Electronic interventions in primary care to address substance use: A systematic review.

The present systematic review aims to identify electronic interventions for addressing substance use and understand their effectiveness in primary care settings. A systematic search was carried out in the Web of Science, PubMed/MEDLINE, Scopus, and Cochrane Library. The search included the keywords "electronic intervention", "substance use", "primary care" and synonyms. To determine the quality and recommendation of the analyzed interventions, the efficacy results reported by the studies were considered, as well as the Mixed Methods Appraisal Tool (MMAT) assessment and the GRADE Evidence Assessment. Twenty-one electronic interventions in Primary Care were identified: internet, mobile or tablet applications, text messages, emails, automated telephone calls, or electronic self-reports. These interventions had diverse components, incorporating theories that have proven effective in face-to-face interventions as their theoretical frameworks. Some of them were complementary to in-person treatment, while others replaced it. Six interventions (28.5 %) displayed high quality: HealthCall, AB-CASI, Quit Genius, eCHECKUP-TOGO, CBI, and TES. Another nine interventions (42.8 %) were found to have moderate-high quality: Alcohol y Salud, IVR-BI, Program of Wallace et al., Let's Talk About Smoking, SMSalud, ESCAPE, AAC-ASPIRE, iQuit, and Programa VIH. One intervention (4.7 %) had moderate-low quality: Vive sin tabaco ¡Decídete! The remaining five interventions (23.8 %) were found to have very low quality: Connection to health, cSBI, Teen Well Check, the program of Helzer et al. (2008), and Down your drink. The programs with the highest recommendation for addressing alcohol-related issues are HealthCall and AB-CASI; for tobacco use, it is Quit Genius; for cannabis use, it is eCHECKUP-TOGO; for addressing both legal and illegal substances, it is CBI and TES. Finally, for specific illicit drug use, the only recommended program is CBI. This last intervention, CBI, is of the highest quality and, therefore, can be considered a model intervention for dissemination in the primary care setting.

Model of structural equations on the perception of aspects of school life and substance consumption as predictors of problem behavior in adolescents.

Introduction: Problematic behavior and drug use are behaviors of social concern, especially in adolescence. There are school factors that can contribute to their development or prevent them. The objective was to establish explanatory models of the relationship between various school variables with the consumption of alcohol, tobacco and cannabis; determining its direct and/or indirect relationship with problematic behaviors. Materials and methods: The study was cross-sectional with a sample of 346 students (Main Age=14.81; 54% women) from secondary education. Structural Equation Model (SEM) were carried to analyze the relationship between the dimensions of the Scale of perception of aspects of school life and alcohol, tobacco and cannabis consume with the presence of Problematic Behavior. Results: Problem behavior was predicted by alcohol, tobacco and cannabis consume, and binge drinking. Different aspects of school life differentially predicted problem behavior and drug use. Sense of challenge was observed as having a reciprocal predictive relationship with problem behavior. Perception of oneself at school predicts both alcohol and tobacco use; while the value given to school predicts binge drinking. Discussion: These findings suggests that, when addressing problem behavior and drug use that affect minors in school and have repercussions on class dynamics and academic outcomes, we should not focus exclusively on these problem areas, but rather take a more integrated approach that includes modifying different school-related aspects that act as risk factors for these types of problems.

Changes in tobacco and e-cigarette consumption in Spanish university students during the COVID-19 lockdown: Identification of vulnerable groups.

INTRODUCTION: The objective of this study was to determine the changes in tobacco consumption in Spanish university students during the lockdown in 2020, and to identify vulnerable groups based on gender, age, and living situation. METHODS: This was a cross-sectional descriptive study. From a sample of 1540 Spanish university students, 19.9% (n=306; 77.6% women; mean age=30.9 years; SD=8.3) reported having consumed tobacco. The frequency and average daily consumption of cigarettes and electronic nicotine delivery systems (ENDS) before the pandemic and during lockdown were analyzed. RESULTS: A total of 97.1% of students consumed only cigarettes, 2.9% only ENDS, and 3.3% were dual consumers. During lockdown, cigarette consumption was significantly reduced (5.3 before; 4.0 during; t(71)=3.6255; p<0.001) in the youngest group (aged 18-24 years). However, women daily users significantly increased their consumption (t(149)= -2.5461; p<0.05) and so did the 35-44 years age group (t(32)= -2.2285; p<0.05). Cigarette consumption significantly increased in those who were living alone (5.6 to 7.2; Z= -2.351; p<0.05) and with a partner (7.2 to 8.0; t(97)= -2.3771; p<0.05), but decreased in those who were living with their parents or other relatives (6.2 to 4.5; t(101)=3.4298; p<0.001). A total of 17.0% ceased consumption during lockdown, mainly women, younger students (aged 18-24 years), and those who lived with their parents. None of the people who used cigarettes daily during the pre-pandemic period stopped smoking during lockdown. CONCLUSIONS: Younger university students and those living with their parents decreased their tobacco use during the lockdown. Potentially vulnerable groups at risk of increasing their consumption were women who consumed tobacco daily before the pandemic and students aged 35-44 years who lived alone or with their partner.