Polysubstance use by sexual identity among US adults, 2021.

OBJECTIVE: Understanding polysubstance use among US sexual minority adults is important to serve as a population-level baseline to promote health equity around substance use prevention and public health strategies. This study quantifies the number of substances used by sexual identity among US adults. METHODS: We used the 2021 National Survey on Drug Use and Health and included adults (aged ≥18) (unweighted n = 47,291). We conducted multivariable Poisson regression models to examine the number of substances used in the past year (count variable; range: 0-18) by sexual identity ("heterosexual", "gay/lesbian", "bisexual", "unknown" [don't know, refused, blank]), after adjusting for covariates (i.e., age, sex, race/ethnicity, income level, education level, having insurance status, living in urban area, past-year distress level (Kessler-6), any drug or alcohol use disorder in the past year, and sexual attraction). RESULTS: Of the total sample (51.4% were female, 12.1% were non-Hispanic Black and 17.0% were Hispanic adults), 88.3% were heterosexual, 2.4% were gay/lesbian, 5.0% were bisexual adults, and 4.3% reported "unknown" sexual identity. After adjusting for covariates, a greater number of substances were used in the past year among gay/lesbian individuals (aIRR = 1.44, 95% CI = 1.09, 1.75), bisexual individuals (aIRR =1.34, 95% CI = 1.26, 1.41), and individuals reporting an "unknown" sexual identity (aIRR = 1.22, 95% CI = 1.09, 1.36) (vs. heterosexual adults). CONCLUSIONS: Tailored substance use prevention and public health strategies specializing in sexual minority populations are warranted.

Hospitalised versus outpatient COVID-19 patients' background characteristics and comorbidities: A systematic review and meta-analysis.

This study aimed to systematically assess COVID-19 patient background characteristics and pre-existing comorbidities associated with hospitalisation status. The meta-analysis included cross-sectional, cohort, and case-series studies with information on hospitalisation versus outpatient status for COVID-19 patients, with background characteristics and pre-existing comorbidities. A total of 1,002,006 patients from 40 studies were identified. Significantly higher odds of hospitalisation were observed in Black individuals (OR = 1.33, 95% CI: 1.04-1.70), males (OR = 1.59, 95% CI: 1.43-1.76), and persons with current/past smoking (OR = 1.59, 95% CI: 1.34-1.88). Additionally, individuals with pre-existing comorbidities were more likely to be hospitalised [asthma (OR = 1.22, 95% CI: 1.02-1.45), COPD (OR = 3.68, 95% CI: 2.97-4.55), congestive heart failure (OR = 6.80, 95% CI: 4.97-9.31), coronary heart disease (OR = 4.40, 95% CI: 3.15-6.16), diabetes (OR = 3.90, 95% CI: 3.29-4.63), hypertension (OR = 3.89, 95% CI: 3.34-4.54), obesity (OR = 1.98, 95% CI: 1.59-2.46) and renal chronic disease (OR = 5.84, 95% CI: 4.51-7.56)]. High heterogeneity and low publication bias among all factors were found. Age was not included due to the large variability in the estimates reported. In this systematic review/meta-analysis for patients with COVID-19, Black patients, males, persons who smoke, and those with pre-existing comorbidities were more likely to be hospitalised than their counterparts. Findings provide evidence of populations with higher odds of hospitalisation for COVID-19.

Results and Methodological Implications of the Digital Epidemiology of Prescription Drug References Among Twitter Users: Latent Dirichlet Allocation (LDA) Analyses.

BACKGROUND: Social media is an important information source for a growing subset of the population and can likely be leveraged to provide insight into the evolving drug overdose epidemic. Twitter can provide valuable insight into trends, colloquial information available to potential users, and how networks and interactivity might influence what people are exposed to and how they engage in communication around drug use. OBJECTIVE: This exploratory study was designed to investigate the ways in which unsupervised machine learning analyses using natural language processing could identify coherent themes for tweets containing substance names. METHODS: This study involved harnessing data from Twitter, including large-scale collection of brand name (N=262,607) and street name (N=204,068) prescription drug-related tweets and use of unsupervised machine learning analyses (ie, natural language processing) of collected data with data visualization to identify pertinent tweet themes. Latent Dirichlet allocation (LDA) with coherence score calculations was performed to compare brand (eg, OxyContin) and street (eg, oxys) name tweets. RESULTS: We found people discussed drug use differently depending on whether a brand name or street name was used. Brand name categories often contained political talking points (eg, border, crime, and political handling of ongoing drug mitigation strategies). In contrast, categories containing street names occasionally referenced drug misuse, though multiple social uses for a term (eg, Sonata) muddled topic clarity. CONCLUSIONS: Content in the brand name corpus reflected discussion about the drug itself and less often reflected personal use. However, content in the street name corpus was notably more diverse and resisted simple LDA categorization. We speculate this may reflect effective use of slang terminology to clandestinely discuss drug-related activity. If so, straightforward analyses of digital drug-related communication may be more difficult than previously assumed. This work has the potential to be used for surveillance and detection of harmful drug use information. It also might be used for appropriate education and dissemination of information to persons engaged in drug use content on Twitter.

Prescription Psychotherapeutic Drug Use and Nicotine Use among Young People in the United States.

Background: While prescription psychotherapeutic drug use (PPDU) and nicotine use pose substantial problems in isolation, they pose an increased risk in combination. This study aimed to estimate the prevalence of PPDU for young people, stratified by nicotine use status. A trend analysis was used to examine changes in PPDU and nicotine use over time. Methods: We used a cross-sectional population-based sample of young people aged 16-25 years (n = 10,454) from the National Health and Nutrition Examination Survey (NHANES, 2003-2018). For each data cycle, the prevalence of self-reported PPDU and nicotine including pain relievers, sedatives, stimulants, and tranquilizers was estimated. Using Joinpoint regression, we tested for significant changes in trends using a log-linear model and permutation test approach and produced the average data cycle percentage change (ADCPC). Results: From 2003 to 2018, 6.7% of young people had PPDU and 27.3% used nicotine. The prevalence of cigarette smoking decreased while other nicotine product use increased (p's < 0.001). Those who used nicotine were more likely to have PPDU (8.2%; 95% CI = 6.5%, 9.8%) vs. non-nicotine use (6.1%; 95% CI = 5.1%, 7.0%; p = 0.01). Results indicated a decreasing trend for nicotine use (ADCPC = -3.8, 95% CI = -7.2, -0.3; p = 0.04), but not for PPDU (ADCPC = 1.3; 95% CI = -4.7, 7.8; p = 0.61). On further examination, opioid use decreased, sedative use remained stable, and stimulant and tranquilizer use increased over time. Conclusions: From 2003 to 2018, young people who used nicotine had a higher prevalence of PPDU than those who did not. Clinicians should communicate the association between nicotine use and prescription drugs when prescribing or managing young patients' medications.

Service Utilization among Persons Who Inject Drugs Attending a Syringe Exchange Program in New York State.

BACKGROUND: Epidemiologic studies commonly recommend the integration of harm reduction programs with health and social services to improve the well-being of persons who inject drugs (PWIDs). This study identified service utilization clusters for PWIDs attending a syringe exchange program (SEP) in 2017 to better understand in-house service usage. METHODS: We applied Multiple Correspondence Analysis and Hierarchical Clustering on Principal Components to classify 475 PWIDs into clusters using anonymized, SEP records data from New York. Multinomial logistic regression was used to identify sociodemographic and program engagement correlates of cluster membership. RESULTS: Only 22% of participants utilized at least one service. We identified three clusters of service utilization defined by 1) Nonuse; 2) Support, Primary Care, & Maintenance service use; and 3) HIV/STD, Support, Primary Care, & Maintenance service use. Cluster 2 members were less likely to be living alone compared to Cluster 1 (AOR = 0.08, 95% CI: 0.04, 0.17) while Cluster 3 members were less likely to be White (AOR = 0.19, 95% CI: 0.07, 0.50) or living alone (AOR = 0.16, 95% CI: 0.06, 0.44) and more likely to be Medicaid recipients (AOR = 2.89, 95% CI: 1.01, 8.36) compared to Cluster 1. Greater than one SEP interaction, lower syringe return ratios, and being a long-term client increased the odds of service utilization. DISCUSSION: Overall, PWID clients had a low prevalence of in-house service use particularly those who live alone. However, higher service utilization was observed among more vulnerable populations (i.e., non-White and LGBT). Future research is needed to profile services used outside of the SEP.

The association between E-cigarette use and Kratom use among US adults.

Kratom, an herbal substance with stimulant and opioid-like effects commonly used in capsules or powder to be ingested or brewed as a tea, has been gaining popularity in the United States (US). US e-cigarette use (i.e., vaping) has exponentially increased in recent years. Given the potential risks of kratom (e.g., poisonings) and the increasing prevalence of e-cigarette use, understanding the association between them is important to inform prevention strategies and regulatory policies. We harnessed data from the 2020 National Survey on Drug Use and Health (NSDUH; n = 27,170) to examine past-year kratom use by past-year e-cigarette use among adults. We ran a logistic regression model on kratom use by e-cigarette use adjusting for associated factors with substance use. Among all respondents, the estimated prevalence of past-year kratom use was 0.9% and an estimated 9.7% reported past-year e-cigarette use. Our multivariable model found those with e-cigarette use (vs. not) had 4.80 higher odds of using kratom in the past year (aOR = 4.80; 95% CI = 2.62, 8.80). These findings might help inform the need for continuing education for physicians and healthcare providers related to practice in managing patients with kratom use, future studies for regulatory policies on e-cigarettes (e.g., e-liquids), or other FDA policies related to kratom.

Relating individual differences in the reinforcing value of smoking and dependence severity to nicotine exposure levels in vulnerable populations.

Cigarette smoking is overrepresented in populations with psychiatric conditions and socioeconomic disadvantage. Greater understanding of the role of reinforcement and nicotine dependence in smoking among vulnerable populations may facilitate development of better targeted interventions to reduce smoking. Prior research demonstrated that individual differences in the reinforcing value of smoking and nicotine-dependence severity predicted total nicotine-exposure in vulnerable populations. The present study uses multivariate regression to address two aims: (1) Quantify the degree to which the reinforcing value of smoking, assessed using the Cigarette Purchase Task (CPT), and dependence severity assessed using the Fagerström Test of Nicotine Dependence and Brief Wisconsin Inventory of Smoking Dependence Motives (B-WISDM) each account for individual differences in cotinine-plus-3'-hydroxycotinine (COT+3HC) levels. (2) Explore whether there is overlap in the variance accounted for by the CTP, FTND, and B-WISDM. Participants were 628 adults with co-morbid psychiatric conditions or socioeconomic disadvantage who smoked daily. The CPT, FTND, and B-WISDM models accounted for 23.76%, 32.45%, and 29.61% of the variance in COT+3HC levels, respectively. Adding CPT to the FTND model failed to increase the variance accounted for and adding it to the B-WISDM model did so by only 1.2% demonstrating considerable overlap in the variance in nicotine exposure levels accounted for by these three instruments. These results provide new knowledge on the relationship between individual differences in the reinforcing value of smoking and nicotine-exposure levels and suggest differences in reinforcing value may underpin a considerable portion of the variance in nicotine exposure accounted for by dependence severity.

National Trends in Suicide Thoughts and Behavior among US Adults with Opioid Use Disorder from 2015 to 2020.

INTRODUCTION: Suicide thoughts and behavior (STB) are associated with premature mortality and is disproportionately represented among those with opioid use disorder (OUD). Recent trends in STB among those with OUD are lacking. We investigated trends in STB among US adults with versus without OUD using six waves of cross-sectional, nationally-representative, epidemiological data. METHODS: Data came from the 2015-2020 National Survey on Drug Use and Health (combined n = 241,675). We compared past-year STB outcomes (i.e., thoughts of seriously considering killing self (SI), suicide plan (SP), suicide attempt (SA)) among adults with versus without past-year OUD. Unadjusted and adjusted logistic regression tested the association between survey-year and past-year STB outcomes (i.e., SI, SP/SA) stratified by OUD status. RESULTS: Between 2015 and 2020, 26% versus 4% of those with and without OUD, respectively, reported SI, 10% versus 1% reported a SP, and 6% versus 1% reported SA (all ps < 0.001). In adjusted analyses, across survey years, no changes in the prevalence of SI were observed for adults with or without OUD, and no changes were observed over time for SP/SA in adults with or without OUD. OUD severity and treatment status did not moderate the relationship between OUD and STB outcomes. CONCLUSIONS: Among US adults, OUD was associated with thoughts of suicide and suicide behavior. The heightened prevalence of STB in adults with OUD has not changed in recent years. Screening for SI is needed among those reporting opioid misuse and should be routinely integrated into OUD prevention and treatment.

Opioid Use Disorder Trends from 2002 to 2017 by Cigarette Smoking Status in the United States.

INTRODUCTION: There have been significant increases in opioid use and opioid-related overdose deaths in the United States (US). While cigarette smoking remains disproportionately high among individuals with opioid use disorder (OUD), it is unknown whether trends in OUD differ by cigarette use. This study examined differences in OUD by smoking status and trends in OUD by smoking status over time. METHODS: Data were harnessed from US National Surveys on Drug Use and Health, annual cross-sectional, nationally representative samples of individuals aged 12 and older. Past-year OUD prevalences were estimated each year from 2002 to 2017 among persons with current daily, current nondaily, former, and never cigarette smoking (n = 891 548). Linear time trends of OUD were examined using logistic regression models. RESULTS: In 2017, OUD was significantly more common among persons with daily (2.6%) and nondaily (1.5%) smoking compared with those with former (0.5%) or never (0.2%) smoking. Overall, the prevalence of OUD increased between 2002 and 2017, although trends differed by smoking status. Adjusting for background characteristics, the prevalence of OUD increased significantly among individuals with daily (adjusted odds ratio [AOR] = 1.06; 95% confidence interval [CI]: 1.04, 1.07), nondaily (AOR = 1.03; 95% CI: 1.01, 1.05), and former smoking (AOR = 1.05; 95% CI: 1.02, 1.09), but decreased among those who never smoked (AOR = 0.98; 95% CI: 0.97, 0.99). CONCLUSIONS: In the United States, the prevalence of OUD was higher among individuals with current cigarette smoking relative to those with former and never smoking. OUD increased among persons with current and former smoking from 2002 to 2017, in contrast to a decrease in OUD among those who never smoked. IMPLICATIONS: OUDs are increasing in the United States and are associated with difficulty quitting cigarettes. Our data from representative national samples of US individuals showed that although OUD increased among those with both current and former smoking over time, OUD remained significantly higher among persons with current (daily and nondaily) smoking versus persons who formerly smoked cigarettes. In addition, youth with cigarette smoking had particularly high prevalences of OUDs. Cigarette smoking may be important to address alongside OUD to reduce the harmful consequences of OUD and cigarette use especially among younger individuals.

Relationship between Comorbid Drug Use Disorders, Affective Disorders, and Current Smoking.

OBJECTIVE: This study aimed to identify subgroups of adults based on comorbid psychiatric disorders and to examine the relationship with current smoking. Method: The National Epidemiologic Survey on Alcohol and Related Conditions-III, 2012-2013, sampled, recruited, and assessed 36,309 adults, with interviews on drug use and other characteristics. The Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-5 Version (AUDADIS-5) was used to identify psychiatric conditions. Latent class models were developed based on various psychiatric diagnoses. Multinomial logistic regression estimated the significance of covariates in predicting class membership. Results: Four latent classes optimally distinguished the population: no comorbid conditions (63%), comorbid affective disorders (16%), those with alcohol use disorder (AUD; 17%), and a highly comorbid subgroup (i.e., co-occurring affective and drug use disorders; 4%). Current smoking was about twice as prevalent in the classes defined by psychiatric conditions compared to the group with no comorbid conditions. The highly comorbid class was more likely to be current smokers than the comorbid affective disorders class and the AUD class. Furthermore, the highly comorbid class was younger and had lower income, and the AUD class had a higher proportion of males than the other classes. Conclusions: Cigarette smoking was higher in the nearly 40% of respondents characterized by psychiatric disorders, particularly those with drug use disorders. Correlates of membership in these classes were consistent with known vulnerabilities for smoking, highlighting the need for mental health interventions and future research to explicitly address tobacco cessation in clinical settings based on psychiatric diagnoses.

Reasons for non-medical use of prescription opioids among young adults: Role of educational status.

Non-medical use of prescription opioids (NMUPO) and related overdoses are disproportionately elevated among young adults. Efforts to understand the underlying reasons for NMUPO are critical for developing more effective prevention and intervention strategies for this group. Given the robust literature on the association between educational status and substance abuse risk, we examined the reasons for NMUPO through the lens of educational attainment among young adults. Data from the 2016 National Survey on Drug Use and Health came from an unweighted sample of 941 young adults aged 18-25 years who reported past-year NMUPO. Self-reported reasons for most recent NMUPO were compared by educational status. The most commonly-endorsed reasons for past-year NMUPO was physical pain relief (47.6%), followed by feel good/get high (19.8%), relax/relieve tension (13.2%) and experiment/see what it feels like (6.8%). Reasons for NMUPO did not differ as a function educational status (p = 0.17). These findings suggest that efforts to prevent and address opioid misuse among young adults should focus on understanding and improving pain management in this vulnerable population.

Examining Age as a Potential Moderator of Response to Reduced Nicotine Content Cigarettes in Vulnerable Populations.

INTRODUCTION: Young adults (aged 18-24 years) have a higher smoking prevalence than younger and older age groups and young adulthood is an important developmental period during which long-term behavior patterns like cigarette smoking are established. The aim of the current study was to examine how young adult smokers with additional vulnerabilities to smoking respond to reduced nicotine content cigarettes. METHODS: This is a secondary analysis of a double-blind, within-subject experiment conducted with 169 cigarette smokers recruited from populations with comorbid psychiatric conditions or socioeconomic disadvantage assessing acute effects of research cigarettes varying in nicotine content (0.4, 2.4, 5.2, 15.8 mg/g). Participants were dichotomized by chronological age (18-24 vs. ≥25 years). Across 14 laboratory sessions effects of nicotine content were examined on measures of relative reinforcing efficacy (Cigarette Purchase Task [CPT] and Concurrent Choice testing), subjective effects, craving/withdrawal, and smoking topography. Repeated measures analysis of variances were used to examine potential moderating effects of age. RESULTS: Young adults exhibited lower demand for reduced nicotine content cigarettes than older adults across three of five CPT indices (ps < .05). No differences by age were observed on other measures of reinforcing efficacy, subjective effects, craving/withdrawal, or smoking topography where effects generally decreased as an orderly function of decreasing nicotine content (ps <.05). CONCLUSION: Overall, these findings suggest that reducing the nicotine content of cigarettes would decrease the addiction potential of cigarette smoking in young adult smokers as much or perhaps more than older adult smokers from populations at increased vulnerability to smoking, addiction, and smoking-related health consequences. IMPLICATIONS: Reducing the nicotine content in cigarettes to lower addiction potential of smoking has been proposed as a means to improve overall population health. It is imperative to examine how young adults may respond to a nicotine reduction policy. We saw minimal evidence that age moderates acute response and where there was evidence it was in the direction of reduced nicotine content cigarettes having less addictive potential among young versus older adults (eg, steeper decreases in demand for very low nicotine content cigarettes among young versus older adults). Overall, a nicotine reduction policy has the potential to reduce smoking across age groups.

A case report of two siblings with Alstrom syndrome without hearing loss associated with two new ALMS1 variants.

BACKGROUND: Alström syndrome (AS) is a rare monogenic disorder characterized by progressive multi-organ pathology including retinal degeneration, hearing impairment and type 2 diabetes. Here we present clinical features in two siblings diagnosed with Alström syndrome associated with two novel changes in ALMS1. CASE PRESENTATION: Two siblings originally diagnosed as having achromatopsia presented with mild light sensitivity, nonspecific otitis media, and mild developmental delay during the first decade of life with a relatively stable ocular appearance during second decade, late onset of nystagmus and dyschromatopsia (after 20 years) and preserved vision during the third decade of life. One sibling had late onset hearing loss and both siblings had symmetric high myopia, normal stature, and ptosis. Clinical findings revealed structural and functional tests consistent with a cone-rod dystrophy. Novel variants c.9894dupC (p.S3298 fs) and c.10769delC (p.T3590 fs) in ALMS1 gene were found. CONCLUSIONS: Two North American siblings who presented with a mild clinical phenotype of Alström syndrome were found to have novel mutations in ALMS1. These two frame-shift mutations segregated with the disease phenotype lending evidence to their pathogenicity.

Patterns and Frequency of Current e-Cigarette Use in United States Adults.

Background: In the United States (US), electronic cigarette (e-cigarette) use prevalence has increased since 2010. Few studies, however, have addressed frequency of use at the population-level. This study examines patterns and correlates of e-cigarette use frequency in a novel national sample. Methods: Data were from 36,277 US adults interviewed between 2012 and 2013 for the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). Sociodemographic characteristics, other tobacco/drug use, and psychiatric disorders were compared by e-cigarette use status (i.e. current [past-month], past, never) and e-cigarette use frequency (i.e. infrequent [≤3 days/month], moderate [1-6 days/week], daily). Multinomial logistic regression models compared correlates of e-cigarette use status and e-cigarette use frequency. Results: Current e-cigarette use was low in adults (1.4%) and past e-cigarette use was 3.9%. Among current e-cigarette users, 38.1% were infrequent users, 32.9% were moderate users, and 29.0% were daily users. Compared to infrequent e-cigarette users, daily users were more likely to be male and older, but less likely to be current cigarette smokers and alcohol drinkers (p's < .05). Compared to daily e-cigarette users, moderate users were more likely be female, current cigarette smokers, and fall into the 25-34 age group (p's < .05). Moderate and daily e-cigarette users had higher prevalence of current extra-medical opioid use than infrequent users (p's < .05). Conclusions/Importance: E-cigarette users were most often infrequent users versus moderate or daily users. Compared to infrequent and moderate users, daily e-cigarette users were less likely to be current alcohol drinkers or cigarette smokers. Novel findings highlight a correlation between more frequent e-cigarette and opioid use.

Examining the relationship between pregnancy and quitting use of tobacco products in a U.S. national sample of women of reproductive age.

This study examined quit rates longitudinally for cigarettes, e-cigarettes, hookah, cigars, and all tobacco products in a U.S. national sample of women aged 18-44 who completed both Wave 1 (W1) and Wave 2 (W2) of the Population Assessment of Tobacco and Health (PATH, 2013-2014, 2014-2015) study (N = 7814). Quit rates were examined among women who transitioned into pregnancy across survey waves, and among a comparable sample of non-pregnant women to provide contextual information about quitting among the broader population of reproductive-aged women. Multiple logistic regression modeling was used to estimate the associations of pregnancy and quitting adjusting for other demographic and psychosocial characteristics. Quit rates among women who were pregnant in W2 were highest for hookah (98.3%), followed by cigars (88.0%), e-cigarettes (81.3%), and lowest for tobacco cigarettes (53.4%). Slightly more than half (58.7%) of women reported quitting use all tobacco products while pregnant. Pregnancy was independently associated with increased odds of quitting hookah (AOR = 52.9, 95%CI = 3.4, 830.2), e-cigarettes (AOR = 21.0, 95%CI = 2.6, 170.3), all tobacco products (AOR = 9.6, 95%CI = 6.4, 14.5), and cigarettes (AOR = 6.5, 95%CI = 4.2, 10.1), although not cigars. Relative to other demographic and psychosocial characteristics, pregnancy was the strongest predictor of quitting use of each tobacco product. While these data indicate that pregnancy has strong, independent associations with quitting a variety of commercially available tobacco products, the comparatively lower quit rates for cigarettes versus other tobacco products underscores the long-standing need for more intensive, multipronged clinical and regulatory interventions to reduce cigarette use among reproductive-aged women.

Tobacco use in cardiac patients: Perceptions, use, and changes after a recent myocardial infarction among US adults in the PATH study (2013-2015).

Smoking status following cardiac events strongly predicts future morbidity and mortality. Using a nationally representative sample of United States adults, aims of this study were (1) to estimate use of, and attitudes towards, tobacco products as a function of level of cardiac risk, and (2) to explore changes in attitudes and tobacco use among adults experiencing a recent myocardial infarction (MI). Data were obtained from the first and second waves of the Population Assessment of Tobacco and Health (PATH) study. Use and attitudes towards tobacco products were examined at Wave 1 among adults with no chronic health condition (n = 18,026), those with risk factors for heart disease (n = 4593), and those who reported ever having had an MI (n = 643). Changes in perceived risk of tobacco and use between the two waves and having an MI in the last 12 months (n = 240) were also examined. Those who reported lifetime MI were more likely to believe that smoking/using tobacco was causing/worsening a health problem. Having had a recent MI event increased perceived tobacco-related risk and attempts at reduction/quitting, but did not significantly impact combusted tobacco cessation/reduction or uptake of non-combusted tobacco products. Sociodemographic characteristics and use of other tobacco products were associated with change in use of tobacco products. Those who have an MI are sensitized to the harm of continued smoking. Nonetheless, having an MI does not predict quitting combusted tobacco use or switching to potentially reduced harm products. Intense intervention is necessary to reduce combusted use in this high-risk population.

Aerobic exercise during adolescence and anxiety disorders in adulthood: A cohort study using Add Health.

INTRODUCTION: The prevalence of anxiety disorders, and mental chronic diseases, has increased over the last decade among adolescents. Since aerobic exercise reduces the risk of chronic diseases and stress symptoms, we aimed to examine the association between aerobic exercise in adolescence and anxiety disorders in adulthood. METHODS: Self-reported, publicly available data from 5,114 adolescents who participated in Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) was analyzed from 1994-2009. We included US-based individuals aged 16 years on average and observed them for 15 years. Weighted Poisson regression models estimated the association between aerobic exercise in Wave I (1994, baseline) and anxiety disorders in Wave IV (2009, adulthood), adjusting for sociodemographic characteristics and substance use at baseline. RESULTS: Overall, 639/5,114 (weighted 12.96%) individuals experienced anxiety disorders at baseline. Age and sex differed significantly across all exercise groups (p's<0.001). Aerobic exercise did not significantly protect against anxiety disorders in adulthood: compared to adolescents who did not exercise at all, those who exercised 1-2 times/week had 0.85 times the prevalence of anxiety disorders during adulthood (95% CI = 0.65, 1.12; p = 0.25). Those who exercised 3-4 times/week had 0.81 times the prevalence (95% CI = 0.61, 1.08, p = 0.15) and those who exercised 5+ times/week had 0.84 times the prevalence (95% CI = 0.63, 1.13, p = 0.25) than those who did not exercise at all. CONCLUSION: Aerobic Exercise in adolescence did not protect against anxiety disorders in adulthood. More evidence is needed on this association, including using homogeneous measures of exercise and repeated measures methods.

The association between exercise and prescription opioid misuse: A scoping review.

Exercise prevents chronic diseases and modulates pain. People experiencing pain often use opioids for relief, increasing the risk of prescription opioid misuse. Nonetheless, exercise may influence prescription opioid misuse through the release of endorphins or induced injury-related pain. We aimed to summarize the existing literature on the association between exercise and prescription opioid misuse. We identified studies published through December 2021 in Cochrane, Embase, Medline, and Pubmed, using search terms like "opioid-related disorders," "opioid misuse," "exercise," and "sports." Observational and experimental studies with adult samples published in English were included. Exclusion criteria included participants < 18 years old, studies including heroin use as the outcome, and studies conducted among pregnant or institutionalized individuals. The risk of bias and quality assessment were conducted independently by two authors using the National Institutes of Health Study Quality Assessment Tools, and decisions were cross-checked with a third author. Our search yielded 10,796 records, of which eight studies were included. These studies were heterogeneous clinically and methodologically. Three were intervention trials, three were cross-sectional, and two were cohort studies. Three studies evaluated yoga, two evaluated exercise, and three evaluated sports. Significant findings showed lower prescription opioid misuse among people who exercise, except for one study that showed greater odds of prescription opioid misuse among college athletes. We conclude that the findings on the association between exercise and prescription opioid misuse vary, even within similar study types and samples. Future researchers should consider large samples, standardized questions, and common outcome measures in research on exercise and prescription opioid misuse. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Assessing the association between e-cigarette use and cardiovascular disease: A meta-analysis of exclusive and dual use with combustible cigarettes.

BACKGROUND: Growing evidence highlights the impact of e-cigarette use on cardiovascular health, prompting a crucial examination of its association with cardiovascular disease (CVD) in both exclusive e-cigarette and dual use scenarios with combustible cigarettes. This meta-analysis assessed the association between e-cigarette use and CVD by synthesizing the existing literature. METHODS: Pertinent observational studies were identified using multiple electronic databases, from August 22nd, 2006, to April 10th, 2024. A meta-analysis was conducted using random-effect models. Risk of bias was assessed using the National Institutes of Health (NIH) Study Quality Assessment Tools. FINDINGS: A total of 20 observational studies involving 8,499,444 participants were included in the meta-analysis. Dual use (e-cigarettes and combustible cigarette) increased the odds of CVD by 2.56 times (95 % CI: 2.11, 3.11) compared to never use of both. Current e-cigarette use combined with former combustible cigarette increased the odds of CVD by 2.02 times (95 % CI: 1.58, 2.58) compared to never use of either. Exclusive current e-cigarette use did not show a statistically significant association with CVD odds compared to never use of either (OR = 1.24, 95 % CI: 0.93, 1.67). CONCLUSIONS: Dual use of e-cigarettes and combustible cigarettes was significantly associated with CVD, but results failed to show a significant association between exclusive e-cigarette use and CVD. Robust and longitudinal studies are needed to understand the long-term implications of e-cigarette use and CVD. Public health efforts should focus on awareness, smoking cessation, and regulating both e-cigarettes and combustible cigarettes.

Prevalence and Trends in Cigarette Smoking With and Without Tobacco Use Disorder Among Adults in the United States: 2010-2021.

Objective: Few national estimates are available on the prevalence of tobacco use disorder (TUD) in the United States (US), and most trials exclusively assess daily smoking rather than TUD. We examined the prevalence and trends in cigarette smoking with vs without TUD among adults.Methods: Data came from the 2010-2021 National Survey on Drug Use and Health (n = 483,982), a cross sectional, US representative dataset. A TUD composite variable was created based on established definitions (eg, DSM-5 symptoms). Weighted prevalence of past 30-day cigarette smoking, daily smoking (30/30 days) and nondaily smoking (<30/30 days) with and without TUD, was calculated annually.Results: In 2021, the prevalence of past 30- day overall cigarette smoking was 17%; 11% reported daily cigarette smoking, whereas 6% reported nondaily cigarette smoking. Only 1% of the population reported daily smoking without TUD, whereas 10% reported daily smoking with TUD. Two percent of the population reported nondaily smoking without TUD, and 4% of the population reported nondaily smoking with TUD. Daily smoking with TUD and nondaily smoking with and without TUD decreased significantly from 2010 to 2021 (all P's < .001). US adults reporting TUD symptoms (vs not) were more likely to be older, identify as White, have lower income and less education, and have a substance use disorder.Conclusions: The prevalence of daily cigarette smoking with TUD was 10× higher than the prevalence of daily cigarette smoking without TUD. Twice as many US adults with nondaily smoking reported TUD than no TUD, illustrating that daily smoking is not necessary for TUD.