AUD. Genetic risk for AAI accounted for 44% (95%CI 17%, 71%) of the total genetic risk for AUD, and the correlation between genetic factors for AAI and AUD was −0.66 (95%CI −0.87, −0.46). Individual‐specific environmental risk for AAI explained only 1% (95%CI 0%, 3%) of the risk for AUD. Shared environmental factors did not influence AUD, but accounted for 25% (95%CI 7%, 35%) of the variance in AAI. Conclusions The association between early age of alcohol initiation and alcohol use disorders in later life does not reflect a causal relationship, but is almost entirely due to common genetic risk factors.
    May 20, 2014   doi: 10.1111/add.12620   open full text
  • Future Orientation and Smoking Cessation: Secondary Analysis of Data from A Smoking Cessation Trial.
    Jane Beenstock, Nicola Lindson‐Hawley, Paul Aveyard, Jean Adams.
    Addiction. May 20, 2014
    Aims To examine the association between future orientation (how individuals consider and value outcomes in the future) and smoking cessation at four weeks and six months post quit‐date in individuals enrolled in a smoking cessation study. Design Cohort analysis of randomised controlled trial data. Setting UK primary care. Participants Adults aged ≥18 years smoking ≥15 cigarettes daily, prepared to quit in the next two weeks. Measurements Future orientation was measured prior to quitting and at four weeks post‐quitting using the Consideration of Future Consequences Scale. Smoking cessation at four weeks and six months was confirmed biochemically. Those lost to follow up were assumed to not be abstinent. Potential confounders adjusted for were: age, gender, educational attainment, nicotine dependence and longest previous period quit. Findings 697 participants provided data at baseline. 422 provided information on future orientation at four weeks. There was no evidence of an association between future orientation at baseline and abstinence at four weeks (adjusted odds ratio (95% confidence intervals): 1.05 (0.89 to 1.38) or six months (0.85 (0.60 to 1.20). There was no change in future orientation from baseline to four weeks and no evidence that the change differed between those who were and were not quit at four weeks (adjusted regression coefficient (95% confidence intervals): ‐0.04 (‐0.16 to 0.08). Conclusions In smokers who are prepared to quit in the next two weeks, extent of future orientation is unlikely to be a strong predictor of quitting over four weeks or six months and any increase in future orientation following quitting is likely to be small.
    May 20, 2014   doi: 10.1111/add.12621   open full text
  • Real‐world effectiveness of e‐cigarettes when used to aid smoking cessation: a cross‐sectional population study.
    Jamie Brown, Emma Beard, Daniel Kotz, Susan Michie, Robert West.
    Addiction. May 20, 2014
    Background And Aims Electronic cigarettes (e‐cigarettes) are rapidly increasing in popularity. Two randomised controlled trials have suggested that e‐cigarettes can aid smoking cessation but there are many factors that could influence their real‐world effectiveness. This study aimed to assess, using an established methodology, the effectiveness of e‐cigarettes when used to aid smoking cessation compared with nicotine replacement therapy (NRT) bought over‐the‐counter and with unaided quitting in the general population. Design And Setting A large cross‐sectional survey of a representative sample of the English population. Participants The study included 5863 adults who had smoked within the previous 12 months and made at least one quit attempt during that period with either an e‐cigarette only (n=464), NRT bought over‐the‐counter only (n=1922) or no aid in their most recent quit attempt (n=3477). Measurements The primary outcome was self‐reported abstinence up to the time of the survey, adjusted for key potential confounders including nicotine dependence. Findings E‐cigarette users were more likely to report abstinence than either those who used NRT bought over‐the‐counter (odds ratio 2.23, 95% confidence interval 1.70 to 2.93, 20.0% vs. 10.1%) or no aid (odds ratio 1.38, 95% confidence interval 1.08 to 1.76, 20.0% vs. 15.4%). The adjusted odds of non‐smoking in users of e‐cigarettes were 1.63 (95% confidence interval 1.17 to 2.27) times higher compared with users of NRT bought over‐the‐counter and 1.61 (95% confidence interval 1.19 to 2.18) times higher compared with those using no aid. Conclusions Among smokers who have attempted to stop without professional support, those who use e‐cigarettes are more likely to report continued abstinence than those who used a licensed NRT product bought over‐the‐counter or no aid to cessation. This difference persists after adjusting for a range of smoker characteristics such as nicotine dependence.
    May 20, 2014   doi: 10.1111/add.12623   open full text
  • Alcohol industry sponsorship and hazardous drinking in UK university students who play sport.
    Kerry S. O'Brien, Jason Ferris, Ian Greenlees, Sophia Jowett, Daniel Rhind, Penny Cook, Kypros Kypri.
    Addiction. May 13, 2014
    Aim To examine whether receipt of alcohol industry sponsorship is associated with problematic drinking in UK university students who play sport. Methods University students (n=2450) participating in sports were invited to complete a pen‐and‐paper questionnaire by research staff approaching them at sporting facilities and in university settings. Respondents were asked whether they personally, their team, and/or their club were currently in receipt of sponsorship (e.g., money, free or subsidised travel, or sporting products), from an alcohol‐related industry (e.g., bars, liquor stores, wholesalers), and whether they had solicited the sponsorship. Drinking was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Results Questionnaires were completed by 2048 of those approached (response rate=83%). Alcohol industry sponsorship was reported by 36% of the sample. After accounting for confounders (age, gender, disposable income, and location) in multivariable models, receipt of alcohol sponsorship by a team (adjusted βadj=.41, p=.013), club (βadj=.73, p=.017), team and club (βadj=.79, p=0.002), and combinations of individual and team or club sponsorships (βadj=1.27, p<0.002), were each associated with significantly higher AUDIT‐Consumption substance scores. Receipt of sponsorship by team and club (aOR=2.04; 95% CI: 1.04‐3.99) and combinations of individual and team or club sponsorships (aOR=4.12; 95% CI: 1.29‐13.15) were each associated with increased odds of being classified a hazardous drinker (AUDIT score >8). Respondents who sought out sponsorship were not at greater risk than respondents who had, or whose teams or clubs had, been approached by the alcohol industry. Conclusions University students in the United Kingdom who play sport and who personally receive alcohol industry sponsorship or whose club or team receives alcohol industry sponsorship appear to have more problematic drinking behaviour than UK university students who play sport and receive no alcohol industry sponsorship. Policy to reduce or cease such sponsorship should be considered.
    May 13, 2014   doi: 10.1111/add.12604   open full text
  • Sustained‐Release Methylphenidate in a Randomized Trial of Treatment of Methamphetamine Use Disorder.
    Walter Ling, Linda Chang, Maureen Hillhouse, Alfonso Ang, Joan Striebel, Jessica Jenkins, Jasmin Hernandez, Mary Olaer, Larissa Mooney, Susan Reed, Erin Fukaya, Shannon Kogachi, Daniel Alicata, Nataliya Holmes, Asher Esagoff.
    Addiction. May 13, 2014
    Background and aims No effective pharmacotherapy for methamphetamine (MA) use disorder has yet been found. This study evaluated sustained‐release methylphenidate (MPH‐SR) compared with placebo (PLA) for treatment of MA use disorder in people also undergoing behavioural support and motivational incentives. Design This was a randomized, double‐blind, placebo‐controlled design with MPH‐SR or PLA provided for 10 weeks (active phase) followed by 4 weeks of single‐blind PLA. Twice‐weekly clinic visits, weekly group counseling (CBT), and motivational incentives (MI) for MA‐negative urine drug screens (UDS) were included. Setting Treatment sites were in Los Angeles, California (LA) and Honolulu, Hawaii (HH), USA. Participants 110 MA‐dependent (via DSM‐IV) participants (LA = 90; HH = 20). Measurements The primary outcome measure is self‐reported days of MA use during the last 30 days of the active phase. Included in the current analyses are drug use (UDS and self‐report), retention, craving, compliance (dosing, CBT, MI), adverse events, and treatment satisfaction. Findings No difference was found between treatment groups in self‐reported days of MA use during the last 30 days of the active phase (p=0.22). In planned secondary outcomes analyses, however, the MPH group had fewer self‐reported MA use days from baseline through the active phase compared with the PLA group (p=0.05). The MPH group also had lower craving scores and fewer marijuana‐positive UDS than the PLA group in the last 30 days of the active phase. The two groups had similar retention, other drug use, adverse events, and treatment satisfaction. Conclusions Methylphenidate may lead to a marginal reduction in concurrent methamphetamine use when provided as treatment for patients undergoing behavioural support for moderate to severe methamphetamine use disorder but this requires confirmation.
    May 13, 2014   doi: 10.1111/add.12608   open full text
  • Who under‐reports their alcohol consumption in telephone surveys and by how much? An application of the Yesterday Method in a national Canadian substance use survey.
    Tim Stockwell, Jinhui Zhao, Scott Macdonald.
    Addiction. May 13, 2014
    Background and aim Adjustments for under‐reporting in alcohol surveys have been used in epidemiological and policy studies which assume that all drinkers underestimate their consumption equally. This study aims to describe a method of estimating how under‐reporting of alcohol consumption might vary by age, gender and consumption level. Method The Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) 2008 to 2010 (N= 43,371) asks about beverage specific ‘yesterday’ consumption (BSY) and Quantity‐Frequency (QF). Observed drinking frequencies for different age and gender groups were calculated from BSY and used to correct values of F in QF. Beverage‐specific correction factors for quantity (Q) were calculated by comparing consumption estimated from BSY with sales data. Results Drinking frequency was underestimated by males (Z=24.62, p<0.001) and females (Z=17.46, p<0.001) in the QF as assessed by comparing with frequency and quantity of Yesterday drinking. Spirits consumption was underestimated by 65.94% compared with sales data, wine by 38.35% and beer by 49.02%. After adjusting Q and F values accordingly, regression analysis found alcohol consumption to be under‐estimated significantly more by younger drinkers (e.g.82.9 ±1.19% for underage drinkers vs 70.38 ±1.54% for those 65+, p<0.001) and by low risk more than high risk drinkers (76.25 ±0.34% vs 49.22 ±3.01%, p<0.001). Under‐reporting did not differ by gender. Conclusions Alcohol consumption surveys can use the Beverage‐Specific Yesterday method to correct for underreporting of consumption among sub‐groups. Alcohol consumption among Canadians appears to be under‐reported to an equal degree by men and women. Younger drinkers underreport alcohol consumption to a greater degree than do older, while low risk drinkers underestimate more than do medium and high‐risk.
    May 13, 2014   doi: 10.1111/add.12609   open full text
  • Drinking in social groups. Does ‘groupdrink’ provide safety in numbers when deciding about risk?
    Tim Hopthrow, Georgina Randsley de Moura, Rose Meleady, Dominic Abrams, Hannah J. Swift.
    Addiction. May 05, 2014
    Aims To investigate the impact of alcohol consumption on risk decisions taken both individually and while part of a four‐ to six‐person ad‐hoc group. Design A 2 (alcohol: consuming versus not consuming alcohol) × 2 (decision: individual, group) mixed‐model design; decision was a repeated measure. The dependent variable was risk preference, measured using choice dilemmas. Setting Opportunity sampling in campus bars and a music event at a campus‐based university in the United Kingdom. Participants A total of 101 individuals were recruited from groups of four to six people who either were or were not consuming alcohol. Measurements Participants privately opted for a level of risk in response to a choice dilemma and then, as a group, responded to a second choice dilemma. The choice dilemmas asked participants the level of accident risk at which they would recommend someone could drive while intoxicated. Findings Five three‐level multi‐level models were specified in the software program HLM 7. Decisions made in groups were less risky than those made individually (B = −0.73, P < 0.001). Individual alcohol consumers opted for higher risk than non‐consumers (B = 1.27, P = 0.025). A significant alcohol × decision interaction (B = −2.79, P = 0.001) showed that individual consumers privately opted for higher risk than non‐consumers, whereas risk judgements made in groups of either consumers or non‐consumers were lower. Decisions made by groups of consumers were less risky than those made by groups of non‐consumers (B = 1.23, P < 0.001). Conclusions Moderate alcohol consumption appears to produce a propensity among individuals towards increased risk‐taking in deciding to drive while intoxicated, which can be mitigated by group monitoring processes within small (four‐ to six‐person) groups.
    May 05, 2014   doi: 10.1111/add.12496   open full text
  • Change in physical activity after smoking cessation: the Coronary Artery Risk Development in Young Adults (CARDIA) study.
    Reto Auer, Eric Vittinghoff, Catarina Kiefe, Jared P. Reis, Nicolas Rodondi, Yulia A. Khodneva, Stefan G. Kertesz, Jacques Cornuz, Mark J. Pletcher.
    Addiction. May 04, 2014
    Aims To estimate physical activity trajectories for people who quit smoking, and compare them to what would have been expected had smoking continued. Design, Setting and Participants A total of 5115 participants in the Coronary Artery Risk Development in Young Adults Study (CARDIA) study, a population‐based study of African American and European American people recruited at age 18–30 years in 1985/6 and followed over 25 years. Measurements Physical activity was self‐reported during clinical examinations at baseline (1985/6) and at years 2, 5, 7, 10, 15, 20 and 25 (2010/11); smoking status was reported each year (at examinations or by telephone, and imputed where missing). We used mixed linear models to estimate trajectories of physical activity under varying smoking conditions, with adjustment for participant characteristics and secular trends. Findings We found significant interactions by race/sex (P = 0.02 for the interaction with cumulative years of smoking), hence we investigated the subgroups separately. Increasing years of smoking were associated with a decline in physical activity in black and white women and black men [e.g. coefficient for 10 years of smoking: −0.14; 95% confidence interval (CI) = −0.20 to −0.07, P < 0.001 for white women]. An increase in physical activity was associated with years since smoking cessation in white men (coefficient 0.06; 95% CI = 0 to 0.13, P = 0.05). The physical activity trajectory for people who quit diverged progressively towards higher physical activity from the expected trajectory had smoking continued. For example, physical activity was 34% higher (95% CI = 18 to 52%; P < 0.001) for white women 10 years after stopping compared with continuing smoking for those 10 years (P = 0.21 for race/sex differences). Conclusions Smokers who quit have progressively higher levels of physical activity in the years after quitting compared with continuing smokers.
    May 04, 2014   doi: 10.1111/add.12561   open full text
  • Association between stricter alcohol advertising regulations and lower hazardous drinking across European countries.
    Marina Bosque‐Prous, Albert Espelt, Anna M. Guitart, Montserrat Bartroli, Joan R. Villalbí, M. Teresa Brugal.
    Addiction. May 04, 2014
    Aims To analyse the association between alcohol advertising restrictions and the prevalence of hazardous drinking among people aged 50–64 years in 16 European countries, taking into account both individual and contextual‐level factors (alcohol taxation, availability, etc.). Design Cross‐sectional study based on SHARE project surveys. Setting and Participants A total of 27 773 subjects, aged 50–64 years, from 16 European countries who participated in wave 4 of the SHARE (Survey of Health, Ageing and Retirement in Europe) project. Measurements We estimated the prevalence of hazardous drinking (through adaptation of the SHARE questions to the scheme used by the Alcohol Use Disorders Identification Test Consumption (AUDIT‐C) for each country. To determine whether the degree of advertising restrictions was associated with prevalence of hazardous drinking, we fitted robust variance multi‐level Poisson models, adjusting for various individual and contextual variables. Prevalence ratios (PR) and their 95% confidence intervals (95% CI) were obtained. Findings The observed prevalence of hazardous drinking was 24.1%, varying by sex and country. Countries with greater advertising restrictions had lower prevalence of hazardous drinking: 30.6% (95% CI = 29.3–31.8) in countries with no restrictions, 20.3% (95% CI = 19.3–21.2) in countries with some restrictions and 14.4% (95% CI = 11.9–16.8) in those with greatest restrictions. The PR found (with respect to countries with greatest restrictions) were 1.36 (95% CI = 0.90–2.06) for countries with some restrictions and 1.95 (95% CI = 1.31–2.91) for those with no advertising restrictions. Conclusions The extent of advertising restrictions in European countries is associated inversely with prevalence of hazardous drinking in people aged 50–64 years.
    May 04, 2014   doi: 10.1111/add.12562   open full text
  • Gambling expenditure predicts harm: Evidence from a venue‐level study.
    Francis Markham, Martin Young, Bruce Doran.
    Addiction. April 28, 2014
    Background and Aims The Total Consumption Theory of gambling suggests that gambling expenditure is positively associated with gambling‐related harm. We test the hypothesis that electronic gaming machine (EGM) expenditure predicts gambling‐related harm at the level of the EGM venue. Design Cross‐sectional analysis of survey and administrative data. Setting General urban adult population of the Northern Territory of Australia. Participants Sample consisted of 7049 respondents to a mail‐survey about venue visitation and gambling behaviour across 62 EGM venues. Measurements Gambling‐related harm was defined as the endorsement of two or more items on the Problem Gambling Severity Index. We obtained venue‐level EGM expenditure data from the local licensing authority for all venues in the study area. We compared the prevalence of gambling‐related harm among patrons aggregated at the venue level with the estimated mean EGM expenditure for each adult resident in the venue's service area using a Huff model, correlation analysis and multivariate binomial regression. Findings Aggregated to the venue level (n = 62), per capita EGM expenditure was significantly correlated with rates of gambling‐related harm [r = 0.27, n = 62, p = 0.03]. After adjusting for venue type and number of EGMs, an increase in mean per capita monthly EGM expenditure from AUD10 to AUD150 was associated with a doubling in the prevalence of gambling‐related harm from 9% (95% CI 6% ‐ 12%) to 18% (95% CI 13% ‐ 23%). Conclusions As suggested by the Total Consumption Theory of gambling, aggregate patron electronic gaming machine expenditure predicts the prevalence of gambling‐related harm at the venue level.
    April 28, 2014   doi: 10.1111/add.12595   open full text
  • The impact of alcohol on clinical outcomes in established psychosis: a longitudinal study.
    Christine Barrowclough, Emily Eisner, Sandra Bucci, Richard Emsley, Til Wykes.
    Addiction. April 28, 2014
    Background and aims Alcohol use disorders are common among people with psychosis and are associated with poorer prognoses. In psychosis patients, there are inconsistent findings regarding the link between alcohol disorders and clinical symptomatic outcomes. This study examined the relationships between alcohol consumption and specific clinical outcomes, including affective symptoms, in psychosis. Methods Participants were recruited from secondary care services in the UK. Two hundred and ten participants whose substance use met inclusion for an alcohol disorder were compared with other substance users (n=117) on baseline demographic, clinical, and substance use variables. The alcohol sub‐group was assessed at three time points, with repeated measures of psychopathology and alcohol use over a 2 year period. Generalised Estimating Equations (GEE) models were used to examine whether change in alcohol use was associated with change in clinical outcomes. We controlled for a wide range of potential confounds, including other substance use. Results A small but specific effect was evident for change in the quantity of alcohol consumed on change in depression (adjusted coefficient for 10 total units over 90 days: 0.0015, p=0.047). Alcohol consumption was not associated with subsequent severity of psychotic symptoms (adjusted coefficient for Positive and Negative Syndrome Scale general for 10 average daily units 0.2492, p=0.420) or severity of anxiety symptoms (adjusted coefficient for 10 average daily units 0.0534, p=0.473). Conclusions For people with psychosis, the most detrimental effect of alcohol consumption appears to be its effect on mood. Some of this effect seems to be reversible, with drinking reduction associated with subsequent mood improvement.
    April 28, 2014   doi: 10.1111/add.12599   open full text
  • An Early Evaluation of Implementation of Brief Intervention for Unhealthy Alcohol Use in the U.S. Veterans Health Administration.
    Emily C. Williams, Anna D. Rubinsky, Laura J. Chavez, Gwen T. Lapham, Stacey E. Rittmueller, Carol E. Achtmeyer, Katharine A. Bradley.
    Addiction. April 28, 2014
    Aims The U.S. Veterans Health Administration (VA) used performance measures and electronic clinical reminders to implement brief intervention for unhealthy alcohol use. We evaluated whether documented brief intervention was associated with subsequent changes in drinking during early implementation. Design Observational, retrospective cohort study using secondary clinical and administrative data. Setting 30 VA facilities. Participants Outpatients who screened positive for unhealthy alcohol use (AUDIT‐C ≥ 5) in the 6 months after the brief intervention performance measure (n=22,214) and had follow‐up screening 9‐15 months later (n=6,210; 28%). Measurements Multilevel logistic regression estimated the adjusted prevalence of resolution of unhealthy alcohol use (follow‐up AUDIT‐C <5 with ≥ 2 point reduction) for patients with and without documented brief intervention (documented advice to reduce or abstain from drinking). Findings Among 6,210 patients with follow‐up alcohol screening, 1,751 (28%) had brief intervention and 2,922 (47%) resolved unhealthy alcohol use at follow‐up. Patients with documented brief intervention were older and more likely to have other substance use disorders, mental health conditions, poor health, and more severe unhealthy alcohol use than those without (p‐values <0.05). Adjusted prevalences of resolution were 47% (95% Confidence Interval (CI) 42% ‐ 52%) and 48% (95% CI 42% ‐ 54%) for patients with and without documented brief intervention, respectively (p=0.50). Conclusions During early implementation of brief intervention in the U.S. Veterans Health Administration, documented brief intervention was not associated with subsequent changes in drinking among outpatients with unhealthy alcohol use and repeat alcohol screening.
    April 28, 2014   doi: 10.1111/add.12600   open full text
  • The global epidemiology and burden of opioid dependence: results from the global burden of disease 2010 study.
    Louisa Degenhardt, Fiona Charlson, Bradley Mathers, Wayne D. Hall, Abraham D. Flaxman, Nicole Johns, Theo Vos.
    Addiction. April 24, 2014
    Aims To estimate the prevalence and burden of disease attributable to opioid dependence globally, regionally and at country level. Methods Multiple search strategies: (i) peer‐reviewed literature searches; (ii) systematic searches of online databases; (iii) internet searches; (iv) consultation and feedback from experts. Culling and data extraction followed protocols. DisMod‐MR, the latest version of the generic disease modelling system, a Bayesian meta‐regression tool, imputed prevalence by age, year and sex for 187 countries and 21 regions. Disability weight for opioid dependence was estimated through population surveys and multiplied by prevalence data to calculate the years of life lived with disability (YLDs). Opioid dependence premature mortality was computed as years of life lost (YLLs) and summed with YLDs to calculate disability‐adjusted life years (DALYs). Results There were 15.5 million opioid‐dependent people globally in 2010 [0.22%, 95% uncertainty interval (UI) = 0.20–0.25%]. Age‐standardized prevalence was higher in males (0.30%, 95% UI = 0.27–0.35%) than females (0.14%, 95% UI = 0.12–0.16%), and peaked at 25–29 years. Prevalence was higher than the global pooled prevalence in Australasia (0.46%, 95% UI = 0.41–0.53%), western Europe (0.35%, 95% UI = 0.32–0.39) and North America (0.30%, 95% UI = 0.25–0.36). Opioid dependence was estimated to account for 9.2 million DALYs globally (0.37% of global DALYs) in 2010, a 73% increase on DALYs estimated in 1990. Regions with the highest opioid dependence DALY rates were North America (292.1 per 100 000), eastern Europe (288.4 per 100 000), Australasia (278.6 per 100 000) and southern sub‐Saharan Africa (263.5 per 100 000). The contribution of YLLs to opioid dependence burden was particularly high in North America, eastern Europe and southern sub‐Saharan Africa. Conclusion Opioid dependence is a substantial contributor to the global disease burden; its contribution to premature mortality (relative to prevalence) varies geographically, with North America, eastern Europe and southern sub‐Saharan Africa most strongly affected.
    April 24, 2014   doi: 10.1111/add.12551   open full text
  • Randomized controlled trial to assess the short‐term effectiveness of tailored web‐ and text‐based facilitation of smoking cessation in primary care (iQuit in Practice).
    Felix Naughton, James Jamison, Sue Boase, Melanie Sloan, Hazel Gilbert, A. Toby Prevost, Dan Mason, Susan Smith, James Brimicombe, Robert Evans, Stephen Sutton.
    Addiction. April 24, 2014
    Aims To estimate the short‐term effectiveness, feasibility and acceptability of a smoking cessation intervention (the iQuit system) that consists of tailored printed and Short Message Service (SMS) text message self‐help delivered as an adjunct to cessation support in primary care to inform the design of a definitive trial. Design A stratified two parallel‐group randomized controlled trial comparing usual care (control) with usual care plus the iQuit system (intervention), delivered by primary care nurses/healthcare assistants who were blinded to the allocation sequence. Setting Thirty‐two general practice (GP) surgeries in England, UK. Participants A total of 602 smokers initiating smoking cessation support from their local GP surgery were randomized (control n = 303, intervention n = 299). Measurements Primary outcome was self‐reported 2‐week point prevalence abstinence at 8 weeks follow‐up. Secondary smoking outcomes and feasibility and acceptability measures were collected at 4 weeks after quit date, 8 weeks and 6 months follow‐up. Findings There were no significant between‐group differences in the primary outcome [control 40.3%, iQuit 45.2%; odds ratio (OR) = 1.22, 95% confidence interval (CI) = 0.88–1.69] or in secondary short‐term smoking outcomes. Six‐month prolonged abstinence was significantly higher in the iQuit arm (control 8.9%, iQuit 15.1%; OR = 1.81, 95% CI = 1.09–3.01). iQuit support took on average 7.7 minutes (standard deviation = 4.0) to deliver and 18.9% (95% CI = 14.8–23.7%) of intervention participants discontinued the text message support during the programme. Conclusions Tailored printed and text message self‐help delivered alongside routine smoking cessation support in primary care does not significantly increase short‐term abstinence, but may increase long‐term abstinence and demonstrated feasibility and acceptability compared with routine cessation support alone.
    April 24, 2014   doi: 10.1111/add.12556   open full text
  • Sexual orientation and alcohol problem use among UK adolescents: an indirect link through depressed mood.
    Francesca Pesola, Katherine H. Shelton, Marianne B. M. Bree.
    Addiction. April 17, 2014
    Background and Aims Sexual minority adolescents are more likely to engage in alcohol use than their heterosexual counterparts; however, the underlying reasons remain unclear and longitudinal research is limited. Owing to evidence that this group also experiences greater depressive symptoms than their peers, we aimed to (i) assess to what extent depressed mood explains the increased likelihood of engaging in alcohol use among sexual minority adolescents, and (ii) explore potential gender‐specific patterns. Design Structural equation modelling was used to test the indirect relationship between sexual orientation and alcohol use through depressed mood, with heterosexuals as the reference group. Settings and Participants A total of 3710 adolescents (12% sexual minority), from the Avon Longitudinal Study of Parents and Children (ALSPAC) study, assessed between the ages of 15 and 18 years. Measurements Sexual orientation was assessed at age 15, while alcohol use was measured using the Alcohol Use Disorders Identification Test (AUDIT) at age 18. Depressed mood was indexed by the Short Mood and Feelings Questionnaire (SMFQ) at age 16. Findings Sexual minority adolescents were more likely to engage in alcohol problem use compared to their heterosexual counterparts [Btotal = 0.12, 95%confidence interval (CI) = 0.04–0.20, P = 0.003]. Depressed mood explained 21% of the link between sexual orientation and alcohol use after adjustment for covariates and earlier measures (Z = 3.2, P = 0.001). No gender differences were observed. Conclusions A higher prevalence of alcohol problem use in adolescents who are gay, lesbian or bisexual is partly explained by increased rates of depression in this group.
    April 17, 2014   doi: 10.1111/add.12528   open full text
  • Betel‐quid dependence domains and syndrome associated with betel‐quid ingredients among chewers: an Asian multi‐country evidence.
    Chien‐Hung Lee, Shang‐Lun Chiang, Albert Min‐Shan Ko, Chun‐Hung Hua, Ming‐Hsui Tsai, Saman Warnakulasuriya, Salah Osman Ibrahim, Sunarjo, Rosnah Binti Zain, Tian‐You Ling, Chieh‐Liang Huang, Hsien‐Yuan Lane, Cheng‐Chieh Lin, Ying‐Chin Ko.
    Addiction. April 14, 2014
    Aims Betel‐quid (BQ) contains biologically psychoactive ingredients; however, data are limited concerning the symptoms and syndrome of BQ dependence among chewers. The aims of this study were to evaluate the ingredients‐associated BQ dependence syndrome and country‐specific chewing features and behaviour for BQ dependence among chewers from six Asian communities. Design An intercountry Asian Betel‐quid Consortium study. Setting Six Asian general communities in Taiwan, Mainland China, Indonesia, Malaysia, Sri Lanka and Nepal. Participants Six multi‐stage random samples of BQ chewers in the Asian Betel‐quid Consortium study (n = 2078). Measurements All chewers were evaluated for BQ dependence using the DSM‐IV and ICD‐10 criteria. Findings The 12‐month BQ dependence rate was 12.5–92.6% and 47.9–99.3% (P = 0.023) among tobacco‐free and tobacco‐added BQ chewers across the six Asian communities, with a higher dependence rate in chewers who used tobacco‐free BQ with lime added than without (23.3–95.6% versus 4.0%, P ≤ 0.001). Taiwanese and Hunanese BQ chewers both notably endorsed the dependency domain of ‘time spent chewing’. ‘Tolerance’ and ‘withdrawal’ were the major dependence domains associated with the Nepalese and Indonesian chewers, with high BQ dependence rates. Malaysian and Sri Lankan chewers formed a BQ dependence cluster linked closely to ‘craving’. In Sri Lanka, the quantity consumed explained 90.5% (P < 0.001) of the excess dependence risk for tobacco‐added use, and could be a mediator between tobacco‐derived psychoactive effect and BQ dependence development. Conclusions DSM‐IV criteria for dependence apply to a significant proportion of betel quid users in Asian communities, more so if they use it with tobacco or lime.
    April 14, 2014   doi: 10.1111/add.12530   open full text
  • The impact of opioid substitution therapy on mortality post‐release from prison: retrospective data linkage study.
    Louisa Degenhardt, Sarah Larney, Jo Kimber, Natasa Gisev, Michael Farrell, Timothy Dobbins, Don J. Weatherburn, Amy Gibson, Richard Mattick, Tony Butler, Lucy Burns.
    Addiction. April 14, 2014
    Aims Release from prison is a high‐risk period for mortality. We examined the impact of opioid substitution therapy (OST), for opioid dependence during and after incarceration, upon mortality post‐release. Design A cohort was formed of all opioid‐dependent people who entered OST between 1985 and 2010 and who, following first OST entry, were released from prison at least once between 2000 and 2012. We linked data on OST history, court and prison records and deaths. Setting New South Wales (NSW), Australia. Participants A total of 16 453 people released from prison 60 161 times. Measurements Crude mortality rates (CMRs) were calculated according to OST retention; multivariable Cox regressions for post‐release periods were undertaken to examine the association between OST exposure (a time‐dependent variable) and mortality post‐release, for which covariates were updated per‐release. Findings There were 100 978 person‐years (PY) post‐release; 1050 deaths occurred. Most received OST while incarcerated (76.5%); individuals were receiving OST in 51% of releases. Lowest post‐release mortality was among those continuously retained in OST post‐release CMR 4 weeks post‐release = 6.4 per 1000 PY; 95% confidence interval (CI) = 5.2, 7.8, highest among those with no OST (CMR = 36.7 per 1000 PY; 95% CI = 28.8, 45.9). Multi‐factorial models showed OST exposure in the 4 weeks post‐release reduced hazard of death by 75% (adjusted hazard ratio 0.25; 95% CI = 0.12, 0.53); OST receipt in prison had a short‐term protective effect that decayed quickly across time. Conclusion In New South Wales, Australia, opioid substitution therapy in prison and post‐release appears to reduce mortality risk in the immediate post‐release period.
    April 14, 2014   doi: 10.1111/add.12536   open full text
  • Trends in non‐drinking among Australian adolescents.
    Michael Livingston.
    Addiction. April 10, 2014
    Background and Aims Recent evidence suggests that there has been a sharp increase in non‐drinking among Australian adolescents. This study aimed to explore the socio‐demographic patterns of this increase to identify the potential causal factors. Design Two waves (2001 and 2010) of cross‐sectional data from the National Drug Strategy Household Survey, a large‐scale population survey. Logistic regression analyses were used to identify significant changes over time, with interaction terms used to test whether trends varied by respondent characteristics. Setting Australia. Participants Respondents aged 14–17 years (n = 1477 in 2001 and 1075 in 2010). Measurements The key outcome measure was 12‐month abstention from alcohol. Socio‐demographic variables including sex, age, income, socio‐economic status, state and rurality were examined. Findings Rates of abstention increased overall from 32.9% [95% confidence interval (CI) = 30.0–35.7%) to 50.2% (95% CI = 46.7–53.6%) (P < 0.01). Abstention increased significantly across all population subgroups examined. Conclusions A broad change in drinking behaviour has occurred among Australian adolescents in the last decade, with rates of abstention among 14–17‐year‐olds increasing markedly. Increases in abstention have occurred consistently across a wide range of population subgroups defined by demographic, socio‐economic and regional factors.
    April 10, 2014   doi: 10.1111/add.12524   open full text
  • Alcohol Consumption and Cognitive Performance: a Mendelian Randomisation Study.
    Meena Kumari, Michael V Holmes, Caroline E Dale, Jaroslav Hubacek, Tom M Palmer, Hynek Pikhart, Anne Peasey, Annie Britton, Pia Horvat, Ruzena Kubinova, Sofia Malyutina, Andrzej Pajak, Abdonas Tamosiunas, Aparna Shanka, Archana Singh‐Manoux, Mikhail Voevoda, Mika Kivimaki, Aroon D Hingorani, Michael G Marmot, Juan P Casas, Martin Bobak.
    Addiction. April 09, 2014
    Aims To use Mendelian randomisation to assess whether any versus no alcohol intake causes either increased or reduced cognitive function. Design Mendelian randomization using a genetic variant related to alcohol intake (ADH1B rs1229984) was used to obtain unbiased estimates of the association between any alcohol intake and either higher or lower cognitive performance. Setting Europe Participants More than 34,000 adults. Measurements Any versus no alcohol intake in the previous week was measured by questionnaire. Cognitive function was assessed in terms of immediate and delayed word recall, verbal fluency and processing speed. Findings Having consumed any vs no alcohol was associated with higher scores by 0.17 standard deviations (SD) (95% confidence interval [CI] 0.15, 0.20) for immediate recall, 0.17 SD (95%CI 0.14, 0.19) for delayed recall, 0.17 SD (95%CI 0.14, 0.19) for verbal fluency and 0.12 SD (95%CI 0.09, 0.15) for processing speed. The minor allele of rs1229984 was associated with reduced odds of consuming any alcohol (odds ratio 0.87; 95% CI 0.80, 0.95; P=0.001; R2=0.1%; F‐statistic=47). In Mendelian randomisation analysis, the minor allele was not associated with any cognitive test score, and instrumental variable analysis suggested no causal association between alcohol consumption and cognition: ‐0.74 SD (95%CI ‐1.88, 0.41) for immediate recall, ‐1.09 SD (95%CI ‐2.38, 0.21) for delayed recall, ‐0.63 SD (95%CI ‐1.78, 0.53) for verbal fluency and ‐0.16 SD (95%CI ‐1.29, 0.97) for processing speed. Conclusions Consuming alcohol in some quantity does not appear to affect cognitive ability.
    April 09, 2014   doi: 10.1111/add.12568   open full text
  • Are Alcohol Policies Associated with Alcohol Consumption in Low‐and Middle‐Income Countries?
    Won Kim Cook, Jason Bond, Thomas K. Greenfield.
    Addiction. April 09, 2014
    Aims To examine the associations between alcohol control policies in four regulatory domains with alcohol consumption in low‐ and middle‐income countries (LAMICs), controlling for country‐level living standards and drinking patterns. Design Cross‐sectional analyses of individual‐level alcohol consumption survey data and country‐level alcohol policies using multi‐level modeling Setting Data from 15 LAMICs collected in the Gender, Alcohol, and Culture: an International Study (GENACIS) Participants Persons aged 18‐65 Measurements Alcohol policy data compiled by the World Health Organization; individual‐level current drinking status, usual quantity and frequency of drinking, binge drinking frequency, and total drinking volume; Gross Domestic Product based on purchasing power parity (GDP‐PPP) per capita; detrimental drinking pattern scale; and age and gender as individual‐level covariates Findings Alcohol policies regulating the physical availability of alcohol, particularly those concerning business hours or involving a licensing system for off‐premises alcohol retail sales, as well as minimum legal drinking age, were the most consistent predictors of alcohol consumption. Aggregate relative alcohol price levels were inversely associated with all drinking variables (p<.05) except drinking volume. Greater restrictions on alcohol advertising, particularly beer advertising, were inversely associated with alcohol consumption (p<.05). Policies that set legal blood alcohol concentration (BAC) limits for drivers and random breath testing to enforce BAC limits were not significantly associated with alcohol consumption. Conclusions Alcohol policies that regulate the physical availability of alcohol are associated with lower alcohol consumption in low‐ and middle‐income countries.
    April 09, 2014   doi: 10.1111/add.12571   open full text
  • The declining trend in Swedish youth drinking: collectivity or polarization?
    Thor Norström, Johan Svensson.
    Addiction. March 28, 2014
    Aims Alcohol consumption among youth in Sweden has declined markedly during the last decade. This study aims to tackle the following research questions: (i) how is the decrease in drinking distributed across consumption categories; and (ii) is the pattern of change in consumption consistent with Skog's theory of the collectivity of drinking behaviour? Design, Setting, Participants and Measurements We analysed data from the nationally representative annual school survey of alcohol and drug habits among Swedish 9th‐grade students (aged 15–16 years) covering the period 2000–12 (n ≈ 5000/year). Respondents were divided into seven drinking groups based on their relative ranking on consumption, which was measured by beverage‐specific quantity and frequency items summarized into a measure of overall drinking in litres of 100% alcohol per year. In addition, the mean number of heavy episodic drinking occasions (HED) was computed for each drinking group. Findings The decline in consumption among Swedish youth was mirrored in all seven drinking groups, although the relative decrease was smaller for heavy drinkers (top 5%) than for light drinkers (below the median). Among the top 5%, the average annual decrease was 2% (P = 0.027), while the corresponding figure for light drinkers was 28.9% (P < 0.001). The reverse pattern was true when looking at the absolute decrease. The decrease among the top 5% accounted for 26.1% of the decrease in mean consumption during the study period, whereas the light drinkers accounted for 2.9%. There was a marked relation between overall consumption, on one hand, and mean consumption and HED, on the other hand, in each of the seven drinking groups. Conclusion The marked decrease in youth drinking in Sweden that occurred during the period 2000–12 was manifest at all consumption levels. The findings are consistent with Skog's theory of the collectivity of drinking behaviour.
    March 28, 2014   doi: 10.1111/add.12510   open full text
  • The collectivity of changes in alcohol consumption revisited.
    Ingeborg Rossow, Pia Mäkelä, William Kerr.
    Addiction. March 28, 2014
    Aims Within‐country temporal changes in alcohol consumption in the United States, Finland and Norway were examined to assess (i) whether a change in mean alcohol consumption is accompanied by a change in the prevalence of heavy drinkers, (ii) whether this mean change reflects a collective displacement in the whole distribution of consumption and (iii) whether collective displacement is found for both an upward and a downward shift in mean consumption. Methods We applied repeated cross‐sectional survey data on distribution measures for estimated annual alcohol consumption from national population sample surveys covering 30–40‐year periods in two countries with increasing trends in mean consumption (Finland and Norway) and one country with decreasing trends (the United States). Results There was a strong positive association (P < 0.001) between changes in mean consumption and changes in the prevalence of heavy drinkers in all three countries. Moreover, a change in mean consumption was accompanied by a consumption change in the same direction in all consumer categories in all three countries, i.e. a collective displacement. The regression coefficients were approximately 1. Conclusions Drinkers at all levels of consumption appear to move in concert, both up and down the consumption scale, in Finland, Norway and the United States, as predicted by Skog's theory of the collectivity of drinking cultures.
    March 28, 2014   doi: 10.1111/add.12520   open full text
  • Effectiveness of the ‘Healthy School and Drugs’ prevention programme on adolescents' substance use: a randomized clustered trial.
    Monique Malmberg, Marloes Kleinjan, Geertjan Overbeek, Ad Vermulst, Karin Monshouwer, Jeroen Lammers, Wilma A. M. Vollebergh, Rutger C. M. E. Engels.
    Addiction. March 25, 2014
    Aim To evaluate the effectiveness of the Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents. Design Randomized clustered trial with two intervention conditions (i.e. e‐learning and integral). Setting General population of 11–15‐year‐old adolescents in the Netherlands. Participants A total of 3784 students of 23 Dutch secondary schools. Measurements Structured digital questionnaires were administered pre‐intervention and at 32 months follow‐up. The primary outcome measures were new incidences of alcohol (life‐time and 1‐month prevalence), tobacco (life‐time and 1‐month prevalence) and marijuana use (life‐time prevalence). Findings Main effect analyses showed no programme effects on incidences of alcohol consumption (life‐time prevalence: e‐learning condition: B = 0.102, P = 0.549; integral condition: B = −0.157, P = 0.351; 1‐month prevalence: e‐learning condition: B = 0.191, P = 0.288; integral condition: B = −0.140, P = 0.445), tobacco consumption (life‐time prevalence: e‐learning condition: B = 0.164, P = 0.444; integral condition: B = 0.160, P = 0.119; 1‐month prevalence: e‐learning condition: B = 0.088, P = 0.746; integral condition: B = 0.261, P = 0.093), or marijuana consumption (life‐time prevalence: e‐learning condition: B = 0.070, P = 0.732; integral condition: B = 0.186, P = 0.214). Conclusion The non‐significant impact of the Healthy School and Drugs programme (a Dutch school‐based prevention programme for early adolescents) on incidences of alcohol, tobacco and marijuana use indicates that the programme is either ineffective or implemented inadequately.
    March 25, 2014   doi: 10.1111/add.12526   open full text
  • The association between smoking and depression from adolescence to adulthood.
    Tore Tjora, Jørn Hetland, Leif Edvard Aarø, Bente Wold, Nora Wiium, Simon Øverland.
    Addiction. March 25, 2014
    Background and Aims The association between depression and smoking is firmly established, but how the association develops remains unclear. The aim of this study was to examine development of the smoking–depression association from early adolescence to adulthood. Design Cross‐sectional and longitudinal analyses of the smoking–depression association from adolescence to adulthood. Setting Hordaland, Norway. Participants A cohort of adolescents (initially, 924 pupils) in the Norwegian Longitudinal Health Behaviour Study (NLHB) was followed over nine data collection waves from ages 13 to 30 years. Measurements Daily smoking and depressed mood were measured in each wave. Findings In the cross‐sectional analyses, daily smoking and depression were significantly associated (P‐value range from P < 0.01 to 0.04) in eight of nine waves. In the final longitudinal model, after controlling for the time‐invariant effects of smoking and depression and of tertiary factors, the only significant paths were early adolescent smoking prediction of early adolescent depression (waves 1–2: β = 0.07, P < 0.05; waves 2–3: β = 0.12, P < 0.05) and vice versa (waves 1–2: β = 0.10, P < 0.05; waves 2–3: β = 0.08, P < 0.05). Conclusions The inter‐relationship between depression and smoking seems to be due to the reciprocal causal effects between smoking and depression that are established in early adolescence and maintained into adulthood.
    March 25, 2014   doi: 10.1111/add.12522   open full text
  • Heavy episodic drinking and deliberate self‐harm in young people: a longitudinal cohort study.
    Ingeborg Rossow, Thor Norström.
    Addiction. March 25, 2014
    Aim To assess the association between heavy episodic drinking (HED) and deliberate self‐harm (DSH) in young people in Norway. Design, setting, participants and measurements We analysed data on past‐year HED and DSH from the second (1994) and third (1999) waves of the Young in Norway Longitudinal Study (cumulative response rate: 68.1%, n = 2647). Associations between HED and DSH were obtained as odds ratios and population‐attributable fractions (PAF) applying fixed‐effects modelling, which eliminates the effects of time‐invariant confounders. Findings An increase in HED was associated with an increase in risk of DSH (OR = 1.64, P = 0.013), after controlling for time‐varying confounders. The estimated PAF was 28% from fixed‐effects modelling and 51% from conventional modelling. Conclusion Data on Norwegian youths show a statistically significant association between heavy episodic drinking and deliberate self‐harm.
    March 25, 2014   doi: 10.1111/add.12527   open full text
  • Ex‐smokers are happier than current smokers among Chinese adults in Hong Kong.
    Man Ping Wang, Xin Wang, Tai Hing Lam, Kasisomayajula Viswanath, Sophia S. Chan.
    Addiction. March 25, 2014
    Aim To investigate the cross‐sectional association between smoking and happiness in Chinese adults in Hong Kong. Design, Setting and Participants Telephone surveys were conducted between 2009 and 2012, with 4553 randomly sampled Chinese adults (male 54%, mean age 58.3 years) in Hong Kong. Measurements Happiness was measured using the four‐item Subjective Happiness Scale (SHS) and single‐item Global Happiness Item (GHI). Smoking status was categorized as current smokers (7.7%%), ex‐smokers (6.5%, 93% quit for >6 months) and never smokers (85.8%). Linear and ordinal logistic regressions were used to calculate adjusted β‐coefficients for SHS and proportional adjusted odds ratios (aOR) for GHI in relation to smoking. Findings Compared with current smokers, ex‐smokers enjoyed greater happiness according to both SHS (adjusted β = 0.16, P < 0.05) and GHI (aOR = 1.52, P < 0.05) measurements, but current and never smokers were similar. Among current smokers, the number of cigarettes smoked was not associated with happiness, but the lack of any attempt to quit was associated significantly with greater happiness (adjusted β = 0.31 for SHS, aOR = 1.82 for GHI) compared with smokers who had tried to quit but not succeeded. Smokers not intending to quit in the next 6 months had higher odds of happiness (GHI) than those wanting to quit within 6 months (aOR = 1.86, P < 0.05). Conclusions Ex‐smokers in Hong Kong are happier than current smokers and never smokers, whose happiness measurements are similar. Causal associations have yet to be established.
    March 25, 2014   doi: 10.1111/add.12531   open full text
  • Time to first cigarette predicts 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanol (NNAL) in adolescent regular and intermittent smokers, National Health and Nutrition and Examination Survey (NHANES) 2007–10.
    Steven A. Branstetter, Melissa Mercincavage, Joshua E. Muscat.
    Addiction. March 19, 2014
    Background and Aims The time to first cigarette (TTFC) of the day is an indicator of nicotine intake in adults and adolescents. However, the relation between TTFC and biological markers of nicotine addiction and health risk in youths has not been well described. The current study examined whether an earlier TTFC predicts higher levels of a tobacco‐specific carcinogen, 4‐(methylnitrosamino)‐1‐(3‐pyridal)‐1 (NNAL), in regular and intermittent adolescent smokers and if this relation is mediated by nicotine intake (measured by cotinine) or cigarettes per day (CPD). Design A cross‐sectional analysis of a nationally representative subsample of adolescents. Setting A general community sample from the 2007–08 and 2009–10 National Health and Nutrition and Examination Survey. Participants A total of 215 adolescents in the United States between the ages of 12 and 19 years who reported smoking at least once in the 5 days prior to data collection. Measurements The primary outcome measure was urinary levels of NNAL. Findings In both regular and intermittent smokers, earlier TTFC was associated dose‐dependently with higher levels of NNAL (P < 0.03 in both cases). TTFC had an indirect effect on NNAL, mediated by nicotine intake (cotinine) in both regular [β = −0.08, standard error (SE) = 0.03, 95% confidence interval (CI) = −0.15, −0.03] and intermittent (β = −0.02, SE = 0.01, 95% CI = −0.05, −0.002) smokers. CPD was not found to be an important mediator of the relation between TTFC and NNAL. Conclusions Time between waking and the first cigarette of the day is correlated in daily and non‐daily adolescent smokers with overall nicotine and therefore carcinogen intake.
    March 19, 2014   doi: 10.1111/add.12515   open full text
  • Polygenic risk scores for smoking: predictors for alcohol and cannabis use?
    Jacqueline M. Vink, Jouke Jan Hottenga, Eco J. C. Geus, Gonneke Willemsen, Michael C. Neale, Helena Furberg, Dorret I. Boomsma.
    Addiction. March 18, 2014
    Background and Aims A strong correlation exists between smoking and the use of alcohol and cannabis. This paper uses polygenic risk scores to explore the possibility of overlapping genetic factors. Those scores reflect a combined effect of selected risk alleles for smoking. Methods Summary‐level P‐values were available for smoking initiation, age at onset of smoking, cigarettes per day and smoking cessation from the Tobacco and Genetics Consortium (n between 22 000 and 70 000 subjects). Using different P‐value thresholds (0.1, 0.2 and 0.5) from the meta‐analysis, sets of ‘risk alleles’ were defined and used to generate a polygenic risk score (weighted sum of the alleles) for each subject in an independent target sample from the Netherlands Twin Register (n = 1583). The association between polygenic smoking scores and alcohol/cannabis use was investigated with regression analysis. Results The polygenic scores for ‘cigarettes per day’ were associated significantly with the number of glasses alcohol per week (P = 0.005, R2 = 0.4–0.5%) and cannabis initiation (P = 0.004, R2 = 0.6–0.9%). The polygenic scores for ‘age at onset of smoking’ were associated significantly with ‘age at regular drinking’ (P = 0.001, R2 = 1.1–1.5%), while the scores for ‘smoking initiation’ and ‘smoking cessation’ did not significantly predict alcohol or cannabis use. Conclusions Smoking, alcohol and cannabis use are influenced by aggregated genetic risk factors shared between these substances. The many common genetic variants each have a very small individual effect size.
    March 18, 2014   doi: 10.1111/add.12491   open full text
  • Predictors of change in cocaine use in a street‐recruited cohort of young cocaine users.
    José Pulido, Gemma Molist, Antonia Domingo‐Salvany, M. Teresa Brugal, Albert Sanchez‐Niubò, Gregorio Barrio, Luis Fuente,.
    Addiction. March 17, 2014
    Aim To determine predictors of changes in amount of cocaine use among regular users outside treatment services. Design Longitudinal study—we estimated the proportion of subjects who increased or decreased cocaine use and assessed possible predictors related to these changes among a street‐recruited cohort of young regular cocaine users (RCU). Setting Three Spanish cities: Barcelona, Madrid and Seville Participants A total of 720 RCU aged 18–30 years not regularly using heroin were recruited in the community during 2004–06 (Itinere Project). Follow‐up interviews (n = 501) were carried out at 12–24 months. Measurements The average amount of cocaine used weekly was calculated taking into account the number of days of use and the usual quantity (g/day). A multinomial logistic regression approach was used to investigate the association between changes in amount of cocaine use (i.e. difference exceeded 33.3% of baseline level) after 12–24 months, and baseline socio‐demographic characteristics, nightlife, patterns of cocaine use and use of alcohol and other psychoactive drugs. Findings Cocaine use baseline average level was 2.14 g/week [95% confidence interval (CI) = 2.02–2.42]. It decreased in 71.5% of subjects and increased in 14.1%. In multinomial analysis, negative associations were found between decreasing cocaine use and high levels of alcohol consumption and using an increasing number of psychoactive drugs. Moreover, low education level, having used cocaine frequently in houses and reporting cocaine binges were associated with increasing cocaine use. Conclusions A street‐recruited cohort of cocaine users in Spain showed a significant reduction in cocaine use over a period of 12–24 months. High consumption of alcohol and increasing use of other psychoactive drugs decreased the probability of reducing cocaine use.
    March 17, 2014   doi: 10.1111/add.12503   open full text
  • Maternal smoking during pregnancy and offspring smoking initiation: assessing the role of intrauterine exposure.
    Amy E. Taylor, Laura D. Howe, Jon E. Heron, Jennifer J. Ware, Matthew Hickman, Marcus R. Munafò.
    Addiction. March 16, 2014
    Aims To assess whether associations between maternal smoking during pregnancy and offspring smoking initiation are due to intrauterine mechanisms. Design Comparison of associations of maternal and partner smoking behaviour during pregnancy with offspring smoking initiation using partner smoking as a negative control (n = 6484) and a Mendelian randomization analysis (n = 1020), using a genetic variant in the mothers as a proxy for smoking cessation during pregnancy. Setting A longitudinal birth cohort in South West England. Participants Participants of the Avon Longitudinal Study of Parents and Children (ALSPAC). Measurements Smoking status during pregnancy was self‐reported by mother and partner in questionnaires administered at pregnancy. Latent classes of offspring smoking initiation (non‐smokers, experimenters, late‐onset regular smokers and early‐onset regular smokers) were previously developed from questionnaires administered at 14–16 years. A genetic variant, rs1051730, was genotyped in the mothers. Findings Both mother and partner smoking were similarly positively associated with offspring smoking initiation classes, even after adjustment for confounders. Odds ratios (OR) [95% confidence interval (CI)] for class membership compared with non‐smokers were: experimenters: mother OR = 1.33 (95% CI = 1.06, 1.67), partner OR = 1.28 (95% CI = 1.06, 1.55), late‐onset regular smokers: mother OR = 1.80 (95% CI = 1.43, 2.26), partner OR = 1.86 (95% CI = 1.52, 2.28) and early‐onset regular smokers: mother OR = 2.89 (95% CI = 2.12, 3.94), partner OR = 2.50 (95% CI = 1.85, 3.37). There was no clear evidence for a dose–response effect of either mother or partner smoking heaviness on class membership. Maternal rs1051730 genotype was not clearly associated with offspring smoking initiation class in pre‐pregnancy smokers (P = 0.35). Conclusion The association between smoking during pregnancy and offspring smoking initiation does not appear to operate through intrauterine mechanisms.
    March 16, 2014   doi: 10.1111/add.12514   open full text
  • Clinical features of methamphetamine‐induced paranoia and preliminary genetic association with DBH‐1021C→T in a Thai treatment cohort.
    Rasmon Kalayasiri, Viroj Verachai, Joel Gelernter, Apiwat Mutirangura, Robert T. Malison.
    Addiction. March 16, 2014
    Aims To explore the clinical features of methamphetamine‐induced paranoia (MIP) and associations between MIP and a genetic polymorphism in dopamine β‐hydroxylase (DBH‐1021C→T). Design Retrospective analysis of clinical presentation and genetic association by χ2 test and logistic regression analysis. Setting A Thai substance abuse treatment center. Participants A total of 727 methamphetamine‐dependent (MD) individuals. Measurements Clinical: Semi‐Structured Assessment for Drug Dependence and Alcoholism (SSADDA) and the Methamphetamine Experience Questionnaire (MEQ). Genetic: DBH‐1021C→T. Findings Forty per cent of individuals (289 of 727; 39.8%) with MD had MIP. Within‐binge latency to MIP onset occurred more rapidly in the most recent compared with initial MIP episode (P = 0.02), despite unchanging intake (P = 0.89). Individuals with MIP were significantly less likely to carry lower (TT/CT) compared with higher (CC) activity genotypes (34.3 versus 43.3%; χ21 = 5, P = 0.03). DBH effects were confirmed [odds ratio (OR) = 0.7, P = 0.04] after controlling for associated clinical variables (MD severity, OR = 3.4, P < 0.001; antisocial personality disorder, OR = 2.2, P < 0.001; alcohol dependence, OR = 1.4, P = 0.05; and nicotine dependence, OR = 1.4, P = 0.06). TT/CT carriers were more likely to initiate cigarette smoking (OR = 3.9, P = 0.003) and probably less likely to be dependent on alcohol (OR = 0.6, P = 0.05). Conclusions Among methamphetamine‐dependent individuals, paranoia appears to occur increasingly rapidly in the course of a session of methamphetamine use. Severity of methamphetamine dependence and antisocial personality disorder predicts methamphetamine‐induced paranoia. The genetic polymorphism in dopamine β‐hydroxylase is associated with methamphetamine‐induced paranoia and influences smoking initiation.
    March 16, 2014   doi: 10.1111/add.12512   open full text
  • Unexpected adverse childhood experiences and subsequent drug use disorder: a Swedish population study (1995‐2011).
    Giuseppe N. Giordano, Henrik Ohlsson, Kenneth S. Kendler, Kristina Sundquist, Jan Sundquist.
    Addiction. March 11, 2014
    Aims Exposure to extraordinary traumatic experience is one acknowledged risk factor for drug use. We aim to analyse the influence of potentially life‐changing childhood stressors, experienced second‐hand, on later drug use disorder in a national population of Swedish adolescent and young adults (aged 15‐26 years). Design We performed Cox Proportional Hazard regression analyses, complemented with co‐relative pair comparisons. Setting Sweden Participants All individuals in the Swedish population born 1984 to 1995, who were registered in Sweden at the end of the calendar year they turned 14 years of age. Our follow‐up time (Mean: 6.2 years; Range 11 years) started at the year they turned 15 and continued to December 2011 (N=1,409,218). Measurements Our outcome variable was drug use disorder, identified from medical, legal and pharmacy registry records. Childhood stressors, as per DSM‐IV stressor criteria, include death of an immediate family member and second‐hand experience of diagnoses of malignant cancer, serious accidental injury, and victim of assault. Other covariates include parental divorce, familial psychological well‐being, and familial drug and alcohol use disorders. Findings After adjustment for all considered confounders, individuals exposed to childhood stressors ‘parental death’ or ‘parental assault’ had over twice the risk of drug use disorder than those who were not (HR = 2.63 (2.23‐3.09) and 2.39 (2.06‐2.79), respectively). Conclusions Children under 15 who experience second‐hand an extraordinary traumatic event (such as a parent or sibling being assaulted, diagnosed with cancer, or dying) appear to have approximately twice the risk of developing a drug use disorder than those who do not.
    March 11, 2014   doi: 10.1111/add.12537   open full text
  • Effectiveness of tobacco control television advertising in changing tobacco use in England: a population‐based cross‐sectional study.
    Michelle Sims, Ruth Salway, Tessa Langley, Sarah Lewis, Ann McNeill, Lisa Szatkowski, Anna B. Gilmore.
    Addiction. March 10, 2014
    Aim To examine whether government‐funded tobacco control television advertising shown in England between 2002 and 2010 reduced adult smoking prevalence and cigarette consumption. Design Analysis of monthly cross‐sectional surveys using generalised additive models. Setting England. Participants More than 80 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey. Measurements Current smoking status, smokers' daily cigarette consumption, tobacco control gross rating points (GRPs—a measure of per capita advertising exposure combining reach and frequency), cigarette costliness, tobacco control activity, socio‐demographic variables. Findings After adjusting for other tobacco control policies, cigarette costliness and individual characteristics, we found that a 400‐point increase in tobacco control GRPs per month, equivalent to all adults in the population seeing four advertisements per month (although actual individual‐level exposure varies according to TV exposure), was associated with 3% lower odds of smoking 2 months later [odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.95, 0.999] and accounted for 13.5% of the decline in smoking prevalence seen over this period. In smokers, a 400‐point increase in GRPs was associated with a 1.80% (95%CI = 0.47, 3.11) reduction in average cigarette consumption in the following month and accounted for 11.2% of the total decline in consumption over the period 2002–09. Conclusion Government‐funded tobacco control television advertising shown in England between 2002 and 2010 was associated with reductions in smoking prevalence and smokers' cigarette consumption.
    March 10, 2014   doi: 10.1111/add.12501   open full text
  • Increasing public support for supervised injection facilities in Ontario, Canada.
    Carol Strike, Jennifer A. Jairam, Gillian Kolla, Peggy Millson, Susan Shepherd, Benedikt Fischer, Tara Marie Watson, Ahmed M. Bayoumi.
    Addiction. March 10, 2014
    Aim To determine the level and changes in public opinion between 2003 and 2009 among adult Canadians about implementation of supervised injection facilities (SIFs) in Canada. Design Population‐based, telephone survey data collected in 2003 and 2009 were analysed to identify strong, weak, and intermediate support for SIFs. Setting Ontario, Canada Participants Representative samples of adults aged 18 years and over. Measurements Analyses of the agreement with implementation of SIFs in relation to four individual SIF goals and a composite measure. Findings The final sample sizes for 2003 and 2009 were 1212 and 968, respectively. Between 2003 and 2009, there were increases in the proportion of participants who strongly agreed with implementing SIFs to: reduce neighbourhood problems (0.309 versus 0.556, respectively); increase contact of people who use drugs with health and social workers (0.257 versus 0.479, respectively); reduce overdose deaths or infectious disease among people who use drugs (0.269 versus 0.482, respectively); and encourage safer drug injection (0.213 versus 0.310, respectively). Analyses using a composite measure of agreement across goals showed that 0.776 of participants had mixed opinions about SIFs in 2003, compared with only 0.616 in 2009. There was little change among those who strongly disagreed with all SIF goals (0.091 versus 0.113 in 2003 and 2009, respectively). Conclusions Support for implementation of supervised injection facilities in Ontario, Canada increased between 2003 and 2009, but at both time‐points a majority still held mixed opinions.
    March 10, 2014   doi: 10.1111/add.12506   open full text
  • Heterogeneous population effects of an alcohol excise tax increase on sexually transmitted infections morbidity.
    Stephanie A. S. Staras, Melvin D. Livingston, Alana M. Christou, David H. Jernigan, Alexander C. Wagenaar.
    Addiction. March 03, 2014
    Background and Aims Alcohol taxes reduce population‐level excessive alcohol use and alcohol‐related morbidity and mortality, yet little is known about the distribution of the effects of alcohol taxation across race/ethnicity and age subgroups. We examined the race/ethnicity‐ and age group‐specific effects of an excise alcohol tax increase on a common and routinely collected alcohol‐related morbidity indicator, sexually transmitted infections. Methods We used an interrupted time series design to examine the effect of a 2009 alcohol tax increase in Illinois, USA on new cases of two common sexually transmitted infections (chlamydia and gonorrhea) reported to the US National Notifiable Disease Surveillance System from January 2003 to December 2011 (n = 108 repeated monthly observations). We estimated the effects of the tax increase on infection rates in the general population and within specific race/ethnicity and age subgroups using mixed models accounting for temporal trends and median income. Results Following the Illinois alcohol tax increase, state‐wide rates of gonorrhea decreased 21% [95% confidence Interval (CI) = −25.7, −16.7] and chlamydia decreased 11% [95% CI = −17.8, −4.4], resulting in an estimated 3506 fewer gonorrhea infections and 5844 fewer chlamydia infections annually. The null hypothesis of homogenous effects by race/ethnicity and age was rejected (P < 0.0001). Significant reductions were observed among non‐Hispanic blacks: gonorrhea rates decreased 25.6% (95% CI = −30.0, −21.0) and chlamydia rates decreased 14.7% (95% CI = −20.9, −8.0). Among non‐Hispanics, point estimates suggest decreases were highest among 25–29‐year‐olds. Conclusions Increased alcohol taxes appear to reduce sexually transmitted infections, especially among subpopulations with high disease burdens, such as non‐Hispanic blacks.
    March 03, 2014   doi: 10.1111/add.12493   open full text
  • Patterns of cannabis use and prospective associations with health issues among young males.
    Stéphanie Baggio, Alexandra A. N'Goran, Stéphane Deline, Joseph Studer, Marc Dupuis, Yves Henchoz, Meichun Mohler‐Kuo, Jean‐Bernard Daeppen, Gerhard Gmel.
    Addiction. February 28, 2014
    Background and Aims To test prospective associations between cannabis disorder symptoms/frequency of cannabis use and health issues and to investigate stability versus transience in cannabis use trajectories. Design Two waves of data collection from the longitudinal Cohort Study on Substance Use Risk Factors (C‐SURF). Setting A representative sample of young Swiss men in their early 20s from the general population. Participants A total of 5084 young men (mean age 19.98 ± 1.19 years at time 1). Measurements Cannabis use (life‐time use, frequency of use, cannabis disorder symptoms) and self‐reported measures of health issues (depression, mental/physical health, health consequences) were assessed. Significant changes in cannabis use were tested using t‐test/Wilcoxon's rank test for paired data. Cross‐lagged panel models provided evidence regarding longitudinal associations between cannabis use and health issues. Findings Most of the participants (84.5%) remained in the same use category and cannabis use kept to similar levels at times 1 and 2 (P = 0.114 and P = 0.755; average of 15 ± 2.8 months between times 1 and 2). Cross‐lagged panel models showed that cannabis disorder symptoms predicted later health issues (e.g. depression, β = 0.087, P < 0.001; health consequences, β = 0.045, P < 0.05). The reverse paths from health issues to cannabis disorder symptoms and the cross‐lagged panel model between frequency of cannabis use and health issues were non‐significant. Conclusions Patterns of cannabis use showed substantial continuity among young Swiss men in their early 20s. The number of symptoms of cannabis use disorder, rather than the frequency of cannabis use, is a clinically important measure of cannabis use among young Swiss men.
    February 28, 2014   doi: 10.1111/add.12490   open full text
  • The freeze on mass media campaigns in England: a natural experiment of the impact of tobacco control campaigns on quitting behaviour.
    Tessa Langley, Lisa Szatkowski, Sarah Lewis, Ann McNeill, Anna B. Gilmore, Ruth Salway, Michelle Sims.
    Addiction. January 16, 2014
    Aims To measure the impact of the suspension of tobacco control mass media campaigns in England in April 2010 on measures of smoking cessation behaviour. Design Interrupted time series design using routinely collected population‐level data. Analysis of use of a range of types of smoking cessation support using segmented negative binomial regression. Setting England. Measurements Use of non‐intensive support: monthly calls to the National Health Service (NHS) quitline (April 2005–September 2011), text requests for quit support packs (December 2007–10) and web hits on the national smoking cessation website (January 2009–March 2011). Use of intensive cessation support: quarterly data on the number of people setting a quit date and 4‐week quitters at the NHS Stop Smoking Services (SSS) (quarter 1, 2001 and quarter 3, 2011). Findings During the suspension of tobacco control mass media spending, literature requests fell by 98% [95% confidence interval (CI) = 96–99], and quitline calls and web hits fell by 65% (95% CI = 43–79) and 34% (95% CI: 11–50), respectively. The number of people setting a quit date and 4‐week quitters at the SSS increased throughout the study period. Conclusions The suspension of tobacco control mass media campaigns in England in 2012 appeared to markedly reduce the use of smoking cessation literature, quitline calls and hits on the national smoking cessation website, but did not affect attendance at the Stop Smoking Services. Within a comprehensive tobacco control programme, mass media campaigns can play an important role in maximizing quitting activity.
    January 16, 2014   doi: 10.1111/add.12448   open full text
  • Parental monitoring trajectories and gambling among a longitudinal cohort of urban youth.
    Grace P. Lee, Elizabeth A. Stuart, Nicholas S. Ialongo, Silvia S. Martins.
    Addiction. December 10, 2013
    Aim To test the strength of the association between parental monitoring trajectories throughout early adolescence (ages 11–14) and gambling behaviours by young adulthood (age 22). Design Longitudinal cohort design. Setting Baltimore, Maryland. Participants The sample of 514 participants with gambling data between ages 16–22 and parental monitoring data between ages 11–14 were predominantly African American and received subsidized lunches at age 6. Measurements The South Oaks Gambling Screen and South Oaks Gambling Screen–Revised for Adolescents collected self‐reports on annual gambling and gambling problems between ages 16–22. The Parental Monitoring Subscale of the Structured Interview of Parent Management Skills and Practices–Youth Version collected self‐reports on annual parental monitoring between ages 11–14. Findings General growth mixture modelling identified two parental monitoring trajectories: (i) ‘stable’ class (84.9%) began with a high level of parental monitoring at age 11 that remained steady to age 14; (ii) ‘declining’ class (15.1%) began with a significantly lower level of parental monitoring at age 11 and experienced a significant to through age 14. The declining class had increased significantly unadjusted (OR = 1.91; 95% CI = 1.59, 2.23; P ≤ 0.001) and adjusted (aOR = 1.57; 95% CI = 1.24, 1.99; P = 0.01) odds of problem gambling compared with non‐gambling. Conclusion Low and/or declining parental monitoring of children between the ages of 11 and 14 is associated significantly with problem gambling when those children reach young adulthood.
    December 10, 2013   doi: 10.1111/add.12399   open full text