Casino Gambling in Adolescents: Gambling-Related Attitudes and Behaviors and Health and Functioning Relationships.

Recreational and problem gambling have been linked with adverse health and functioning outcomes among adolescents. Youth may gamble and engage in other risk-taking behaviors in casinos. There are limited data available regarding casino gambling in high-school students, and factors linked to adolescent gambling in casinos have yet to be systematically investigated. To address this gap, we analyzed cross-sectional data from 2010 Connecticut high-school students with chi-square tests and logistic regression models to examine casino gambling in relation to at-risk/problem gambling (ARPG) with respect to sociodemographic characteristics, gambling perceptions & attitudes, health/functioning measures and gambling behaviors. Approximately 11 % of adolescents acknowledged gambling in casinos. ARPG was more frequent and gambling perceptions were more permissive among adolescents endorsing casino gambling. Stronger relationships between ARPG and heavy alcohol and drug use and weaker relationships between ARPG and engagement in extracurricular activities, gambling with friends, gambling with strangers and gambling for financial reasons were observed among adolescents endorsing casino gambling. In conclusion, gambling in casinos was endorsed by a sizable minority of adolescents who gamble, and prevention efforts should consider targeting permissive attitudes towards gambling, adolescent drinking and participation in extracurricular activities when addressing underage casino gambling.

Community health workers to improve uptake of maternal healthcare services: A cluster-randomized pragmatic trial in Dar es Salaam, Tanzania.

BACKGROUND: Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable maternal and pediatric morbidity and mortality in sub-Saharan Africa. This cluster-randomized trial aimed to determine the impact of a community health worker (CHW) intervention on the proportion of women who (i) visit ANC fewer than 4 times during their pregnancy and (ii) deliver at home. METHODS AND FINDINGS: As part of a 2-by-2 factorial design, we conducted a cluster-randomized trial of a home-based CHW intervention in 2 of 3 districts of Dar es Salaam from 18 June 2012 to 15 January 2014. Thirty-six wards (geographical areas) in the 2 districts were randomized to the CHW intervention, and 24 wards to the standard of care. In the standard-of-care arm, CHWs visited women enrolled in prevention of mother-to-child HIV transmission (PMTCT) care and provided information and counseling. The intervention arm included additional CHW supervision and the following additional CHW tasks, which were targeted at all pregnant women regardless of HIV status: (i) conducting home visits to identify pregnant women and refer them to ANC, (ii) counseling pregnant women on maternal health, and (iii) providing home visits to women who missed an ANC or PMTCT appointment. The primary endpoints of this trial were the proportion of pregnant women (i) not making at least 4 ANC visits and (ii) delivering at home. The outcomes were assessed through a population-based household survey at the end of the trial period. We did not collect data on adverse events. A random sample of 2,329 pregnant women and new mothers living in the study area were interviewed during home visits. At the time of the survey, the mean age of participants was 27.3 years, and 34.5% (804/2,329) were pregnant. The proportion of women who reported having attended fewer than 4 ANC visits did not differ significantly between the intervention and standard-of-care arms (59.1% versus 60.7%, respectively; risk ratio [RR]: 0.97; 95% CI: 0.82-1.15; p = 0.754). Similarly, the proportion reporting that they had attended ANC in the first trimester did not differ significantly between study arms. However, women in intervention wards were significantly less likely to report having delivered at home (3.9% versus 7.3%; RR: 0.54; 95% CI: 0.30-0.95; p = 0.034). Mixed-methods analyses of additional data collected as part of this trial suggest that an important reason for the lack of effect on ANC outcomes was the perceived high economic burden and inconvenience of attending ANC. The main limitations of this trial were that (i) the outcomes were ascertained through self-report, (ii) the study was stopped 4 months early due to a change in the standard of care in the other trial that was part of the 2-by-2 factorial design, and (iii) the sample size of the household survey was not prespecified. CONCLUSIONS: A home-based CHW intervention in urban Tanzania significantly reduced the proportion of women who reported having delivered at home, in an area that already has very high uptake of facility-based delivery. The intervention did not affect self-reported ANC attendance. Policy makers should consider piloting, evaluating, and scaling interventions to lessen the economic burden and inconvenience of ANC. TRIAL REGISTRATION: ClinicalTrials.gov NCT01932138.

The effect of a community health worker intervention on public satisfaction: evidence from an unregistered outcome in a cluster-randomized controlled trial in Dar es Salaam, Tanzania.

BACKGROUND: There is a dearth of evidence on the causal effects of different care delivery approaches on health system satisfaction. A better understanding of public satisfaction with the health system is particularly important within the context of task shifting to community health workers (CHWs). This paper determines the effects of a CHW program focused on maternal health services on public satisfaction with the health system among women who are pregnant or have recently delivered. METHODS: From January 2013 to April 2014, we carried out a cluster-randomized controlled health system implementation trial of a CHW program. Sixty wards in Dar es Salaam, Tanzania, were randomly allocated to either a maternal health CHW program (36 wards) or the standard of care (24 wards). From May to August 2014, we interviewed a random sample of women who were either currently pregnant or had recently delivered a child. We used five-level Likert scales to assess women's satisfaction with the CHW program and with the public-sector health system in Dar es Salaam. RESULTS: In total, 2329 women participated in the survey (response rate 90.2%). Households in intervention areas were 2.3 times as likely as households in control areas to have ever received a CHW visit (95% CI 1.8, 3.0). The intervention led to a 16-percentage-point increase in women reporting they were satisfied or very satisfied with the CHW program (95% CI 3, 30) and a 15-percentage-point increase in satisfaction with the public-sector health system (95% CI 3, 27). CONCLUSIONS: A CHW program for maternal and child health in Tanzania achieved better public satisfaction than the standard CHW program. Policy-makers and implementers who are involved in designing and organizing CHW programs should consider the potential positive impact of the program on public satisfaction. TRIAL REGISTRATION: ClinicalTrials.gov, EJF22802.

Perceived injunctive norms and cannabis-related problems: The interactive influence of parental injunctive norms and race.

Cannabis use among college students is associated with negative consequences, including those that can negatively affect academic functioning. Perceived descriptive and injunctive norms are among the strongest predictors of college cannabis use and related problems, and perceived norms differentially relate to cannabis outcomes depending on the reference group (e.g., close friends, family members). However, no known studies have examined the effect of race on these relationships. Yet, given that African American students are more strongly affected by parental influence than Caucasian students and that they endorse more social motives for cannabis use, African American students may be affected by perceived norms regarding parents and friends differentially from Caucasian students. The current study tested the moderational role of race on the relationship between perceived norms and cannabis use and related problems. Cannabis-using undergraduates (N = 103; 78.6% female) completed an online survey. Race moderated the relationship between injunctive norms regarding parents and cannabis-related problem severity such that among African American students (but not Caucasian students), endorsement of more permissive perceived parental injunctive norms was related to greater cannabis-related problem severity (but not cannabis use frequency). Interactions were not significant between race and descriptive norms or between race and peer injunctive norms. African American students who perceive that their parents are more accepting of cannabis use may be especially at risk for cannabis-related problems. Results underscore the importance of considering cultural factors in identification of vulnerability factors related to cannabis problems.

Longitudinal Associations Between Alcohol-Related Cognitions and Use in African American and European American Adolescent Girls.

BACKGROUND: African American (AA) girls initiate alcohol use later and drink less than European American (EA) girls, potentially reflecting differences in the development of drinking behaviors. This study examined alcohol-related cognitions: expectancies, attitudes, and intention to drink, as possible sources of variation by race in alcohol use. The aim of this study was to characterize the nature and degree of association between cognitions and use over time and by race in EA and AA girls. METHODS: Data were drawn from the longitudinal Pittsburgh Girls Study (N = 2,450), an urban population-based sample of girls and their caregivers recruited when girls were between ages 5 and 8, and assessed annually through adolescence. Cross-lagged panel models were conducted separately by race (56.2% AA, 43.8% EA) to identify patterns of association between alcohol use and cognitions from ages 12 to 17 in 2,173 girls. RESULTS: Endorsement of cognitions and use was higher overall in EA than AA girls but the magnitude of cross-lagged path coefficients did not differ significantly by race. In both groups, bidirectional effects emerged between intentions and use, and alcohol use largely predicted cognitions across ages. However, intention to drink was the only alcohol-related cognition that consistently predicted subsequent use (odds ratios ranged from 1.55 to 2.71). CONCLUSIONS: Although rates of alcohol use and endorsement of cognitions were greater in EA than AA girls, the anticipated racial differences in longitudinal associations between cognitions and use did not emerge, indicating that variation in associations between use and cognitions does not account for the lower prevalence of alcohol use in AA compared with EA girls. Furthermore, our finding that intention to drink is a consistent, robust predictor of subsequent alcohol use suggests the need to investigate potentially modifiable factors that influence intention to drink across racial groups.

Testing the nicotine dependence measure mFTQ for adolescent smokers: A multinational investigation.

BACKGROUND AND OBJECTIVES: As a measure of nicotine dependence among adolescent smokers, the modified Fagerström Tolerance Questionnaire (mFTQ; seven items), has been successfully used in the United States (USA). Nonetheless, the validity and reliability of mFTQ at the international level is still needed. The current study is the first to test the validity and reliability of mFTQ in four countries: Thailand, Spain, the USA, and Russia. METHODS: In a cross-sectional survey, mFTQ, risk factors of nicotine dependence, and sociodemographic characteristics were assessed. Risk factors included age of first cigarette, frequency of alcohol use, frequency of marijuana use, and number of cigarettes smoked yesterday. Salivary cotinine was also obtained in Thailand and Spain. RESULTS: For all four countries, mFTQ exhibited a single factor structure, as supported by previous work in the USA. For all studied countries except Thailand, mFTQ presented acceptable internal reliability. Overall, risk factors of nicotine dependence have predicted mFTQ scores across countries. Frequency of alcohol use in the USA and frequency of marijuana use in Thailand and Spain were not associated with mFTQ scores. DISCUSSION AND CONCLUSIONS: mFTQ is a single-factor measure of nicotine dependence that shows acceptable internal consistency and validity across countries. Further work can advance the scale and tailor it to different cultures. SCIENTIFIC SIGNIFICANCE: mFTQ can be a clinically practical international measure of nicotine dependence. This study provides initial support for the utility of the mFTQ among Thai, Spanish, American, and Russian adolescents. Further research is needed to test and advance mFTQ across cultures. (Am J Addict 2017;26:689-696).

Predictors of Adult E-Cigarette Users Vaporizing Cannabis Using E-Cigarettes and Vape-Pens.

BACKGROUND: Given limited extant research, we assessed the use of portable, battery-powered cannabis vaporizers by adult e-cigarette users. METHODS: 522 adult vapers completed an online survey. Demographics; lifetime and past-month cannabis vaporization via e-cigarettes/vape-pens; preferences for hash oil, D-9-tetrahydrocannabinol (THC) wax, or dried buds; and cannabis vaporization beliefs and motives were examined. Demographics, age of e-cigarette onset, e-cigarette use frequency, state-level legal status of cannabis, cannabis vaping beliefs/motives, and impulsivity were examined as predictors of lifetime cannabis vaporization, past-month cannabis vaporization, and cannabis vaping frequency. RESULTS: E-cigarette users reported lifetime (17.8%) and past-month (11.5%) cannabis vaporization. Vapers preferred hash oil (LT/PM 45.5/47.5%), THC wax (15.2/32.2%), and dried buds (39.4/35.6%). Motivations to vape cannabis included: it tastes better (39.3/37.9%), is healthier (42.9/39.7%), is easier to conceal/hide (35.7/46.6%), does not smell as strong (42.9/39.7%), is more convenient (42.9/27.6%), and produces a stronger/better high (58.1/40.7%) than smoking cannabis. Lifetime and past-month cannabis vaporization, respectively, were associated with initiating e-cigarette use at an earlier age (odds ratio (OR) = 0.09/0.88), being impulsive (OR = 2.25/3.23), having poor self-control (OR = 2.23/1.85), and vaporizing cannabis because it is easier to conceal/hide (OR = 2.45/2.48) or is more convenient than smoking cannabis (OR = 5.02/2.83). Frequency of vaping cannabis was associated with heavier e-cigarette use (ηp2 = 0.10) and impulsivity (ηp2 = 0.09). CONCLUSIONS: Adult e-cigarette users are vaporizing cannabis using e-cigarettes/vape-pens. Efforts to curb cannabis vaporization may benefit from targeting impulsivity in users and regulating device features that facilitate or promote convenient, inconspicuous cannabis use.

Injunctive Norms and Alcohol Consumption: A Revised Conceptualization.

BACKGROUND: Injunctive norms have been found to be important predictors of behaviors in many disciplines with the exception of alcohol research. This exception is likely due to a misconceptualization of injunctive norms for alcohol consumption. To address this, we outline and test a new conceptualization of injunctive norms and personal approval for alcohol consumption. Traditionally, injunctive norms have been assessed using Likert scale ratings of approval perceptions, whereas descriptive norms and individual behaviors are typically measured with behavioral estimates (i.e., number of drinks consumed per week, frequency of drinking). This makes comparisons between these constructs difficult because they are not similar conceptualizations of drinking behaviors. The present research evaluated a new representation of injunctive norms with anchors comparable to descriptive norms measures. METHODS: A study and a replication were conducted including 2,559 and 1,189 undergraduate students from 3 different universities. Participants reported on their alcohol-related consumption behaviors, personal approval of drinking, and descriptive and injunctive norms. Personal approval and injunctive norms were measured using both traditional measures and a new drink-based measure. RESULTS: Results from both studies indicated that drink-based injunctive norms were uniquely and positively associated with drinking, whereas traditionally assessed injunctive norms were negatively associated with drinking. Analyses also revealed significant unique associations between drink-based injunctive norms and personal approval when controlling for descriptive norms. CONCLUSIONS: These findings provide support for a modified conceptualization of personal approval and injunctive norms related to alcohol consumption and, importantly, offer an explanation and practical solution for the small and inconsistent findings related to injunctive norms and drinking in past studies.

Multisubstance Use Among Treatment-Seeking Smokers: Synergistic Effects of Coping Motives for Cannabis and Alcohol Use and Social Anxiety/Depressive Symptoms.

OBJECTIVE: This study examined the impact of coping motives for cannabis and alcohol use on the relation between social anxiety/depressive symptoms and severity of substance use for alcohol, tobacco, and cannabis among treatment-seeking smokers who also use cannabis and alcohol. METHODS: The sample included 197 daily cigarette smokers (MAge 34.81 years, SD = 13.43) who reported using cannabis and alcohol. RESULTS: Hierarchical multiple regression analyses were conducted wherein separate models were constructed for each dependent variable. Among individuals with higher social anxiety, alcohol coping motives were associated with heavier drinking, and this was more pronounced among those low in depressive symptoms. Similarly, those at greater risk for nicotine dependence were anxious individuals with lower depressive symptoms who endorse coping-oriented motives for using cannabis. Further, among those with higher social anxiety, cannabis coping motives were associated with marginally greater drinking, particularly for those high in depressive symptoms. CONCLUSIONS: The present findings support the perspective that among multisubstance users, the interplay between social anxiety, depressive symptoms, and coping-oriented motives for using one substance (e.g., cannabis or alcohol) may pose difficulties in refraining from other substances (e.g., tobacco). This observation highlights the importance of tailoring multisubstance treatments to specific needs of multiusers for whom single-substance interventions may be less effective. Findings also support previous work exploring the benefits of concurrently treating co-occurring substance use and lend credence to the perspective that motivation to use substances for coping reasons is of central theoretical and clinical relevance.

Social Anxiety and Cannabis-Related Impairment: The Synergistic Influences of Peer and Parent Descriptive and Injunctive Normative Perceptions.

OBJECTIVES: Cannabis users, especially socially anxious cannabis users, are influenced by perceptions of other's use. The present study tested whether social anxiety interacted with perceptions about peer and parent beliefs to predict cannabis-related problems. METHODS: Participants were 148 (36.5% female, 60.1% non-Hispanic Caucasian) current cannabis users aged 18-36 (M = 21.01, SD = 3.09) who completed measures of perceived descriptive and injunctive norms, social anxiety, and cannabis use behaviors. Hierarchical multiple regressions were employed to investigate the predictive value of the social anxiety X parent injunctive norms X peer norms interaction terms on cannabis use behaviors. RESULTS: Higher social anxiety was associated with more cannabis problems. A three-way interaction emerged between social anxiety, parent injunctive norms, and peer descriptive norms, with respect to cannabis problems. Social anxiety was positively related to more cannabis problems when parent injunctive norms were high (i.e., perceived approval) and peer descriptive norms were low. Results further showed that social anxiety was positively related to more cannabis problems regardless of parent injunctive norms. CONCLUSIONS: The present work suggests that it may be important to account for parent influences when addressing normative perceptions among young adult cannabis users. Additional research is needed to determine whether interventions incorporating feedback regarding parent norms impacts cannabis use frequency and problems.

The Interactive Influence of Cannabis-Related Negative Expectancies and Coping Motives on Cannabis Use Behavior and Problems.

OBJECTIVES: The present study tested whether coping motives for cannabis use moderate the effect of negative expectancies on cannabis use. METHODS: Participants were 149 (36.2% female, 61.59% non-Hispanic Caucasian) current cannabis users aged 18-36 (M = 21.01, SD = 3.09) who completed measures of cannabis-related expectancies and motives for use. Hierarchical multiple regressions were employed to investigate the predictive value of the interaction between negative expectancies and coping motives on cannabis use outcomes. RESULTS: Results revealed interactions between negative expectancies and coping motives with respect to past 90 day cannabis use frequency and cannabis problems. Global negative effects expectancies were associated with less frequent cannabis use, particularly among those with fewer coping motives. However, negative expectancies were related to more cannabis problems, particularly among those with higher coping motives. CONCLUSIONS: These results suggest it may be advisable to take coping motives into account when addressing expectancies among cannabis users.

Erosion of the Silicone Peritoneal Dialysis Catheter with the Use of Gentamicin Cream at the Exit Site.

Infection remains the leading complication of peritoneal dialysis (PD). Topical mupirocin and gentamicin are frequently used to prevent infections. Mupirocin ointment has been reported to cause damage to both polyurethane and silicone PD catheters. Gentamicin cream has not been associated with physical damage to catheters.A 64-year-old woman on PD developed relapsing peritonitis with Staphylococcus epidermidis. Because of a drainage problem and white discoloration at the exit site, which is known as " frosting," she underwent catheter exchange. The catheter was found to be fractured within the area of frosting. Four more patients with frosting of the catheter were identified. On further questioning, it was recognized that they were applying excessive amounts of gentamicin cream directly on the catheter surface rather than at the exit site. All patients in the program were educated about the correct method of topical antibiotic application. After the change in practice, no further cases of catheter frosting were identified.Polyurethane catheters can undergo oxidation, mineralization, and environmental stress cracking, leading to physical damage such frosting, ballooning, and fracture. Polyethylene glycol, a component of the mupirocin ointment base, is thought to cause plasticization of polyurethane, reducing its tensile strength. Similar damage has been observed in silicone catheters. Previous reports have not found gentamicin cream to cause that type of damage. We observed that excessive amounts of cream applied directly to the catheter surface can damage it. Damage did not recur once patients had been educated about the proper method of application.

Substance Use in the Perinatal Period.

Perinatal substance use remains a major public health problem and is associated with a number of deleterious maternal and fetal effects. Polysubstance use in pregnancy is common and can potentiate adverse maternal and fetal outcomes. Tobacco is the most commonly used substance in pregnancy, followed by alcohol and illicit substances. The treatments for perinatal substance use are limited and consist mostly of behavioral and psychosocial interventions. Of these, contingency management has shown the most efficacy. More recently, novel interventions such as progesterone for postpartum cocaine use have shown promise. The purpose of this review is to examine the recent literature on the use of tobacco, alcohol, cannabis, stimulants, and opioids in the perinatal period, their effects on maternal and fetal health, and current treatments.

Decisional Balance: Alcohol Decisional Balance Intervention for Heavy Drinking Undergraduates.

BACKGROUND: This study evaluated a decisional balance intervention among heavy drinking undergraduates and compared a nonweighted decisional balance proportion (DBP; Collins, Carey, & Otto, 2009) to a participant-weighted DBP with weights based on relative importance of items. We expected: (1) the intervention to decrease drinking compared to control; (2) the weighted intervention to be more effective compared to the nonweighted or control in reducing drinking; and (3) intervention efficacy to be moderated by initial DBP. METHOD: Participants (N = 162, Mean age = 24.37, SD = 6.81, 27% male) were randomly assigned to an alcohol intervention wherein they were either asked to assign weights of importance to pros and cons (weighted intervention), or not (nonweighted intervention), or to control. Participants completed web-based questionnaires at baseline and again during a one month follow-up assessment. RESULTS: Consistent with expectations, the nonweighted intervention was associated with reduced follow-up weekly drinking, and the weighted intervention was associated with reductions in drinking frequency. Results further indicated that initial decisional balance did not moderate intervention efficacy. DISCUSSION: Findings suggest that the decisional balance procedure can reduce drinking but there was not compelling evidence for the addition of weights. This study lays the groundwork for enhancing future interventions by increasing empirical knowledge of the role motivation plays in heavy alcohol use.

Smoking processes, panic, and depressive symptoms among treatment-seeking smokers.

OBJECTIVES: The present study evaluated the relative contribution of panic and depressive symptoms in relation to past cessation difficulties and smoking motives among treatment-seeking daily smokers. METHODS: The sample included 392 treatment-seeking daily smokers (47.07% female; Mage = 35.48; SD = 13.56), who reported smoking an average of 10 or more cigarettes daily for at least one year. RESULTS: Findings indicated that panic and depressive symptoms were significantly associated with quit problems as well as addictive and negative affect motives for smoking. However, depressive symptoms were not associated with habitual smoking motives. CONCLUSIONS: Differential patterns of associations with smoking-based processes imply that although panic and depression are related, there are important distinctions. Such data highlight the need for additional research to examine the putative role of panic and depressive symptoms in relation to smoking behaviors to further elucidate the mechanisms through which panic, depression, and smoking impact one another.

Social anxiety and cannabis cravings: The influences of parent injunctive norms and tension reduction expectancies.

OBJECTIVES: Socially anxious cannabis users are influenced by cannabis expectancies and normative perceptions. The present study examines the influence of psychosocial factors on cannabis use vulnerability factors as the result of interactions between norms perceptions, social anxiety, and expectancies. METHODS: Participants were 149 (36.2% female) current cannabis users aged 18-36 (M=21.01, SD=3.09). Hierarchical multiple regressions were employed to investigate the predictive value of the social anxiety X injunctive norms X expectancies interaction on cannabis cravings. RESULTS: A three-way interaction emerged in the prediction of cannabis cravings. Simple slopes analyses showed that among individuals with perceptions of greater parent approval of cannabis use (higher injunctive norms), social anxiety was associated with greater cannabis craving when expectancies regarding relaxation and tension reduction were greater (t=2.54, p=.01, ß=1.12). CONCLUSIONS: Among cannabis users with perceptions of greater injunctive norms, social anxiety was associated with greater cannabis craving when tension reduction expectancies were greater. However, social anxiety was unrelated to cannabis craving when expectances were low. This suggests that cannabis craving among socially anxious adults was greatest when cannabis use was viewed as acceptable and expected to reduce tension, and highlights the importance of considering norms, expectancies, and social anxiety in understanding cannabis-related behaviors.

Cannabis Motives and Quitting Tobacco: Smoking Expectancies and Severity among Treatment-seeking Cigarette Smokers.

OBJECTIVE: The present research examined the impact of cannabis motives on tobacco outcomes. METHODS: The sample included 403 daily smokers (214 males, mean age 35.24 years). A bifactor model of cannabis motives was examined to determine whether this approach might best elucidate relations between cannabis motives and smoking. RESULTS: Coping motives were associated with reduced barriers for smoking, fewer negative smoking expectancies, and decreased positive reinforcement with respect to smoking. Conformity motives were associated with fewer internal smoking barriers. Expansion motives were associated with more positive reinforcement related to smoking. Enhancement motives were associated with reductions in smoking for appetite/weight control consequences. The general motives variable, comprised of each of the five motives subscales, was associated with more barriers related to tobacco addiction, more external barriers, greater positive reinforcement consequences, and more negative expectancies. Coping motives were negatively associated with quit status, and were positively associated with quit status. CONCLUSIONS: Cannabis motives subscales were not uniformly predictive of quit success. Individuals who used cannabis for conformity reasons were more likely to successfully quit smoking, however, individuals who used cannabis for coping reasons were less likely to quit smoking. Thus, those who use cannabis for conformity reasons are less likely to turn to cannabis during times of stress or to relieve tension or anxiety, a view supported by existing literature. This suggests that individuals who use cannabis for coping reasons may represent a population vulnerable to cannabis misuse and problems. Additional work is needed to better understand underlying mechanisms.

Self-control as a moderator of the relationship between drinking identity and alcohol use.

This study evaluated self-control in the relationship between drinking identity and drinking. We expected those higher in drinking identity would drink more than those lower in drinking identity, particularly if low in self-control. Data were collected in 2012 via an online survey (N = 690 undergraduates, M age = 22.87, SD = 5.37, 82.50% female) at an urban university. An interaction emerged between self-control and drinking identity; self-control was negatively associated with drinking among individuals low in drinking identity, but positively associated with drinking among those high in drinking identity. Implications and future directions are discussed. This research was unfunded.

Self-identification as a moderator of the relationship between gambling-related perceived norms and gambling behavior.

This research was designed to evaluate social influences and perceived social norms on gambling behavior among undergraduate students. Furthermore, this research was designed to replicate and extend previous research demonstrating that young adults overestimate the prevalence of gambling among peers, and that the magnitude of overestimation is positively associated with own use (Larimer and Neighbors, Psychol Addict Behav 17:235-243, 2003). We expected that; (1) gambling college students would identify more strongly with other gambling students compared to other students in general; (2) identification with other gambling students would predict gambling behaviors over and above perceived prevalence of gambling; and (3) identification with other gambling students would moderate the association between perceived social norms and gambling behavior. Participants included 1,486 undergraduate students who completed measures assessing gambling quantity and frequency, gambling-related perceived descriptive norms, and identification with groups. Results revealed that perceived norms for gambling were associated with gambling and revealed that students identified more strongly with other students than either gamblers or student gamblers. However, gambling behavior was more strongly associated with identification with gambling students than students in general. There was consistent support for the perspective that social identity moderates the association between perceived norms for gambling and gambling behavior. This research builds on previous examinations of social influences related to gambling and suggests that it may be important to consider the overall prevalence of a given behavior before considering norms-based intervention approaches. Interventions utilizing social norms for gambling may be advised to consider references other than just the typical student.

Relationships between drinking motives and smoking expectancies among daily smokers who are also problem drinkers.

OBJECTIVE: There is a high co-occurrence of problem drinking and regular cigarette smoking, and cognitive processes (e.g., motivation to use, expectations about the consequences of use) related to each are positively associated with one another. We explored drinking motives in relation to cognitive-based smoking processes among smokers with problematic drinking. We expected that drinking coping motives would be associated with smoking consequences related to negative reinforcement and negative personal outcomes and inflexibility of smoking behavior; observed effects for coping motives would be unique from shared variance with other motives and incrementally evident beyond the variance accounted for by tobacco-related health problems, smoking rate, negative affectivity, cannabis use, and gender. METHODS: The sample included 195 individuals recruited into a larger study of smoking cessation treatments (i.e., they were interested in quitting), who were heavy drinkers and smoked daily. Participants were primarily male (n = 122, 63%), fairly young (Mage = 30.3 years; SD = 12.46), and predominantly White/Caucasian (n = 175, 80%). Roughly 57% (n = 111) had at least one comorbid Axis I disorder, the most common being social anxiety (n = 21, 11%) and generalized anxiety disorder (n = 12, 6%). RESULTS: Coping drinking motives predicted negative smoking consequences, negative reinforcement, and smoking inflexibility. Enhancement drinking motives marginally predicted positive reinforcement. Conformity drinking motives predicted smoking consequences related to appetite/weight control. Social drinking motives predicted negative reinforcement and barriers to cessation and marginally predicted positive reinforcement. CONCLUSIONS: Theoretical models and clinical activities focused on smoking cessation among problem drinkers may benefit from considering the role of drinking motives, particularly coping-oriented motives, to better understanding cognitive-based smoking processes.