Correlates of Recent HIV Testing Among People Who Inject Drugs in Rural Areas: A Multi-site Cross-Sectional Study, 2018-2020.

The Rural Opioid Initiative surveyed 2693 people who inject drugs (PWID) in eight rural U.S. areas in 2018-2020 about self-reported HIV testing in the past 6 months. Correlates of interest included receipt of any drug-related services, incarceration history, and structural barriers to care (e.g., lack of insurance, proximity to syringe service programs [SSP]). Overall, 20% of participants reported receiving an HIV test within the past 6 months. Multivariable generalized estimating equations showed that attending substance use disorder (SUD) treatment (OR 2.11, 95%CI [1.58, 2.82]), having health insurance (OR 1.42, 95%CI [1.01, 2.00]) and recent incarceration (OR 1.49, 95%CI [1.08, 2.04]) were positively associated with HIV testing, while experiencing a resource barrier to healthcare (inability to pay, lack of transportation, inconvenient hours, or lack of child care) had inverse (OR 0.73, 95%CI [0.56, 0.94]) association with HIV testing. We found that the prevalence of HIV testing among rural PWID is low, indicating an unmet need for testing. While SUD treatment or incarceration may increase chances for HIV testing for rural PWID, other avenues for expanding HIV testing, such as SSP, need to be explored.

Hidden flaws in e-cigarette industry-funded studies.

Electronic cigarette (e-cigarette) use has increased since e-cigarettes were introduced to the market nearly 20 years ago. Researchers continue to conduct studies to understand the health risks and benefits of e-cigarettes to inform health education and promotion efforts as well as public policy. Studies funded by the tobacco industry examining the potential risks and benefits of e-cigarettes have also been conducted and are sometimes published in the scientific literature. Frequently, tobacco and e-cigarette industry-funded researchers report findings that contradict research funded by other sources. While many industry-funded studies may appear methodologically sound at first glance, in some cases, industry-funded studies include methodological flaws that result in misleading conclusions. The tobacco industry's use of biased research to influence tobacco-related policy decisions in the past is well-documented. This commentary provides specific examples of recent e-cigarette research funded by the tobacco/e-cigarette industry in which methodological flaws result in misleading conclusions that support industry goals. Given the long history of biased research conducted by the tobacco industry, there is a need to assess whether research funded by the e-cigarette industry similarly contains methodological flaws. We emphasise the need for tobacco and e-cigarette-funded research to be scrutinised by non-industry-funded subject matter experts and call for journals to not consider manuscripts that have received support from the tobacco or e-cigarette industry.

Alcohol to-go sales policies at on-premise drinking establishments near large public US universities during the COVID-19 pandemic.

AIMS: Sweeping policy changes during the COVID-19 pandemic increased alcohol availability through permitted to-go sales, potentially posing unique risks to college students. While to-go sales may make binge drinking more convenient, little remains known about these practices. Therefore, this study aimed to assess whether drinking establishments' to-go sales practices are associated with their other operational practices and state policy. METHOD: This cross-sectional analysis included 221 randomly selected bars, nightclubs, and restaurants within two miles of a large public university. Telephone interviews assessed establishment practices, and the Alcohol Policy Information System provided state alcohol to-go laws. Regression models tested whether establishment to-go sales practices were associated with their business practices (logistic regression) and state policy (generalized estimating equations). RESULTS: Nearly one-half (44.8%) of drinking establishments sold alcohol to-go. Establishments with higher vodka prices had nearly 30% higher odds of selling spirits to-go (aOR = 1.29) and establishments offering happy hours specials had more than twice the odds of selling beer (aOR = 2.22), wine (aOR = 2.53), and spirits to-go (aOR = 2.60). Additionally, establishments that implemented physical distance requirements had higher odds of selling wine to-go (aOR = 3.00). State to-go laws were associated with higher odds of selling wine (aOR = 3.99) and spirits to-go (aOR = 5.43) in the full sample and beer to-go (aOR = 4.92) in urban counties. CONCLUSIONS: Establishments that sell alcohol to-go tend to engage in other practices designed to drive sales. Evaluations of alcohol to-go sales laws on risky consumption among priority populations, including college students, are urgently needed to inform decisions about how to appropriately regulate sales.

The relationship between felt stigma and non-fatal overdose among rural people who use drugs.

BACKGROUND: Drug overdose deaths in the United States exceeded 100,000 in 2021 and 2022. Substance use stigma is a major barrier to treatment and harm reduction utilization and is a priority target in ending the overdose epidemic. However, little is known about the relationship between stigma and overdose, especially in rural areas. We aimed to characterize the association between felt stigma and non-fatal overdose in a multi-state sample of rural-dwelling people who use drugs. METHODS: Between January 2018 and March 2020, 2,608 people reporting past 30-day opioid use were recruited via modified chain-referral sampling in rural areas across 10 states. Participants completed a computer-assisted survey of substance use and substance-related attitudes, behaviors, and experiences. We used multivariable logistic regression with generalized estimating equations to test the association between felt stigma and recent non-fatal overdose. RESULTS: 6.6% of participants (n = 173) reported an overdose in the past 30 days. Recent non-fatal overdose was significantly associated with felt stigma after adjusting for demographic and substance use-related covariates (aOR: 1.47, 95% CI: 1.20-1.81). The association remained significant in sensitivity analyses on component fear of enacted stigma items (aOR: 1.48, 95% CI: 1.20-1.83) and an internalized stigma item (aOR: 1.51, 95% CI: 1.07-2.14). CONCLUSIONS: Felt stigma related to substance use is associated with higher risk of non-fatal overdose in rural-dwelling people who use drugs. Stigma reduction interventions and tailored services for those experiencing high stigma are underutilized approaches that may mitigate overdose risk.

The Impact of Temporary Assistance for Needy Families Benefit Requirements and Sanctions on Maternal Material Hardship, Mental Health, and Parental Aggravation.

INTRODUCTION: Temporary Assistance for Needy Families requirements can be stress-inducing, difficult for families to complete, and may be detrimental during early life. We assessed the impact of TANF requirements on primary caregiving mothers' experiences of material hardship, anxiety, depression, and parental aggravation in the first year of a child's life. METHODS: Survey responses were selected from mothers in the Future of Families and Childhood Wellbeing Study, who received TANF in the first year of their child's life (N = 1085). RESULTS: Survey-weighted regression models showed associations between: presence of any requirements and increased material hardship, work requirements and increased material hardship, requirement to name the father of their child and increased depression, benefit cuts and increased parental aggravation, and benefit cuts and increased material hardship. DISCUSSION: Federal and state policies should revise requirement programs to increase program accessibility and support the mental health and financial stability of mothers applying for TANF to facilitate sustainable movement into employment.

#Delta8: a retailer-driven increase in Delta-8 THC discussions on Twitter from 2020 to 2021.

Background: Delta-8 tetrahydrocannabinol (THC) has experienced significant cultivation, use, and online marketing growth in recent years.Objectives: This study utilized natural language processing on Twitter data to examine trends in public discussions regarding this novel psychoactive substance.Methods: This study analyzed the frequency of #Delta8 tweets over time, most commonly used words, sentiment classification of words in tweets, and a qualitative analysis of a random sample of tweets containing the hashtag "Delta8" from January 1, 2020 to September 26, 2021.Results: A total of 41,828 tweets were collected, with 30,826 unique tweets (73.7%) and 11,002 quotes, retweets, or replies (26.3%). Tweet activity increased from 2020 to 2021, with daily original tweets rising from 8.55 to 149. This increase followed a high-engagement retailer promotion in June 2021. Commonly used terms included "cbd," "cannabis," "edibles," and "cbdoil." Sentiment classification revealed a predominance of "positive" (30.93%) and "trust" (14.26%) categorizations, with 8.42% classified as "negative." Qualitative analysis identified 20 codes, encompassing substance type, retailers, links, and other characteristics.Conclusion: Twitter discussions on Delta-8 THC exhibited a sustained increase in prevalence from 2020 to 2022, with online retailers playing a dominant role. The content also demonstrated significant overlap with cannabidiol and various cannabis products. Given the growing presence of retailer marketing and sales on social media, it is crucial for public health researchers to monitor and promote relevant Delta-8 health recommendations on these platforms to ensure a balanced conversation.

Popularity of Delta-8 THC on the Internet Across US States, 2021.

Objectives. To assess the popularity of an emergent drug, delta-8 tetrahydrocannabinol (THC), and compare interest levels between US states with or without legalized recreational cannabis. Methods. We used Google Trends to assess the growth of interest among delta-8 THC-related search terms from May 17, 2020, to May 9, 2021. We examined differences between states with or without legalized cannabis using state-level Google Trends data from February 13 to May 13, 2021, and policy data from the National Conference of State Legislatures. Results. Interest in delta-8 THC increased starting in mid-June 2020, with search volumes for delta-8 THC queries currently at 35% of the "marijuana" query. States where recreational cannabis is illegal had higher relative queries than did states with legalized recreational cannabis (52.3 vs 14.8; t = 40.9; P < .001). Conclusions. There has been rapid growth in interest in delta-8 THC. Findings between state policy contexts likely indicate delta-8 THC's role as a substitute good for delta-9 THC. Public Health Implications. Digital signals such as search volumes may point to an emergent use trend in the substance delta-8 THC. Further studies are needed to assess potential harms and correlates of delta-8 THC use. (Am J Public Health. 2022;112(2):296-299. https://doi.org/10.2105/AJPH.2021.306586).

Predictors of Discussing Lung Cancer Screening with a Health Care Provider Among Current and Former Smokers in HINTS: A Secondary Data Analysis.

INTRODUCTION: Lung cancer screening is greatly underutilized among those who may benefit from early detection. METHODS: We analysed data from a subsample (n = 929) of the 2020 Health Information National Trends Survey. We tested multivariable logistic regression models of associations of cancer worry, information insufficiency, and perceived information gathering capacity with reports of having discussed lung cancer screening with a health care provider. RESULTS: Among former smokers, no factors were associated significantly with lung cancer screening information seeking. However, for current smokers, extreme cancer worry was positively and significantly associated with having discussed lung cancer screening with a health care provider (OR: 12.95; 95% CI: 2.11, 79.39). CONCLUSION: To increase uptake of lung cancer screening, public health campaigns and healthcare providers will face the dual challenge of increasing perceived need for screening among former smokers while directing current smokers with high levels of worry to see the benefits of early detection.

A national assessment of on-premise drinking establishments near public universities: Drink prices, drink specials, indoor tobacco use, and state-level alcohol laws.

BACKGROUND: Inexpensive drinks and price promotions increase alcohol consumption and have been observed at on-premise drinking establishments near large colleges. Some bars may sell tobacco products and allow indoor tobacco use to encourage patrons to stay and drink more. This study examined drink prices/specials and associated practices of on-premise drinking establishments including tobacco sales and policies regarding tobacco use. METHODS: In 2018, telephone calls about prices/practices were made to 403 randomly selected bars/nightclubs within 2 miles of large residential universities in each U.S. state. The Alcohol Policy Information System provided data on state-level alcohol laws. Multivariable linear and logistic regression models examined associations between alcohol prices/specials, state laws, and establishment practices. RESULTS: The average price for the least expensive draft beer and a vodka shot at each location were $3.62 (SD = $1.15) and $4.77 (SD = $1.16), respectively. Most establishments (65%) had happy hour specials, 6% had 2-for-1 specials, 91% sold food, 9% sold cigarettes, 8% allowed smoking indoors, and 18% permitted electronic cigarette (e-cigarette) use indoors. Allowing e-cigarette use indoors (b = -0.54) and selling cigarettes (b = -0.79) were associated with lower vodka prices; allowing cigarette smoking indoors (b = -0.46) was associated with lower beer prices. Lower beer prices (OR = 1.38), selling food (OR = 2.97), and no state law banning happy hour specials altogether (OR = 4.24) or with full-day price reduction exemptions (OR = 12.74) were associated with higher odds of having happy hour specials. Allowing e-cigarette use indoors was associated with having 2-for-1 specials (OR = 6.38). CONCLUSION: In bars near large public universities, beers and shots were often available for less than $5 and drink specials were prevalent. Further, some establishments allowed tobacco use indoors and/or sold cigarettes. Laws that increase alcohol taxes, set minimum drink prices, and ban the sale and indoor use of tobacco products at on-premise drinking locations are important harm reduction tools.

Exploring the Point-of-Sale Among Vape Shops Across the United States: Audits Integrating a Mystery Shopper Approach.

INTRODUCTION: Vape shops represent prominent, unique retailers, subject to Food and Drug Administration (FDA) regulation in the United States. AIMS AND METHODS: This study assessed compliance of US vape shop retail marketing strategies with new regulations (eg, required age verification, prohibited free samples) and pre-implementation conditions for other regulations (eg, health warning labels on all nicotine products, required disclosures of e-liquid contents). RESULTS: 95.0% of shops displayed minimum-age signage; however, mystery shoppers were asked for age verification at 35.6% upon entry and at 23.4% upon purchase. Although 85.5% of shops had some evidence of implementing FDA health warnings, 29.1% had signage indicating prohibited health claims, 16.3% offered free e-liquid samples, 27.4% had signage with cartoon imagery, and 33.3% were within two blocks of schools. All shops sold open-system devices, 64.8% sold closed-system devices, 68.2% sold their own brand of e-liquids, 42.5% sold e-liquids containing cannabidiol, 83.2% offered price promotions of some kind, and 89.9% had signage for product and price promotions. CONCLUSIONS: Results indicated that most shops complied with some implementation of FDA health warnings and with free sampling bans and minimum-age signage. Other findings indicated concerns related to underage access, health claims, promotional strategies, and cannabidiol product offerings, which call for further FDA and state regulatory/enforcement efforts.

Perceptions and Knowledge About the MenB Vaccine Among Parents of High School Students.

Serogroup B meningococcal disease (MenB) causes almost 60% of meningitis cases among adolescents and young adults. Yet, MenB vaccine coverage among adolescents remains below 10%. Since parents are the primary medical decision makers for adolescents, we examined MenB vaccination rates and parent attitudes about meningitis and the MenB vaccine. In 2018, in conjunction with a county-wide, school-based immunization campaign, we conducted a mixed methods study among parents of 16- to 17-year-olds. We facilitated focus groups asking parents about their knowledge of meningitis and reactions to educational materials and sent behavioral surveys based on Health Belief Model constructs to parents through the county high school system. Parents in three focus groups (n = 8; participation rate = 13%) expressed confusion about their child's need to receive the MenB vaccine in addition to the meningococcal conjugate vaccine (MenACWY), but conveyed strong trust in their physicians' recommendation. Among survey participants (n = 170), 70 (41%) had heard of the MenB vaccine. Among those 70 parents, the most common barriers to vaccination were concerns about side effects (55%) and uncertainty of susceptibility due to receipt of the MenACWY vaccine (30%). The percentage of teens that received at least one dose of the MenB vaccine was 50% (n = 35) by parent report and 23% (n = 16) by state vaccination records. Parents demonstrated uncertainty and confusion about the MenB vaccine particularly due to the existence of another meningitis vaccine and limited health care provider recommendations. Confirmatory studies of parent confusion about the MenB vaccine are needed to develop interventions.

Supersized Alcopop Consumption Associated With Homelessness and Gang Membership.

BACKGROUND: Supersized alcopops are single-serving, ready-to-drink beverages with very high alcohol content. Research suggests that consumption of these products is especially dangerous. The current study was one of the first to examine individual-level characteristics associated with recent consumption of supersized alcopops. METHODS: Adults on probation (n = 253; 70% male) in Baltimore City, MD, and Dallas, TX, who reported heavy drinking or any illicit drug use completed interviews. Psychosocial scales were drawn from the Criminal Justice Client Evaluation of Self and Treatment Intake. Bivariate analyses were conducted to examine characteristics associated with past 30-day consumption of supersized alcopops. RESULTS: Past 30-day consumption of supersized alcopops was significantly associated with higher scores for hostility and risk-taking, and lower scores on the self-esteem scale compared to nonconsumers. Recent consumption of supersized alcopops was also significantly associated with past 30-day homelessness and current gang affiliation. Among those who did not experience homelessness, 11% consumed supersized alcopops, compared to 30% of those who experienced homelessness. Further, 11% of those who were not gang-affiliated reported consuming a supersized alcopop within the past 30 days, compared to 57% of those who were gang-affiliated. DISCUSSION: This study identifies disparate consumption of dangerous supersized alcopop products by vulnerable and at-risk groups. Better regulation of supersized alcopop marketing is needed to reduce alcohol consumption among high-risk groups, including people who are homeless and gang members, and display greater hostility and risk-taking traits. Previous research suggests that reducing the alcohol by volume and increasing the retail price of supersized alcopops would reduce some of the harms associated with consumption.

Unemployment insurance program accessibility and suicide rates in the United States.

Unemployment is a risk factor for suicide. Unemployment insurance is the primary policy tool in the United States for alleviating the burden of unemployment on individuals. Our objective was to estimate the effect of state unemployment insurance accessibility on suicide rates, and effect modification by sociodemographic factors and unemployment rate. We used quarterly data from all 50 U.S. states and Washington, DC from 2000 to 2015, for a total of 3264 state-quarter units of analysis. The exposure was the quarterly unemployment insurance recipiency rate, i.e. the percentage of unemployed persons who received unemployment insurance. The outcome was the state-quarterly suicide rate per 100,000 population. Linear regression models included state, year, and calendar quarter fixed effects, state time trends, and state-level economic covariates to account for state-specific time-varying confounding. We assessed effect modification by the state-level unemployment rate, educational attainment, age, gender, and race. Based on fully adjusted models, potential protective effects of higher unemployment insurance recipiency rates appear to be small and restricted to demographic groups at higher risk of suicide including men, non-Hispanic White Americans, and those 45-64 years of age. These groups also generally have higher UI recipiency rates, therefore differences in subgroup estimates may reflect variations in eligibility policies and accessibility of UI programs.

Electronic cigarette explosion/burn and poisoning related emergency department visits, 2018-2019.

BACKGROUND: Electronic cigarette (ECIG) use has increased dramatically in recent years. Negative ECIG-related acute health effects have included explosion/burn injuries from battery failure and child ingestion/poisoning of liquid nicotine. However, there is an urgent need for continued surveillance of ECIG health effects to determine whether these outcomes change as ECIG devices and liquids rapidly evolve. This study updates national estimates of ECIG-related emergency department (ED) visits and describes the context of these injuries. METHODS: A keyword search of case narrative text was used to identify ECIG-related ED visits in the National Electronic Injury Surveillance System (NEISS) data. These cross-sectional data are designed to be weighted to provide national estimates of consumer product-related injuries treated in EDs. ECIG-related injuries were described and categorized, and sampling weights applied to model national estimates. RESULTS: From 2015 to 2019 there were an estimated 3369 ED visits from ECIG explosion/burn injuries (95% CI = 2020, 4718), and an estimated 676 visits from 2019 alone (95% CI = 315, 1036). In 2018-2019, there were an estimated 1550 cases of children <5 years old ingesting ECIG liquids (95% CI = 778, 2322). CONCLUSIONS: Despite a notable shift in the US market towards ECIG devices that use lower electrical power and disposable "pods" (e.g., JUUL), liquid chemical ingestion among young children and ECIG explosion/burn injuries persist. Improved product regulations are urgently needed to prevent negative health effects caused by ECIGs, as well as prevent their ingestion and use by children.

Electronic cigarette explosion and burn injuries, US Emergency Departments 2015-2017.

BACKGROUND: Electronic cigarette (e-cigarette) battery failure can result in explosions and burn injuries. Previous attempts to quantify these events has been limited to compilations of case studies, federal agency reports and media reports. Although e-cigarette explosions and burn injuries are thought to be rare, current surveillance methods likely underestimate actual occurrences. METHODS: Analyses were conducted on cross-sectional data from the US Consumer Product Safety Commission's (CPSC) National Electronic Injury Surveillance System (NEISS). A keyword search of case narrative text was used to identify e-cigarette-related explosion and burn injuries presenting to US emergency departments from 2015 to 2017. Sampling weights were applied to make conservative national incidence estimates. RESULTS: From 2015 to 2017, there were an estimated 2035 e-cigarette explosion and burn injuries presenting to US hospital emergency departments (95% CI 1107 to 2964). CONCLUSIONS: There are more e-cigarette explosion and burn injuries in the USA than estimated in the past reports. Improved surveillance of e-cigarette injuries and regulation of e-cigarette devices is urgently needed. NEISS could be a valuable resource for e-cigarette injury surveillance.

Human Papillomavirus Vaccine Initiation for Adolescents Following Rhode Island's School-Entry Requirement, 2010-2016.

OBJECTIVES: To assess changes in human papillomavirus (HPV) vaccine initiation for adolescent girls and boys in Rhode Island compared with all other states. METHODS: We estimated the gender-specific effects of Rhode Island's school-entry HPV vaccination policy on self-reported HPV vaccination initiation by using a difference-in-differences design with the National Immunization Survey-Teen from 2010 through 2016. RESULTS: Compared with boys in other states, boys in Rhode Island increased their HPV vaccine initiation rate by 11% (b = 0.11; 95% confidence interval [CI] = 0.05, 0.18) after enactment of the requirement. No difference was seen in the probability of HPV vaccine initiation among girls in Rhode Island compared with girls in the multistate control (b = -0.01; 95% CI = -0.08, 0.05). CONCLUSIONS: Our analysis identified an 11% increase in HPV vaccine initiation rate among boys in Rhode Island after the school-entry requirement was enacted, whereas no significant change was observed for girls. Public Health Implications. Given suboptimal vaccine uptake rates in the United States, continued pursuit of state-level public policy to improve HPV vaccination is needed. School-entry requirements for HPV vaccination may be a strategy for closing the gap in HPV vaccine uptake for boys and girls.

Effects of Alcohol Interventions on Other Drug Use in the Cherokee Nation.

OBJECTIVES: To evaluate effects of 2 alcohol prevention interventions-Communities Mobilizing for Change on Alcohol (CMCA), a community organizing intervention designed to reduce youth alcohol access, and CONNECT, an individual-level screening and brief intervention approach-on other drug use outcomes. METHODS: We conducted a community intervention trial with quarterly surveys over 3 years (2012-2015) of high school students living within the jurisdictional service area of the Cherokee Nation in Oklahoma. We used generalized estimating equations and linear probability models to examine intervention spillover effects on other drug use. RESULTS: We found significant reductions in drug use other than alcohol attributable to CMCA and CONNECT. CMCA was associated with a 35% reduction in chewing tobacco use, a 39% reduction in marijuana use, and a 48% reduction in prescription drug misuse. CONNECT was associated with a 26% reduction in marijuana use and a 31% reduction in prescription drug misuse. CONCLUSIONS: Nonalcohol drug use was consistently reduced as a result of 2 theoretically and operationally distinct alcohol prevention strategies. Evaluations of alcohol prevention efforts should continue to include other drug use to understand the broader effects of such interventions.

State-level minimum wage and heart disease death rates in the United States, 1980-2015: A novel application of marginal structural modeling.

Despite substantial declines since the 1960's, heart disease remains the leading cause of death in the United States (US) and geographic disparities in heart disease mortality have grown. State-level socioeconomic factors might be important contributors to geographic differences in heart disease mortality. This study examined the association between state-level minimum wage increases above the federal minimum wage and heart disease death rates from 1980 to 2015 among 'working age' individuals aged 35-64 years in the US. Annual, inflation-adjusted state and federal minimum wage data were extracted from legal databases and annual state-level heart disease death rates were obtained from CDC Wonder. Although most minimum wage and health studies to date use conventional regression models, we employed marginal structural models to account for possible time-varying confounding. Quasi-experimental, marginal structural models accounting for state, year, and state × year fixed effects estimated the association between increases in the state-level minimum wage above the federal minimum wage and heart disease death rates. In models of 'working age' adults (35-64 years old), a $1 increase in the state-level minimum wage above the federal minimum wage was on average associated with ~6 fewer heart disease deaths per 100,000 (95% CI: -10.4, -1.99), or a state-level heart disease death rate that was 3.5% lower per year. In contrast, for older adults (65+ years old) a $1 increase was on average associated with a 1.1% lower state-level heart disease death rate per year (b = -28.9 per 100,000, 95% CI: -71.1, 13.3). State-level economic policies are important targets for population health research.

Comparing methods of misclassification correction for studies of adolescent alcohol use.

BACKGROUND: Despite concerns over measurement error, self-report continues to be the most common measure of adolescent alcohol use used by researchers. Objective measures of adolescent alcohol use continue to advance; however, they tend to be cost prohibitive for larger studies. By combining appropriate statistical techniques and validation subsamples, the benefits of objective alcohol measures can be made more accessible to a greater number of researchers. OBJECTIVES: To compare three easily implemented methods to correct for measurement error when objective measures of alcohol use are available for a subsample of participants, regression calibration, multiple imputation for measurement error (MIME), and probabilistic sensitivity analysis (PSA), and provide guidance regarding the use of each method in scenarios likely to occur in practice. METHODS: This simulation experiment compared the performance of each method across different sample sizes, both differential and non-differential error, and differing levels of sensitivity and specificity of the exposure measure. RESULTS: Failure to adjust for measurement error led to substantial bias across all simulated scenarios ranging from a 35% to 208% change in the log-odds. For non-differential misclassification, regression calibration reduced this bias to between a 1% and 23% change in the log-odds regardless of sample size. At higher sample sizes, MIME produced approximately unbiased (between a 0% and 9% change in the log-odds) and relatively efficient corrections for both non-differential and differential misclassification. PSA provided little utility for correcting misclassification due to the inefficiency of its estimates. CONCLUSION: Concern over measurement error resulting from self-reported adolescent alcohol use persists in research. Where appropriate, methods involving validity subsamples provide an efficient avenue for addressing these concerns.