Sibling disclosure and adolescents' coping from before to during the COVID-19 pandemic: A longitudinal study.

The extraordinary disruptions associated with the COVID-19 pandemic created a unique context to investigate the links between family communication and adolescent adjustment. Given that widespread stay-at-home orders increased time spent in the family setting, the present study examined reciprocal links between older and younger adolescent siblings' disclosure toward each other and concurrent and prospective links between those disclosures and their own and their siblings' coping from before to during the early stages of COVID-19 pandemic. Participants were two adolescent-aged siblings (older siblings: 51% female, M = 15.67 years; younger siblings: 48% female, M = 13.14 years) and one parent (85% mothers, M = 45.15 years) from 682 families (N = 2,046) in five Midwestern states in the United States. Participants completed web-based assessments on three occasions: Time 1 (March 2019-February 2020), Time 2 (May 2020-June 2020), and Time 3 (July 2020-February 2021). Using structural equation modeling, results revealed that the prospective reciprocal linkages between older and younger siblings' disclosures were often moderated by the gender composition of the sibling dyad. Further, older and younger siblings' disclosures were both concurrently associated with their own coping during the pandemic but not prospectively associated with later perceived coping. There were mixed findings regarding the actor and partner associations between siblings' disclosure and adolescents' perceived coping. Results emphasize the complexity and bidirectional nature of sibling disclosure and the potential protective effects of disclosing to siblings in the context of the COVID-19 pandemic. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cannabis policy liberalization is only associated with increased blunt use if states lack strong tobacco control.

INTRODUCTION: Co-use of tobacco and cannabis has long been an issue for prevention and intervention efforts targeting these substances. Blunt use-cannabis inside a cigar wrapper-has been a consistent mode of cannabis consumption since the 1990s. Since then, both tobacco control and cannabis policies have changed considerably. This paper examines the influence of tobacco taxes and smoke-free policies as well as medical and recreational cannabis policies on blunt use among young people. METHODS: Combining state-level tobacco control and cannabis policy data with the restricted-access youth cohort of the Population Assessment of Tobacco and Health (PATH) study, we use multilevel logistic regression models to examine the impact of these policies on past-year blunt use. RESULTS: While we found a main effect whereby both legal medical and recreational cannabis policies are associated with higher odds of blunt use among youth, interaction effects demonstrate that this association only emerges in states lacking a comprehensive tobacco smoke-free policy. In states with smoke-free policies, we found no significant associations between cannabis policy and odds of blunt use. CONCLUSIONS: Denormalization through smoke-free policies may mitigate the effects of recreational and medical cannabis policies on blunt use. Smoke-free policies represent a possible cost-effective mechanism to curb the co-use of tobacco and cannabis in the form of blunts. States with medical and recreational cannabis policies may benefit from greater prevention efforts for young people specifically focused on blunt use, especially in states that do not have strong tobacco control.

Risk Factors for E-Cigarette Ban Relaxation in Homes With Adolescents.

PURPOSE: To identify risk factors for relaxing a strict e-cigarette ban in households with adolescents. METHODS: Youth (ages 12-17) in the Population Assessment of Tobacco and Health (PATH) Study whose parents held a strict vaping ban in 2016 (n = 6,514; 51.5% male) and their parents provided follow-up data on up to four occasions through 2020 on whether the ban was relaxed. RESULTS: 13.5% of households with strict vaping bans relaxed them in a subsequent wave. Results from a logistic regression model showed that the odds of relaxing strict bans were higher if, at baseline, parents vaped (OR = 2.20; 95% CI: 1.22-3.97; p < .01), parents smoked tobacco (OR = 2.55; CI: 2.00-3.26; p < .001), youth smoked tobacco (OR = 2.27; CI: 1.29-4.00; p < .01), parents reported no smoking ban (OR = 2.68; CI: 1.88-3.81; p < .001), youth did not know that their household had a vaping ban (OR = 1.95; CI: 1.50-2.54; p < .001), and parents perceived low harm from vaping (OR = 1.60; CI: 1.16-2.19; p < .01). Although most sociodemographic controls were not independently associated, parents were less likely to relax bans if they had a college degree (OR = 0.71; CI: 0.51-0.998; p < .05), graduate degree (OR = 0.50; CI: 0.43-0.72; p < .001), or children who were non-Hispanic Black (OR = 0.69; CI: 0.49-0.96; p < .05) or Hispanic (OR = 0.62; CI: 0.47-0.81; p < .001). DISCUSSION: While most households with adolescents prohibited e-cigarette use indoors, nearly one in seven relaxed prior strict vaping bans. Parents need support to maintain clear, consistent, and continuous restrictions that communicate that vaping is not safe or permissible for youth.

Hemp-based psychoactive use and risk among young adults: Trend theory, policy, and regulation beyond legality.

BACKGROUND: Hemp-based psychoactives comprise a burgeoning legal substance market with rising trends in use across the U.S. and Canada as well as parts of Europe. Currently, scant empirical research on the use of these Novel Psychoactive Substances (NPS) exists. By examining policy, market conditions, consumer uptake, and related risks, this research extends theory on drug trends by describing the regulatory environments that shape the emergence and popularity of psychoactive hemp-based products among young adults. METHODS: Relying on ethnographic fieldwork of hemp-based markets across 3 U.S. state hemp and cannabis policy contexts as well as in-depth interviews with 40 young adult cannabis consumers recruited across 10 U.S. states, we examined how regulatory conditions shape hemp-based psychoactive markets, trends in their use, and associated risks. RESULTS: Young adults are motivated to consume hemp-based psychoactives due to the regulatory and market environments that facilitate the production of highly potent products that are inexpensive and easily accessible. States that regulate hemp-based psychoactives as cannabis, do not provide hemp markets with a competitive advantage and as such see minimal uptake. In the absence of hemp specific policies, substantial variations in product potencies, insufficient dosing information, and unscrupulous product packaging practices may increase related risks. CONCLUSION: Trend theory provides insight into the complex relationships that exist between drug policy, markets, and the proliferation of legal highs. Understanding the contextual significance that both market and regulatory conditions have on legal drug production, distribution, and consumption may better inform approaches to reduce the risks commonly associated with novel psychoactive substances like hemp-based psychoactives.

Comprehensive vaping bans are associated with lower odds of initiation into electronic nicotine delivery systems use among young people.

BACKGROUND AND AIMS: E-cigarette and other electronic nicotine delivery systems (ENDS) use has grown considerably over the past decade, with notable increases among young people. US state policy contexts for ENDS and tobacco may shape initiation into ENDS use among adolescents as they age into early adulthood. We aimed to determine whether state-level comprehensive vaping ban policies reduce the odds of youth initiation into ENDS use, net of additional state-level ENDS and tobacco policies, as well as the youth's cigarette smoking status. DESIGN: Longitudinal data from the Population Assessment of Tobacco and Health study were merged with a state-year database on tobacco and ENDS policies. Multivariable discrete-time event history models of ENDS initiation were estimated. SETTING: United States. PARTICIPANTS: Twenty thousand twelve youth assessed over six waves from 2013 to 2019 (n = 53 974 observations). MEASUREMENT: We examined comprehensive indoor vaping bans (i.e. 100% vape-free workplaces, restaurants and bars) as a key factor in initiation into ENDS use (i.e. first instance of vaping) from age 13 to 22. FINDINGS: Among young people, residing in a state with a comprehensive vaping ban was associated with 18% lower odds of ENDS initiation (odds ratio = 0.82; 95% confidence interval =[0.71, 0.94]), even after controlling for other state ENDS and tobacco policies, the youth's cigarette smoking and socio-demographic background and state-level covariates. CONCLUSIONS: In the United States, state-level vaping bans (i.e. 100% vape-free workplaces, restaurants and bars) are associated with reduced odds of youth initiation into electronic nicotine delivery systems use.

Household vaping bans and youth e-cigarette use.

AIMS: The aims of this study were to measure whether household bans on vaping were associated with lower odds of youth past-month vaping when compared with (1) otherwise similar youth whose households did not have a vaping ban (using coarsened exact matching); and (2) themselves in waves when their household did not have a ban (using hybrid panel models). We used the same analytical strategies to examine cross-sectional associations between household smoking bans and adolescents' past-month cigarette smoking. DESIGN: This was a longitudinal study using data from a nationally representative sample of youth (age 12-17 years) in the Population Assessment of Tobacco and Health Study. SETTING: United States of America. PARTICIPANTS: A total of 16 214 adolescents followed over 48 103 total observations (approximately three waves). MEASUREMENTS: Measurements comprised youth past-month e-cigarette and cigarette use and parent-reported household bans on vaping and smoking. Potential confounders were prior adolescent smoking, vaping, and other nicotine product use; parent current smoking, vaping, and other nicotine use; adolescent peer e-cigarette/cigarette use; parental monitoring; and demographic characteristics. FINDINGS: Before matching, smoking bans were associated with 46% lower odds of youth smoking [odds ratio (OR) = 0.54; 95% confidence interval (CI) = 0.41-0.70] and vaping bans with 37% lower odds of youth e-cigarette use (OR = 0.63; 95% CI = 0.50-0.80). However, households with and without bans differed significantly on all confounders before matching. After matching, household vaping bans were associated with 56% lower odds of youth vaping (OR = 0.44; 95% CI = 0.33-0.58). Results from hybrid panel models also revealed 37% lower odds of vaping in waves when youth lived in a vape-free household compared to waves when they did not (OR = 0.63; 95% CI = 0.50-0.78). Associations between smoking bans and youth smoking were not statistically significant after matching or when using hybrid panel models. CONCLUSIONS: Household vaping bans appear to be associated with lower odds of past-month vaping among US adolescents, compared with similar youth whose households did not have a ban and to themselves in waves when their households did not have a ban.

Tobacco Policy and ENDS Policy Influences on Adolescent Vaping Across the U.S. States.

INTRODUCTION: Although the use of tobacco has declined among youth, ENDS has the potential to disrupt or reverse these trends. Policies for tobacco and ENDS may have an impact on adolescent ENDS use. The impacts of state-level policies were examined for both tobacco and ENDS indoor use bans, excise taxes, and age-of-purchase laws on past-month adolescent ENDS use from 2013 to 2019. METHODS: This study used cohort data from the Population Assessment of Tobacco and Health study and policy data from the Americans for Nonsmokers' Rights Foundation repository-3 policies for ENDS and 2 policies for tobacco products. Policies included comprehensive indoor vaping/smoking bans, purchase-age restrictions, and excise taxes. Hybrid panel models were estimated in 2022 using data merged from the 2 longitudinal sources on past-month vaping. The analytic sample (observations=26,008) included adolescents aged 12-17 years, yielding a total of 72,684 observations. RESULTS: The odds of adolescent ENDS use were 21.4% lower when the state had an ENDS purchase-age restriction and 55.0% lower when the state had a comprehensive tobacco smoking ban than in the years when the state did not have the ban. CONCLUSIONS: During a period of significant growth in ENDS use among U.S. youth, ENDS purchase-age restrictions and smoking bans reduced the odds of past-month vaping among adolescents. Wider implementation of policies may help intervene in youth vaping.

Efficacy of WeChat-based online smoking cessation intervention ('WeChat WeQuit') in China: a randomised controlled trial.

Background: China has approximately 300 million current smokers, and smoking cessation services are limited. This study aimed to assess the efficacy of a Cognitive Behavioral Theory-based smoking cessation intervention ('WeChat WeQuit') via the most popular social media platform in China, WeChat. Methods: A parallel, single-blind, two-arm randomised controlled trial was conducted via WeChat between March 19, 2020 and November 16, 2022. Chinese-speaking adult smokers (n = 2000) willing to quit within one month were recruited and randomised in a 1:1 ratio. The intervention group (n = 1005) received the 'WeChat WeQuit' program and the control group (n = 955) received control messages for 14 weeks (2-week prequit and 12-week postquit). Participants were followed up to 26 weeks after the quit date. The primary outcome was self-reported continuous smoking abstinence rate, biochemically validated at 26 weeks. The secondary outcomes were self-reported 7-day and continuous abstinence rates at 6 months. All analyses were by intention to treat. The trial is registered at ClinicalTrials.gov (NCT03169686). Findings: By intention-to-treat analysis, the biochemically verified 26-week continuous abstinence rate was 11.94% in the intervention group and 2.81% in the control group (OR = 4.68, 95% CI: 3.07-7.13, p < 0.0001). The self-reported 7-day abstinence rates ranged from 39.70% at week 1-32.04% at week 26 for the intervention group and 14.17%-11.86% in the control group for weeks 1 and 26, respectively; the self-reported continuous abstinence rates at weeks 1 and 26 ranged from 34.33% to 24.28% and 9.65% to 6.13% in the intervention group and the control group respectively (all p < 0.0001). Participants with low nicotine dependence or previous quit attempts were more likely to successfully quit smoking. Interpretation: The 'WeChat WeQuit' intervention significantly increased smoking abstinence rates at 6 months and should be considered for treatment-seeking smokers in China. Funding: The research is supported by the Natural Science Foundation of Hunan Province (2020JJ4794, YLiao), the K.C. Wong Postdoctoral Fellowship for YLiao to study at King's College London, and China Medical Board (CMB) Open Competition Program (grant no. 15-226, 22-485, YLiao).

Correlates of Heroin Use, Pharmaceutical Fentanyl Misuse, and Dual Heroin-Fentanyl Use: Evidence from the U.S.

Purpose: The emergence of fentanyl has deepened concerns about the opioid crisis. The shift has created new distinctions in patterns of opioid use, which may be important for prevention and intervention. We examine socio-demographic correlates as well as health and substance use characteristics of different groups of opioid users. Design: We utilized the 2015-2019 National Survey on Drug Use and Health to examine distinctions between groups (n=11,142) of individuals who misuse prescription opioids, use heroin but not fentanyl, misuse pharmaceutical fentanyl but not heroin, and use both heroin and fentanyl. Multinomial and logistic regression models were used to identify these distinctions. Findings: Few socio-demographic differences emerged between the prescription opioid group and pharmaceutical fentanyl misuse group. While those who misuse fentanyl have higher odds of using other drugs and experiencing certain mental health problems than those misusing prescription pills, both the heroin and fentanyl-heroin use groups reported considerably poorer health and substance use indicators relative to those who solely misuse fentanyl. It is also notable that both heroin use groups are more highly associated with cocaine and methamphetamine use than those misusing fentanyl alone. Originality: This study highlights distinctions between pharmaceutical fentanyl users, heroin users, and users of both substances. Implications: While we identify important distinctions between the opioid use groups studied, individuals using both heroin and pharmaceutical fentanyl report the poorest health and substance use characteristics. Important differences between the fentanyl-only group and the group who consume both drugs may have implications for prevention, intervention, and clinical work amidst shifting patterns of opioid use.

E-cigarette use among early adolescent tobacco cigarette smokers: testing the disruption and entrenchment hypotheses in two longitudinal cohorts.

OBJECTIVE: Using longitudinal data from two large-scale cohorts in the UK and USA, we examine whether e-cigarette use steers adolescent early smokers away from tobacco cigarettes (disruption hypothesis) or deepens early patterns of tobacco smoking (entrenchment hypothesis) in comparison with early smokers who do not use e-cigarettes. METHODS: Youth who smoked tobacco cigarettes by early adolescence (before age 15) were selected from the ongoing UK Millennium Cohort Study (n=1090) and the US Population Assessment of Tobacco and Health (n=803) study. In regression models, the focal predictor was lifetime use of an e-cigarette by early adolescence and the primary outcome was current tobacco use by late adolescence (before age 18). Logistic and multinomial models controlled for early adolescent risk factors and sociodemographic background, and were weighted for attrition and adjusted for complex survey designs. RESULTS: Among youth who were early cigarette smokers, 57% of UK and 58% of US youth also used e-cigarettes. The odds of later adolescent smoking among early smoking youth were significantly higher among e-cigarette users relative to those who had not used e-cigarettes (adjusted OR (AORUK)=1.45; AORUSA=2.19). In both samples, multinomial models indicated that early smoking youth who used e-cigarettes were more likely to be frequent smokers relative to not smoking (AORUK=2.01; AORUSA=5.11) and infrequent smoking (AORUK=1.67; AORUSA=2.11). CONCLUSIONS: Despite national differences in e-cigarette regulation and marketing, there is evidence e-cigarette use among early adolescent smokers in the UK and USA leads to higher odds of any smoking and more frequent tobacco cigarette use later in adolescence.

Trends in Psychotropic Drug-Implicated Cardiovascular Mortality: Patterns in U.S. Mortality, 1999-2020.

INTRODUCTION: Psychotropic drug-implicated (PDI) mortality-deaths in which psychotropic drugs were a contributing but not underlying cause of death-increased over two decades, with circulatory mortality as the primary cause leading to such deaths. Trends in PDI circulatory mortality over a 22-year period and its patterning in U.S. deaths are described. METHODS: Deaths extracted from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research Multiple Causes of Death database from 1999 to 2020 were analyzed to generate annual counts and rates for drug-implicated deaths due to diseases of the circulatory system, including by specific drug, sex, race/ethnicity, age, and state. RESULTS: During a period when overall age-adjusted circulatory mortality rates declined, PDI circulatory mortality more than doubled, from 0.22 per 100,000 in 1999 to 0.57 per 100,000 by 2020, now representing 1 in 444 circulatory deaths. Although PDI deaths from ischemic heart diseases are proportionally aligned with overall circulatory deaths (50.0% vs 48.5%), PDI deaths from hypertensive diseases represent a larger proportion (19.8% vs 8.0%). Psychostimulants generated the greatest escalation for PDI circulatory deaths (0.029-0.332 per 100,000). The sex gap in PDI mortality rates widened (0.291 females, 0.861 males). PDI circulatory mortality is particularly notable for Black Americans and midlife Americans, with considerable geographic variability. CONCLUSIONS: Circulatory mortality with psychotropic drugs as a contributing cause escalated over 2 decades. Trends in PDI mortality are not evenly distributed across the population. Greater engagement with patients about their substance use is needed to intervene in cardiovascular deaths. Prevention and clinical intervention could contribute to reinvigorating previous trends of declining cardiovascular mortality.

Social Network Ties and Responses to COVID-19 Among E-Cigarette Users.

Social networks can enhance behavioral changes or entrench existing patterns of behavior. We aimed to identify how network ties to other e-cigarette users shaped responses to the pandemic and e-cigarette considerations. A national U.S. survey of 562 e-cigarette users was conducted during April 2020. Participants self-reported network ties to other e-cigarette users and pandemic outcomes: receiving expressions of concern about vaping, risk for a bad COVID outcome, changes in e-cigarette risk perceptions, and considerations of quitting. Each additional e-cigarette user tie was associated with a 0.014 unit increase in expressions of concern (p < 0.001), a 0.034 unit increase in perceived risk of a bad outcome (p < 0.05), and 3.9% higher odds of quit considerations (OR = 1.039; p < 0.01). Family ties to e-cigarette users were particularly important. Additional e-cigarette users within a network shaped risk perceptions in response to COVID-19. Network ties to other e-cigarette users have implications for cessation or reduction of e-cigarette use.

Sibling influences on adolescent alcohol use during the spring 2020 COVID-19 pandemic shutdown.

OBJECTIVE: To examine the bidirectional associations between adolescent siblings' alcohol use before and during the onset of the COVID-19 pandemic in Spring 2020 and whether youths' stress about missed social connections (i.e., social disruption stress) moderated these associations. METHOD: The sample consisted of 682 families (2,046 participants) with two adolescent siblings (older siblings: Mage = 15.67 years, 51% female; younger siblings: Mage = 13.14 years, 48% female) and one parent (Mage = 45.15 years; 85% female) from five Midwestern U.S. states. Siblings reported on their own drinking and social disruption stress before and during the onset of the pandemic via online surveys. RESULTS: Accounting for younger siblings' earlier drinking and other confounders, older siblings' prepandemic drinking predicted a greater likelihood of younger siblings' drinking during the Spring 2020 pandemic shutdown. This association was not moderated by younger siblings' social disruption stress. The association between younger siblings' prepandemic drinking and older siblings' drinking during the shutdown was moderated by older siblings' social disruption stress. Specifically, younger siblings' earlier drinking was more strongly related to older siblings' drinking during the shutdown if older siblings reported more social disruption stress. CONCLUSIONS: Siblings are important socialization agents of alcohol use during adolescence. Sibling interventions may be particularly salient during times of stress and isolation when youths' social interactions with peers may be limited. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Vaping in a Time of Pandemics: Risk Perception and Motivations for Electronic Cigarette Use.

INTRODUCTION: Prior studies on the association between the intensity of and motives for vaping e-cigarettes have highlighted the psychological dynamics of motivational changes, but less about how vaping motives may shift as a function of risk perceptions exacerbated by unanticipated events. This study frames the COVID-19 pandemic as an exacerbating threat to pulmonary health, and tests how e-cigarette users' risk perceptions of COVID-19 are related to different motives for vaping and ultimately the intensity of e-cigarette use. AIMS AND METHODS: An online survey of e-cigarette users in the United States (n = 562) was conducted during April 2020 when much of the United States was under "lockdown" conditions. We distinguished three types of vaping motives (health, socialization, and dependence) and established the classification with confirmatory factor analysis. Structural equation modeling was conducted for path analyses and mediation tests. RESULTS: All three vaping motives were significantly associated with greater use intensity. A heightened risk perception of e-cigarette users' vulnerability to COVID-19 was inversely associated with use intensity (-.18, p < .01) and health motives for vaping (-.27, p < .001), but not associated with socialization and dependence motivations. Health motives for vaping mediated 35% of the association between COVID-19 risk perceptions and use intensity. CONCLUSIONS: Our findings indicate that risk perceptions of exacerbated threats may reduce e-cigarette use directly, and also indirectly through shifting certain types of motivations for vaping. Beyond elucidating the relational dynamics between vaping psychology and health risks, these results also indicate health professionals may leverage the pandemic to promote nicotine cessation or reduced use. IMPLICATION: Little is known about how vaping motives shift after unanticipated events such as pandemics. This study contributes to knowledge of how the use of e-cigarettes is motivated by different dimensions of rationales and exogenous risks. Exploiting the emergence of the COVID-19 pandemic, we found risk perceptions are associated with the intensity of e-cigarette use indirectly specifically through health motivations. Risk perceptions are not associated with socialization and dependence motives for vaping.

Associations Between E-cigarettes and Subsequent Cocaine Use in Adolescence: An Analysis of the UK Millennium Cohort Study.

INTRODUCTION: Nicotine exposure via early combustible cigarette smoking can prime the adolescent brain for subsequent cocaine use. However, there is limited evidence whether e-cigarette use, a nicotine delivery system that is increasingly popular among youth, is associated with later cocaine use. We examine the association between e-cigarette use by the age of 14 years and cocaine use by the age of 17 years. AIMS AND METHODS: The Millennium Cohort Study is a nationally representative sample of 18 552 9-month-old children born between September 2000 and January 2002 in the United Kingdom. Follow-up interviews and surveys were collected from children and their caregivers at modal ages 3, 5, 7, 9, 11, 14, and 17 years. Our analytic sample included 340 youth who had used e-cigarettes by age 14 years (exposure variable), matched using coarsened exact matching, to 4867 nicotine naïve youth on childhood common liability confounders and demographics measured from infancy to age 11. The outcome was cocaine use by the modal age of 17 years. RESULTS: Of the 5207 successfully matched youth, 7.6% of adolescent e-cigarette users by age 14 years used cocaine by age 17 years versus 3.1% of non-e-cigarette users. Multivariable logistic regression in the matched sample indicated that e-cigarette use by age 14 years was associated with 2.7 times higher odds of cocaine use by age 17 years (95% CI, 1.75 to 4.28). CONCLUSIONS: These findings in a UK sample showed that e-cigarette use in early adolescence is associated with higher odds of cocaine use later in adolescence, similar to risks posed by tobacco cigarette smoking. IMPLICATIONS: In this large-scale prospective cohort study (n = 5207), youth who had used e-cigarettes by the age of 14 years were matched to nicotine naïve youth on childhood common liability confounders and demographics measured from infancy to age 11 years (e.g. school engagement, risk-taking propensity, delinquency, peer and parental smoking, parental educational attainment). After matching, 7.6% of age 14 years e-cigarette users had subsequently used cocaine by the age of 17 years versus 3.1% of non-e-cigarette users. Although e-cigarettes are promoted as a strategy for nicotine-dependent users to reduce the harms of combustible cigarettes, the evidence here suggests that for nicotine naïve youth, they may increase the risk of subsequent cocaine use.

The association between local tobacco retail licensing and adult cigarette smoking by race/ethnicity, income, and education in California (2012-2019).

This study investigates the association between the strength of TRL ordinances and adult cigarette use, and differences in the relationship by sociodemographic characteristics, using California as a case study. We merged geocoded data from the California Health Interview Survey with the State of Tobacco Control Reports from the American Lung Association from 2012 to 2019. Each jurisdiction was graded (A-strongest to F-weakest) based on the strength of their TRL ordinance while current cigarette use was defined as respondents who had smoked 100 or more cigarettes in their lifetime and currently smoke cigarettes every day or some days. We estimated multilevel logistic regression models to test the relationship between the strength of the TRL ordinance and current cigarette use and tested for effect modification by including interaction terms for race/ethnicity, income, and education in separate models. 11.6 % of sample participants from all years (n = 132,209) were current cigarette smokers. Adults in jurisdictions with stronger grades (A-D) had lower odds of current cigarette use (OR = 0.89, 95 % CI: 0.79-1.01) compared to adults in jurisdictions with the weakest grade (F), but the association was not statistically significant (p < 0.07). We found no evidence of effect modification by race/ethnicity, income, or education. We found limited evidence that stronger TRL ordinances were associated with lower adult cigarette smoking in California. However, future studies testing the relationship between TRL ordinances and adult smoking outcomes should examine the role of TRL fees across jurisdictions and adult cigarette use.

Associations between older siblings' substance use and younger siblings' substance use intentions: Indirect effects via substance use expectations.

OBJECTIVE: We examined the direct and indirect effects of older siblings' substance use behaviors (i.e., cannabis and e-cigarettes) on younger siblings' later substance use intentions via their substance use expectations. MATERIAL AND METHODS: Data were collected from 682 families (N = 2,046) with two adolescent siblings (older siblings: M age = 15.67 years, 51% female; younger siblings: M age = 13.14 years, 48% female) and one parent (M age = 45.15 years; 85% female). Participants completed annual online surveys at two occasions. Older siblings reported on their cannabis and e-cigarette use frequencies (Time 1) and younger siblings reported on their substance use expectations (Time 1) and intentions (Time 1 and 2); parents reported on adolescents' sociodemographic characteristics and their own substance use (Time 2). RESULTS: Structural equation modeling results suggested that older siblings' cannabis and e-cigarette use was indirectly related to younger siblings' later intentions to use these substances through their positive expectations about substances, after accounting for younger siblings' earlier intentions to use substances and control variables including parents' and friends' use. There were no significant direct relations between older siblings' cannabis or e-cigarette use and younger siblings' intentions to use them. CONCLUSIONS: Findings indicate that older siblings are critical and unique socialization agents of younger siblings' expectations and intentions to use substances. Intervention and prevention programs that target adolescents' substance use should consider the ways in which siblings shape each other's substance use.

Adolescent Cannabis Use During a Period of Rapid Policy Change: Evidence From the PATH Study.

PURPOSE: To determine whether shifts in various state-level cannabis policies are associated with individual-level changes in adolescent cannabis use following implementation. METHODS: We use the restricted-access youth cohort of the PATH Study, a recent, longitudinal, and nationally representative dataset, to assess whether changes in cannabis policy affect youth cannabis use. Data include respondents aged 12 to 17 years across up to six repeated observations (N = 26,673). Hybrid (between-person and within-person) panel models are used to examine adolescent past-month cannabis use. RESULTS: Within-person effects showed that the odds of past-month cannabis use are lower (odds ratio [OR] = 0.632; p < .05) in years when a respondent's state allowed only cannabidiol (CBD) compared to years when the state had legalized medical cannabis. The odds of past-month cannabis use are lower during years when a respondent's state had decriminalized (OR = 0.617; p < .01) or criminalized (OR = 0.648; p < .05) adult recreational cannabis possession compared to years when it was legalized. These effects were robust to numerous controls, including time and state fixed effects. By contrast, significant between-person effects became nonsignificant with state fixed effects included, implying that state-level average use distinguishes average differences between states rather than policy. DISCUSSION: Liberalized cannabis policy is significantly associated with recent adolescent cannabis use. The most consequential policy shift associated with adolescent use is from either criminalization or decriminalization of cannabis possession to legalization, such that states making these changes should consider additional prevention efforts.

Direct and Indirect Effects of Maternal and Sibling Intimacy on Adolescents' Volunteering via Social Responsibility Values: A Longitudinal Study.

This study investigates the direct and indirect effects of maternal and sibling relational intimacy on adolescents' volunteering behaviors via their social responsibility values. Participants included two adolescents (50% female; M age = 14 years) and one parent (85% female; M age = 45 years) from 682 families (N = 2,046) from an ongoing longitudinal study. Adolescents self-reported their intimacy with mothers and siblings (Time 1), social responsibility values (Time 1), and volunteering (Times 1 and 2); parents reported on sociodemographic characteristics (i.e., gender, birth order, family income). Results from a structural equation model indicated that after accounting for adolescents' earlier volunteering, both maternal and sibling intimacy were indirectly related to greater volunteering via social responsibility values. There were no significant direct effects from maternal or sibling intimacy to adolescents' volunteering. Results indicate that both mothers and siblings are important in socializing prosocial and civic values and behaviors during adolescence.