Correlates of the use of electronic devices to vape cannabis in a cohort of young Swiss male reporting current cannabis use.

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

Screened Attention Deficit/Hyperactivity Disorder as a Predictor of Substance Use Initiation and Escalation in Early Adulthood and the Role of Self-Reported Conduct Disorder and Sensation Seeking: A 5-Year Longitudinal Study with Young Adult Swiss Men.

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

Children's experience of physical harms and exposure to family violence from others' drinking in nine societies.

AIM: To study caregiver reports of children's experience of physical harm and exposure to family violence due to others' drinking in nine societies, assess the relationship of harm with household drinking pattern and evaluate whether gender and education of caregiver affect these relationships. METHOD: Using data on adult caregivers from the GENAHTO (Gender and Alcohol's Harm to Others) project, child alcohol-related injuries and exposure of children to alcohol-related violence (CAIV) rates are estimated by country and pooled using meta-analysis and stratified by gender of the caregiver. Households with and without heavy or harmful drinker(s) (HHD) are compared assessing the interaction of caregiver gender on the relationship between reporting HHD and CAIV, adjusting for caregiver education and age. Additionally, the relationship between caregiver education and CAIV is analysed with meta-regression. RESULTS: The prevalence of CAIV varied across societies, with an overall pooled mean of 4% reported by caregivers. HHD was a consistent correlate of CAIV in all countries. Men and women in the sample reported similar levels of CAIV overall, but the relationship between HHD and CAIV was greater for women than for men, especially if the HHD was the most harmful drinker. Education was not significantly associated with CAIV. CONCLUSION: One in 25 caregivers with children report physical or family violence harms to children because of others' drinking. The adjusted odds of harm are significantly greater (more than four-fold) in households with a heavy or harmful drinker, with men most likely to be defined as this drinker in the household.

Adult attention-deficit/hyperactivity disorder, risky substance use and substance use disorders: a follow-up study among young men.

We investigated whether adult attention-deficit/hyperactivity disorder (ADHD) predicts risky substance use and substance use disorders (SUDs), and its impact on the course of these problematic substance use patterns. Our sample included 4975 Swiss men (mean age 20 ± 1.2 years) who participated in the baseline and 15-month follow-up assessments of the Cohort Study on Substance Use Risk Factors. We examined: (1) the contribution of ADHD, as assessed at baseline, on the risky use of alcohol, nicotine and cannabis, and their corresponding use disorders (AUD, NUD, CUD) at follow-up; and (2) the association between ADHD and the course of outcomes (i.e., absence, initiation, maturing out, persistence) over 15 months. All analyses were adjusted for socio-demographics and co-morbidity. Men with ADHD were more likely to exhibit persistent risky alcohol and nicotine use, and to mature out of risky cannabis use. ADHD at baseline was positively linked to AUD and negatively to CUD at follow-up, but not to NUD. For all SUDs, ADHD had a positive association with use persistence and maturing out. Comparing these two trajectories revealed that early age of alcohol use initiation distinguished between persistence and maturing out of AUD, while the course of NUD and CUD was related to ADHD symptoms and SUD severity at baseline. Already in their early twenties, men with ADHD are especially likely to exhibit persistent problematic substance use patterns. Substance-specific prevention strategies, particularly implemented before early adulthood, may be crucial to reducing the development and persistence of pathological patterns in such individuals.

Snus and Snuff Use in Switzerland Among Young Men: Are There Beneficial Effects on Smoking?

Introduction: There are few recent longitudinal studies on smokeless tobacco (SLT) products and smoking outside the United States or European Nordic countries. The present longitudinal study tests whether Swedish-type snus and nasal snuff use decreases smoking incidence and prevalence in a central European country. Methods: The sample consisted of 5198 Swiss men (around 20 years of age). Retention rate was 91.5% over 15 months. Regression models, adjusting for a variety of psychosocial, smoking-related, and other risk factors, assessed whether no, low (less than weekly), and high (weekly or more) use baseline groups showed changes or maintenance in snus and snuff use related to smoking initiation, cessation, and reduction. Results: Among baseline nonsmokers, snus initiators (OR = 1.90, p = .003) and low baseline maintainers (OR = 4.51, p < .001) were more likely to start smoking (reference: persistent nonusers of snus). Among baseline smokers, initiators (OR = 2.79, p < .001) and low baseline maintainers (OR = 2.71, p = .005) more often continued smoking, whereas snus quitters less frequently continued smoking (OR = 0.57, p = .009). High baseline maintainers were non-significantly less likely to continue smoking (OR = 0.71, p = .315). Among continuing smokers, only snus quitters significantly reduced the number of cigarettes smoked per day (b = -1.61, p = .002) compared with persistent nonusers of snus. Results were similar for snuff. Conclusions: SLT use did not have any significant beneficial effects on young men in Switzerland but significantly increased the likelihood of smoking initiation and continuation, independent of whether the substance is legally sold (snuff) or not (snus). This does not exclude that there may be beneficial effects at older ages. Implications: Our research provides evidence that SLT use has no benefits for cigarette smoking initiation, cessation, or reduction among young men in a central European country, where SLT is not highly promoted or receives tax incentives. This is true for both legally sold nasal snuff and Swedish-type snus that cannot be legally sold. Results indicate that without incentives for using it, among young people shifts from smoking to SLT use are questionable and confirms the need for country-specific studies before the global public health community engages in promoting SLT.

Game Addiction Scale Assessment Through a Nationally Representative Sample of Young Adult Men: Item Response Theory Graded-Response Modeling.

BACKGROUND: The 7-item Game Addiction Scale (GAS) has been validated under standard confirmatory factor analysis and exhibits good psychometric properties. Whether this scale satisfies the necessary conditions for consideration by item response theory (IRT) modeling remains unknown. However, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) recently proposed criteria, in its section 3, to define internet gaming disorder (IGD) to promote research on this possible condition. OBJECTIVE: The objective of our study was to (1) analyze GAS in the context of IRT (graded-response) modeling; (2) investigate differential item functioning (DIF), a feature of IRT modeling, in 2 subsamples; and (3) contribute to the ongoing (IGD) debate related to the validity of the DSM-5 criteria using GAS items as a proxy. METHODS: We assessed 2 large representative samples of Swiss men (3320 French-speaking and 2670 German-speaking) with GAS. RESULTS: All items comprised high discrimination parameters. GAS items such as relapse, conflict, withdrawal, and problems (loss of interests) were endorsed more frequently in more severe IGD stages, whereas items related to tolerance, salience (preoccupation), and mood modification (escape) were endorsed more widely among participants (including in less severe IGD stages). Several DIF effects were found but were classified as negligible. CONCLUSIONS: The results of the analyses partly support the relevance of using IRT to further establish the psychometric properties of the GAS items. This study contributes to testing the validity of the IGD criteria, although cautious generalization of our findings is required with GAS being only a proxy of the IGD criteria.

Family-Related Stress versus External Stressors: Differential Impacts on Alcohol and Illicit Drug Use in Young Men.

Intense stress increases substance use (SU). However, little is known about the extent to which distinctive forms of stress should be weighted with regard to their effects on SU. This study aimed to determine whether family-related stress factors (FSF) influenced SU in a different way than external stress factors (ESF). Data was drawn from a Swiss cohort study on SU risk factors (C-SURF), involving 5,308 young adult men. Twelve month use of alcohol and of illicit substances was assessed. FSF and ESF for the time period preceding SU were measured. FSF and ESF were both significantly associated with SU. FSF had a greater impact on the use of most substances than did ESF. The FSF with the strongest association with SU was lack of parental monitoring. Regarding ESF, the cumulative number of stressful external events had a higher impact on SU than previous physical or sexual assault by a stranger. In contrast, physical or sexual assault by a family member was not found to be associated with subsequent SU. These findings have important implications for SU prevention programmes focusing on male teenagers, as it is difficult to screen and intervene in subtle forms of maltreatment in families.

Substance Use in Young Swiss Men: The Interplay of Perceived Social Support and Dispositional Characteristics.

BACKGROUND: Social environment plays a central role in substance use behaviors. However, it is not clear whether its role varies as a function of individual dispositional characteristics. OBJECTIVES: To investigate the interaction between dispositional characteristics (i.e. sensation seeking, anxiety/neuroticism) and social environment (i.e. perceived social support [PSS]) in association with substance use. METHODS: A representative sample of 5,377 young Swiss males completed a questionnaire assessing substance use, sensation seeking, anxiety/neuroticism, and PSS from friends and from a significant other. RESULTS: Sensation seeking and anxiety/neuroticism were positively related to most substance use outcomes. PSS from friends was significantly and positively related to most alcohol and cannabis use outcomes, and significantly and negatively associated with the use of hard drugs. PSS from a significant other was significantly and negatively associated with most alcohol and cannabis use outcomes. The associations of sensation seeking with drinking volume, alcohol use disorder and the use of illicit drugs other than cannabis were stronger in individuals reporting high levels of PSS from friends than those with low levels. The associations of sensation seeking with risky single-occasion drinking and the use of hard drugs were weaker in participants reporting high levels of PSS from a significant other than in those with low levels. CONCLUSIONS: Sensation seeking and anxiety/neuroticism may constitute risk factors for substance use and misuse. PSS from friends may amplify the risk for alcohol and illicit drug use (other than cannabis) associated with high sensation seeking, whereas the PSS from a significant other may reduce it.

Reciprocal Influences of Drinking Motives on Alcohol Use and Related Consequences: A Full Cross-Lagged Panel Study Among Young Adult Men.

Using a full cross-lagged model, this study investigates the extent to which drinking motives predict alcohol use and related consequences, and vice versa. At baseline and 15 months later, 4575 men (mean age = 19.4 years) in Switzerland completed a questionnaire assessing drinking motives, average weekly consumption, risky single-occasion drinking, and alcohol-related consequences. Results indicated that social and enhancement motives more strongly influenced alcohol use over time than the other way round. Coping motives predicted an increase in alcohol-related consequences, and vice versa. Higher social motives predicted an increase in coping motives while higher coping motives predicted a decrease in enhancement motives. These results suggest that social and enhancement motives amplify each other in early adulthood and predict increases in risky drinking. Structural measures aimed at reducing opportunities to engage in heavy drinking are recommended. Additionally, the detection of young adult men vulnerable to maladaptive coping behaviors appears important for alcohol prevention strategies.

Psychometric properties of the 7-item game addiction scale among french and German speaking adults.

BACKGROUND: The 7-item Game Addiction Scale (GAS) is a used to screen for addictive game use. Both cross cross-linguistic validation and validation in French and German is needed in adult samples. The objective of the study is to assess the factorial structure of the French and German versions of the GAS among adults. METHODS: Two samples of men from French (N = 3318) and German (N = 2665) language areas of Switzerland were assessed with the GAS, the Major Depression Inventory (MDI), the Brief Sensation Seeking Scale, and the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ-50-cc). They were also assessed for cannabis and alcohol use. RESULTS: The internal consistency of the scale was satisfactory (Cronbach α = 0.85). A one-factor solution was found in both samples. Small and positive associations were found between GAS scores and the MDI, as well as the Neuroticism-Anxiety and Aggression-Hostility subscales of the ZKPQ-50-cc. A small negative association was found with the ZKPQ-50-cc Sociability subscale. CONCLUSION: The GAS, in its French and German versions, is appropriate for the assessment of game addiction among adults.

Socioeconomic status and substance use among Swiss young men: a population-based cross-sectional study.

BACKGROUND: Socioeconomic status (SES) is often inversely related to health outcomes and is likely to play a role in the use of psychoactive substances among young individuals, although little consensus exists on the association between SES and substance use. The purpose of the study was to determine the association of three SES indicators (perceived family income, education level of participants, and parental education level) with past year use of alcohol, tobacco, cannabis, other illicit drugs and non-medical use of prescription drugs (NMPD) among Swiss young men. METHODS: Population-based cross-sectional study of 5,702 men at mean age twenty. Associations between SES indicators and substance use were assessed with regression models adjusted for age and linguistic region. RESULTS: Participants with average or below average perceived family income were less likely to report any use of alcohol (OR = O.75) but more likely to use tobacco daily (OR = 1.31) and cannabis weekly (OR = 1.27) compared to those with perceived above average family income. Participants whose parents had only achieved obligatory education were less likely to engage in any use of alcohol (OR = 0.30), monthly risky single occasion drinking (RSOD, defined as 6 or more drinks per occasion) (OR = 0.48), any use of cannabis (OR = 0.53) and other illicit drugs (OR = 0.58), whereas those whose parents had only achieved secondary education were less at risk of engaging in cannabis (OR = 0.66 for any use and OR = 0.77 for more than once a week use) and other illicit drugs (OR = 0.74) use, compared to those whose parents had achieved tertiary education. Compared to participants who completed secondary or tertiary education, those who completed only obligatory education reported a higher risk of tobacco (OR = 1.18 for any use, OR = 1.31 for daily use), cannabis (OR = 1.23 for any use, OR = 1.37 for more than once a week use), and other illicit drugs (OR = 1.48) use. No association was found between NMPD and the studied SES variables. CONCLUSION: The relationship between SES and substance use was complex in this sample. Higher socioeconomic status was associated with more alcohol and other illicit drugs use, while lower socioeconomic status was related to more tobacco use. Education level and perceived family income may have different impacts on substance use and may vary by substance.

Geographical variation in the prevalence of heavy drinking in young Swiss men.

BACKGROUND: Not much is known about how much geographical units matter for heavy alcohol consumption and how much of the geographical variations are explained by characteristics such as institutional alcohol policies and regional economic conditions. The study aim was to address these gaps considering three types of heavy alcohol consumption. METHODS: Analyses were based on data collected on 5879 men (age: 20.0 years, standard deviation: 1.2) years participating in the Cohort Study on Substance Use Risk Factors in Switzerland. Generalized linear mixed models were used to assess overall prevalence, geographical variations in prevalence across geographical units (institutional units, economic micro regions, linguistic regions, urban/rural status), and explanatory variables in three different types of heavy alcohol consumption (heavy weekend drinking, heavy workweek drinking, heavy volume drinking). RESULTS: The overall prevalence for heavy weekend drinking was 46.8%, 10.8% for heavy volume drinking and 3.6% for heavy workweek drinking. The extent and locations of geographical variation in prevalence rates were contingent upon the type of alcohol consumption. Institutional alcohol policies explained substantial geographical variations in heavy weekend drinking, but not in heavy workweek or heavy volume drinking. Regional economic conditions were not related to alcohol consumption. CONCLUSIONS: Different types of heavy alcohol consumption are determined by different geographical units. Alcohol policies protectively impact the major drinking style of heavy weekend drinking, but not other low prevalence forms of heavy drinking. Research and public health efforts must take into account these differences between types of alcohol consumption.

Bidirectional relationship between the body mass index and substance use in young men.

BACKGROUND: Obesity and substance use are major concern in young people. This study explored the bidirectional longitudinal relationships between the body mass index (BMI) of young men and their use of (1) 4 classes of nonmedical prescription drugs; (2) alcohol; (3) tobacco; and (4) cannabis. METHODS: Baseline and follow-up data from the Cohort Study on Substance Use Risk Factors were used (N = 5007). A cross-lagged panel model, complemented by probit models as sensitivity analysis, was run to determine the bidirectional relationships between BMI and substance use. Alcohol was assessed using risky single-occasion drinking (RSOD); tobacco, using daily smoking; and cannabis, using hazardous cannabis use (defined as twice-weekly or more cannabis use). Nonmedical prescription drugs use (NMPDU) included opioid analgesics, sedatives/sleeping pills, anxiolytics, and stimulants. RESULTS: Different associations were found between BMI and substance use. Only RSOD (ß = -.053, P = .005) and NMPDU of anxiolytics (ß = .040, P = .020) at baseline significantly predicted BMI at follow-up. Baseline RSOD predicted a lower BMI at follow-up, whereas baseline NMPDU of anxiolytics predicted higher BMI at follow-up. Furthermore, BMI at baseline significantly predicted daily smoking (ß = .050, P = .007) and hazardous cannabis use (ß = .058, P = .030). CONCLUSIONS: These results suggest different associations between BMI and the use of various substances by young men. However, only RSOD and NMPDU of anxiolytics predicted BMI, whereas BMI predicted daily smoking and hazardous cannabis use.

Latent Class Analysis of Gambling Activities in a Sample of Young Swiss Men: Association with Gambling Problems, Substance Use Outcomes, Personality Traits and Coping Strategies.

The study aimed to identify different patterns of gambling activities (PGAs) and to investigate how PGAs differed in gambling problems, substance use outcomes, personality traits and coping strategies. A representative sample of 4989 young Swiss males completed a questionnaire assessing seven distinct gambling activities, gambling problems, substance use outcomes, personality traits and coping strategies. PGAs were identified using latent class analysis (LCA). Differences between PGAs in gambling and substance use outcomes, personality traits and coping strategies were tested. LCA identified six different PGAs. With regard to gambling and substance use outcomes, the three most problematic PGAs were extensive gamblers, followed by private gamblers, and electronic lottery and casino gamblers, respectively. By contrast, the three least detrimental PGAs were rare or non-gamblers, lottery only gamblers and casino gamblers. With regard to personality traits, compared with rare or non-gamblers, private and casino gamblers reported higher levels of sensation seeking. Electronic lottery and casino gamblers, private gamblers and extensive gamblers had higher levels of aggression-hostility. Extensive and casino gamblers reported higher levels of sociability, whereas casino gamblers reported lower levels of anxiety-neuroticism. Extensive gamblers used more maladaptive and less adaptive coping strategies than other groups. Results suggest that gambling is not a homogeneous activity since different types of gamblers exist according to the PGA they are engaged in. Extensive gamblers, electronic and casino gamblers and private gamblers may have the most problematic PGAs. Personality traits and coping skills may predispose individuals to PGAs associated with more or less negative outcomes.

Video Gaming Disorder and Sport and Exercise in Emerging Adulthood: A Longitudinal Study.

Among the negative consequences of video gaming disorder, decreased participation in sport and exercise has received little attention. This study aimed to assess the longitudinal association between video gaming disorder and the level of sport and exercise in emerging adult men. A questionnaire was completed at baseline and 15-month follow-up by a representative national sample of 4,933 respondents. The seven items of the Game Addiction Scale were used to construct a latent variable representing video gaming disorder. Level of sport and exercise was also self-reported. Cross-lagged path modeling indicated a reciprocal causality between video gaming disorder and the level of sport and exercise, even after adjusting for a large set of confounders. These findings support the need for better promotion of sport and exercise among emerging adults in order to contribute to the prevention of video gaming disorder, and to raise the level of sport and exercise activity in addicted gamers.

Is the relationship between major depressive disorder and self-reported alcohol use disorder an artificial one?

AIMS: Many studies have suggested a close relationship between alcohol use disorder (AUD) and major depressive disorder (MDD). This study aimed to test whether the relationship between self-reported AUD and MDD was artificially strengthened by the diagnosis of MDD. This association was tested comparing relationships between alcohol use and AUD for depressive people and non-depressive people. METHODS: As part of the Cohort Study on Substance Use Risk Factors, 4352 male Swiss alcohol users in their early twenties answered questions concerning their alcohol use, AUD and MDD at two time points. Generalized linear models for cross-sectional and longitudinal associations were calculated. RESULTS: For cross-sectional associations, depressive participants reported a higher number of AUD symptoms (ß = 0.743, P < 0.001) than non-depressive participants. Moreover, there was an interaction (ß = -0.204, P = 0.001): the relationship between alcohol use and AUD was weaker for depressive participants rather than non-depressive participants. For longitudinal associations, there were almost no significant relationships between MDD at baseline and AUD at follow-up, but the interaction was still significant (ß = -0.249, P < 0.001). CONCLUSION: MDD thus appeared to be a confounding variable in the relationship between alcohol use and AUD, and self-reported measures of AUD seemed to be overestimated by depressive people. This result brings into question the accuracy of self-reported measures of substance use disorders. Furthermore, it adds to the emerging debate about the usefulness of substance use disorder as a concept, when heavy substance use itself appears to be a sensitive and reliable indicator.

Temporal Patterns of Alcohol Consumption and Alcohol-Related Road Accidents in Young Swiss Men: Seasonal, Weekday and Public Holiday Effects.

AIMS: To assess seasonal, weekday, and public holiday effects on alcohol-related road accidents and drinking diaries among young Swiss men. METHODS: Federal road accident data (35,485 accidents) from Switzerland and drinking diary data from a large cohort of young Swiss men (11,930 subjects) were analysed for temporal effects by calendar week, weekday and public holiday (Christmas, New Years, National Day). Alcohol-related accidents were analysed using rate ratios for observed versus expected numbers of accidents and proportions of alcohol-related accidents relative to the total number. Drinking diaries were analysed for the proportion of drinkers, median number of drinks consumed, and the 90th percentile's number of drinks consumed. RESULTS: Several parallel peaks were identified in alcohol-related accidents and drinking diaries. These included increases on Fridays and Saturdays, with Saturday drinking extending until early Sunday morning, an increase during the summer on workdays but not weekends, an increase at the end of the year, and increases on public holidays and the evening before. CONCLUSIONS: Our results suggest specific time-windows that are associated with increases in drinking and alcohol-related harm. Established prevention measures should be enforced during these time-windows to reduce associated peaks.

Cannabis use and other predictors of the onset of daily cigarette use in young men: what matters most? Results from a longitudinal study.

BACKGROUND: According to the gateway hypothesis, tobacco use is a gateway of cannabis use. However, there is increasing evidence that cannabis use also predicts the progression of tobacco use (reverse gateway hypothesis). Unfortunately, the importance of cannabis use compared to other predictors of tobacco use is less clear. The aim of this study was to examine which variables, in addition to cannabis use, best predict the onset of daily cigarette smoking in young men. METHODS: A total of 5,590 young Swiss men (mean age = 19.4 years, SD = 1.2) provided data on their substance use, socio-demographic background, religion, health, social context, and personality at baseline and after 18 months. We modelled the predictors of progression to daily cigarette smoking using logistic regression analyses (n = 4,230). RESULTS: In the multivariate overall model, use of cannabis remained among the strongest predictors for the onset of daily cigarette use. Daily cigarette use was also predicted by a lifetime use of at least 50 cigarettes, occasional cigarette use, educational level, religious affiliation, parental situation, peers with psychiatric problems, and sociability. CONCLUSIONS: Our results highlight the relevance of cannabis use compared to other potential predictors of the progression of tobacco use and thereby support the reverse gateway hypothesis.

Prevalence of and potential influencing factors for alcohol dependence in Europe.

Alcohol use disorders (AUDs), and alcohol dependence (AD) in particular, are prevalent and associated with a large burden of disability and mortality. The aim of this study was to estimate prevalence of AD in the European Union (EU), Iceland, Norway, and Switzerland for the year 2010, and to investigate potential influencing factors. The 1-year prevalence of AD in the EU was estimated at 3.4% among people 18-64 years of age in Europe (women 1.7%, men 5.2%), resulting in close to 11 million affected people. Taking into account all people of all ages, AD, abuse and harmful use resulted in an estimate of 23 million affected people. Prevalence of AD varied widely between European countries, and was significantly impacted by drinking cultures and social norms. Correlations with level of drinking and other drinking variables and with major known outcomes of heavy drinking, such as liver cirrhosis or injury, were moderate. These results suggest a need to rethink the definition of AUDs.

Association between non-medical prescription drug use and personality traits among young Swiss men.

AIM: To investigate the relationships between six classes of non-medical prescription drug use (NMPDU) and five personality traits. METHODS: Representative baseline data on 5777 Swiss men around 20 years old were taken from the Cohort Study on Substance Use Risk Factors. NMPDU of opioid analgesics, sedatives/sleeping pills, anxiolytics, antidepressants, beta-blockers and stimulants over the previous 12 months was measured. Personality was assessed using the Brief Sensation Seeking Scale; attention deficit-hyperactivity (ADH) using the Adult Attention-Deficit-Hyperactivity Disorder Self-Report Scale; and aggression/hostility, anxiety/neuroticism and sociability using the Zuckerman-Kuhlmann Personality Questionnaire. Logistic regression models for each personality trait were fitted, as were seven multiple logistic regression models predicting each NMPDU adjusting for all personality traits and covariates. RESULTS: Around 10.7% of participants reported NMPDU in the last 12 months, with opioid analgesics most prevalent (6.7%), then sedatives/sleeping pills (3.0%), anxiolytics (2.7%), and stimulants (1.9%). Sensation seeking (SS), ADH, aggression/hostility, and anxiety/neuroticism (but not sociability) were significantly positively associated with at least one drug class (OR varied between 1.24, 95%CI: 1.04-1.48 and 1.86, 95%CI: 1.47-2.35). Aggression/hostility, anxiety/neuroticism and ADH were significantly and positively related to almost all NMPDU. Sociability was inversely related to NMPDU of sedatives/sleeping pills and anxiolytics (OR, 0.70; 95%CI: 0.51-0.96 and OR, 0.64; 95%CI: 0.46-0.90, respectively). SS was related only to stimulant use (OR, 1.74; 95%CI: 1.14-2.65). CONCLUSION: People with higher scores for ADH, aggression/hostility and anxiety/neuroticism are at higher risk of NMPDU. Sociability appeared to protect from NMPDU of sedatives/sleeping pills and anxiolytics.