A Bluetooth-Based Smartphone App for Detecting Peer Proximity: Protocol for Evaluating Functionality and Validity.

BACKGROUND: While ecological momentary assessment (EMA) is commonly used to study social contexts and social influence in the real world, EMA almost exclusively relies on participant self-report of present circumstances, including the proximity to influential peers. There is the potential for developing a proximity sensing approach that uses small Bluetooth beacons and smartphone-based detection and data collection to collect information about interactions between individuals passively in real time. OBJECTIVE: This paper aims to describe the methods for evaluating the functionality and validity of a Bluetooth-based beacon and a smartphone app to identify when ≥2 individuals are physically proximal. METHODS: We will recruit 20 participants aged 18 to 29 years with Android smartphones to complete a 3-week study during which beacon detection and self-report data will be collected using a smartphone app (MEI Research). Using an interviewer-administered social network interview, participants will identify up to 3 peers of the same age who are influential on health behavior (alcohol use in this study). These peers will be asked to carry a Bluetooth beacon (Kontakt asset tag) for the duration of the study; each beacon has a unique ID that, when detected, will be recorded by the app on the participant's phone. Participants will be prompted to respond to EMA surveys (signal-contingent reports) when a peer beacon encounter meets our criteria and randomly 3 times daily (random reports) and every morning (morning reports) to collect information about the presence of peers. In all reports, the individualized list of peers will be presented to participants, followed by questions about peer and participant behavior, including alcohol use. Data from multiple app data sets, including beacon encounter specifications, notification, and app logs, participant EMA self-reports and postparticipation interviews, and peer surveys, will be used to evaluate project goals. We will examine the functionality of the technology, including the stability of the app (eg, app crashes and issues opening the app), beacon-to-app detection (ie, does the app detect proximal beacons?), and beacon encounter notification when encounter criteria are met. The validity of the technology will be defined as the concordance between passive detection of peers via beacon-to-app communication and the participant's EMA report of peer presence. Disagreement between the beacon and self-report data (ie, false negatives and false positives) will be investigated in multiple ways (ie, to determine if the reason was technology-related or participant compliance-related) using encounter data and information collected from participants and peers. RESULTS: Participant recruitment began in February 2023, and enrollment was completed in December 2023. Results will be reported in 2025. CONCLUSIONS: This Bluetooth-based technology has important applications and clinical implications for various health behaviors, including the potential for just-in-time adaptive interventions that target high-risk behavior in real time. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50241.

Associations between e-cigarette marketing exposure and vaping nicotine and cannabis among U.S. adults, 2021.

Importance: Vaping has become an increasingly common method for consuming nicotine and cannabis, a trend potentially influenced by e-cigarette marketing. However, little is known about the influence of e-cigarette marketing on cannabis vaping behaviors. Objective: To examine the associations between e-cigarette marketing exposure and nicotine and cannabis vaping behaviors among adults. Design Setting and Participants: This cross-sectional study included a U.S. nationally representative sample of adults (≥18 years) from the Wave 6 survey of the Population Assessment of Tobacco and Health (PATH) Study, conducted from March to November 2021. Exposure: Past 30-day e-cigarette marketing exposure (overall and by ten marketing channels). Main Outcomes and Measures: Past 30-day vaping behavior (sole- and dual-vaping of nicotine and cannabis) overall and stratified by age. Results: The study included 30,516 respondents (48.0% male and 63.9% non-Hispanic White). Overall, 52.0% of respondents reported past 30-day e-cigarette marketing exposure, and 89.8%, 5.6%, 3.2%, and 1.4% reported no vaping, sole-nicotine vaping, sole-cannabis vaping, and dual-vaping, respectively. Multinominal logistic regression results show exposure to e-cigarette marketing was associated with increased odds of reporting sole-cannabis vaping versus no vaping (adjusted risk ratio [aRR], 1.31; 95% confidence interval [CI], 1.09-1.57) and dual-vaping versus no vaping (aRR, 1.26; 95% CI, 1.01-1.57). Stratification analysis found these associations among those aged 18-24 and 25-34 years but not older adults (≥35 years). Those exposed to e-cigarette marketing also had increased odds of reporting sole-cannabis vaping versus sole-nicotine vaping (aRR, 1.28; 95% CI, 1.04-1.58). Stratification analysis found this association only among those aged 18-24 years. E-cigarette marketing exposure via several channels (retail stores, billboards, events, newspapers/magazines) was associated with increased odds of reporting sole-cannabis vaping. Conclusions and Relevance: E-cigarette marketing exposure was only associated with sole-cannabis vaping and dual-vaping, not sole-nicotine vaping among U.S. adults. Such associations were mainly driven by young adults aged 18-24 and 25-35 years and were found for multiple marketing channels. Greater restrictions on tobacco marketing may have reduced the influence of e-cigarette marketing on nicotine vaping, while gaps in such marketing restrictions for cannabis may contribute to continued influence of e-cigarette marketing on cannabis vaping.

A qualitative analysis of adolescents' perspectives on peer and influencer alcohol-related posts on social media.

INTRODUCTION: Adolescent exposure to alcohol-related content on social media is common and associated with alcohol use and perceived norms; however, little is known about how exposure differs by the source of the content (e.g., peer or 'influencer'). The purpose of this study was to utilise qualitative methods to compare adolescent perspectives on peer- versus influencer-generated alcohol content on social media. METHODS: Nine virtual semi-structured focus groups were conducted with adolescents (aged 15-19 years), following a general script aimed at ascertaining adolescent comparative perspectives on peer and influencer alcohol-related media content and the contexts in which it occurs. RESULTS: Five main themes emerged: (i) although both influencers and peers post predominantly positively-valenced alcohol content online, adolescents perceived some differences between these posts; (ii) adolescents perceived their peers to be more cautious and strategic when posting about alcohol than influencers are; (iii) the decision to engage with peer or influencer alcohol-related posts is influenced by a number of factors; (iv) both peer and influencer posts were perceived to send the message that drinking is acceptable, normal or cool; and (v) adolescents believed they are more likely to be influenced by peers' alcohol posts than influencers' alcohol posts, with some exceptions. DISCUSSION AND CONCLUSIONS: Future studies should aim to further understand the unique attributes and circumstances in which exposure to peer and influencer alcohol-related posts impact adolescent alcohol-related cognitions and behaviours. This knowledge will inform prevention and intervention efforts, such as media literacy training and media-specific parenting practices.

Characterizing Alcohol Consumption and Positive and Negative Consequences During Simultaneous Alcohol and Cannabis Use Events.

OBJECTIVE: Young adults who engage in simultaneous alcohol and cannabis use report heavy use of both substances. Event-level studies examining differences between consequences experienced on simultaneous use compared with single substance use days have been mixed. Although studies often control for alcohol use levels, few have examined how quantity of alcohol may influence consequences experienced on simultaneous use days. Furthermore, little research has examined the relationship between simultaneous use and positive consequences or explored individual consequences. This study examined differences in consequences experienced on simultaneous use versus single substance use days (alcohol-only, cannabis-only) including endorsement of specific consequences and examined the relationship among simultaneous use, consequences, and alcohol consumption. METHOD: Young adults who engage in simultaneous use (N = 86) completed 30 days of daily surveys reporting substance use and positive and negative consequences. RESULTS: Simultaneous use days were associated with more negative and positive consequences than single substance use (alcohol-only and cannabis-only) days. We also examined endorsement of specific positive and negative consequences on alcohol-only, cannabis-only, and simultaneous use days. The effect of day type (simultaneous use vs. alcohol-only) on consequences was moderated by alcohol quantity. On lighter drinking days, more positive and negative consequences were endorsed if it was a simultaneous use versus alcohol-only day. On heavier drinking days, number of consequences did not differ between simultaneous use and alcohol-only days. CONCLUSIONS: Findings from this study point to simultaneous use as both reinforcing and high risk and highlight the importance of intervening even on lighter drinking simultaneous use occasions to reduce harms.

Dose-dependent Relationships of Same-day and Typical Substance Use to Sleep Duration in College Cannabis and Alcohol Users: A Multilevel Modeling Approach Using Daily Diary Data.

This study characterized how quantities of cannabis and alcohol use affect sleep. Single-day and typical cannabis and alcohol use patterns were considered to assess acute-chronic use interactions. Linear and non-linear associations assessed dose-dependence. College students (n=337; 52% female) provided 11,417 days of data, with up to five time points per day. Daily self-reported sleep duration, cannabis use quantity, and alcohol use quantity were subjected to linear mixed modeling to capture linear and curvilinear associations between single-day and typical use on same-night and typical sleep. Sleep duration (difference between bedtime and waketime) was the outcome. Quantity of cannabis used each day andtypical quantity used across all days were predictors in the cannabis models. Parallel single-day and typical alcohol variables were predictors in the alcohol models. Follow-up analyses excluded days with alcohol-cannabis co-use. Main effects of single-day and typical cannabis quantity on sleep duration were observed when all cannabis-use days were modeled. Higher than typical doses of single-day and typical cannabis were associated with longer sleep durations, but only to a point; at the highest doses, cannabis shortened sleep. A main effect of single-day alcohol quantity and two interactions (single-day use with both linear and curvilinear typical use) on sleep duration were observed when all alcohol-use days were modeled. Greater alcohol consumption on a given day led to shorter same-night sleep, but typically heavier drinkers required higher doses than typically lighter drinkers to experience these adverse effects. Follow-up models suggested alcohol co-use may contribute to the purported sleep-promoting effects of cannabis.

The daily association between affect and alcohol use: A meta-analysis of individual participant data.

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.

Associations of daily alcohol, cannabis, combustible tobacco, and e-cigarette use with same-day co-use and poly-use of the other substances.

BACKGROUND: Young adults frequently use alcohol, cannabis, and tobacco together. Given the increased prevalence of e-cigarette use and recreational cannabis use, we investigated daily patterns of alcohol, cannabis, and tobacco use and distinguished combustible tobacco from e-cigarettes. METHODS: Young adult college students (N=341) reporting past-month alcohol and cannabis use "at the same time so that their effects overlapped" completed two 28-day bursts of repeated daily surveys. Exposures were day- and person-level use of each substance. Outcomes were (1) same-day co-use of each remaining substance or (2) poly-use of the other substances. RESULTS: Daily use of alcohol, cannabis, combustible cigarettes, and e-cigarettes increased the odds of same-day co-use of the other substances (except combustible tobacco with e-cigarettes) and each poly-use outcome. The influence of person-level substance use on daily substance use was less consistent. Only e-cigarette use increased the odds of daily alcohol use. Use of either tobacco product but not alcohol increased the odds of daily cannabis use. Person-level alcohol and cannabis use increased the odds of daily use of either tobacco product but use of one tobacco product was not associated with daily use of the other product. CONCLUSIONS: These findings increase our understanding of emerging daily patterns of alcohol, cannabis, and tobacco co-use, and the impact of different tobacco products. Future work is needed to extend this research into non-college samples and people who use tobacco but do not use alcohol and cannabis simultaneously, and examine daily chronologies of multiple substances that could serve as dynamic markers of risk.

Associations Among Enacted Stigma, Perceived Chances for Success, Life Satisfaction, and Substance Use Among Sexual Minority and Heterosexual Youth.

Background: Sexual minority youth report high rates of substance use compared to heterosexual youth. Stigma can diminish perceptions of future success and life satisfaction and contribute to elevated substance use. This study examined whether experiences of enacted stigma (i.e., discrimination) and substance use among sexual minority and heterosexual youth were indirectly associated through perceived chances for success and life satisfaction. Method: In a sample of 487 adolescents who indicated their sexual identity (58% female, M age = 16.0, 20% sexual minority), we assessed substance use status and factors that might explain sexual minority disparities in substance use. Using structural equation modeling, we examined indirect associations between sexual minority status and substance use status through these factors. Results: Compared to heterosexual youth, sexual minority youth reported greater stigma, which was associated with both lower perceived chances for success and life satisfaction, which were in turn associated with greater likelihood of substance use. Conclusions: Findings highlight the importance of attending to stigma, perceived chances for success, and general life satisfaction to understand and intervene to prevent substance use among sexual minority youth.

Applying the prototype willingness model to day-level simultaneous alcohol and cannabis use.

OBJECTIVE: The prototype willingness model (PWM) provides a framework for understanding simultaneous alcohol and cannabis use by highlighting important psychosocial (e.g., attitudes, norms) predictors of and pathways (via willingness and/or intentions) to simultaneous use. We examined both the PWM reasoned and social reaction pathways in relation to simultaneous use. METHOD: Eighty-nine young adults self-monitored alcohol, cannabis, and simultaneous use and related constructs for 30 days via daily assessments. RESULTS: Day-level simultaneous use specific attitudes, norms, perceived vulnerability, intentions, and willingness each predicted simultaneous use, while only day-level intentions and willingness predicted number of negative consequences. We observed significant indirect effects for the two social reaction pathways examined (from descriptive norms to willingness to simultaneous use; from perceived vulnerability to willingness to simultaneous use). Only direct effects were seen for the cognitions in the reasoned pathway; injunctive norms predicted simultaneous use, and attitudes predicted simultaneous use with no mediation by intentions. CONCLUSIONS: Findings support applying the PWM to event-level simultaneous use among young adults. Future work should establish if PWM day-level constructs are modifiable targets that may be utilized in intervention work focused on reducing simultaneous use and related harms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Acute Consequences Associated With Co-use of Alcohol and Cannabis: A Daily Survey Analysis.

OBJECTIVE: Co-use of alcohol and cannabis has been associated with more total negative consequences than single-substance use, but results have been mixed depending on whether the single substance was alcohol or cannabis. The present study used within-person analyses to examine whether co-use increased the risk for experiencing specific acute negative consequences. METHOD: College students who were co-users of alcohol and cannabis (N = 341; M age = 19.8 years; 51.3% female; 74.8% White) completed 56 days of five daily surveys across two bursts. We used generalized linear mixed effects models to examine the effects of type of substance use day on specific negative consequences, controlling for consumption and covariates. RESULTS: Relative to both alcohol-only and co-use days, cannabis-only days were associated with decreased likelihood of experiencing hangover, blackout, nausea/vomiting, injury, rude/aggressive behavior, and unwanted sex. Relative to alcohol-only days, cannabis-only and co-use days were associated with an increased likelihood of driving high/drunk. Finally, there was an increased likelihood of hangovers on alcohol-only days compared with co-use days. CONCLUSIONS: Days with different types of substance use differed in specific consequences. Most of the negative co-use consequences investigated here appear to be driven by alcohol consumption rather than cannabis use. The results also indicated that these young adults were more likely to endorse driving under the influence of cannabis than alcohol. Interventions for co-use should target alcohol consumption to reduce negative consequences such as blackout, injury, rude/aggressive behavior, and unwanted sex and highlight the dangers of driving under the influence of cannabis.

Adolescents' perceptions of alcohol portrayals in the media and their impact on cognitions and behaviors.

OBJECTIVE: Exposure to alcohol in the media is pervasive and may influence adolescents' perceptions and use of alcohol. The purpose of this study was to better understand how adolescents perceive alcohol-related content in both entertainment and social media, with a focus on the valence of portrayals (i.e., positive, negative) and impacts on cognitions and behaviors. METHOD: Participants were 40 high school students (60% female). Nine focus groups were conducted via videoconferencing, stratified by grade (9th/10th, 11th/12th) and gender. Transcripts were analyzed via template-style thematic analyses to identify themes. RESULTS: Six themes were developed, including (a) some portrayals of alcohol may increase likelihood of using alcohol, (b) some portrayals of alcohol in the media can discourage drinking, (c) sometimes truly negative consequences of alcohol are portrayed positively or downplayed, (d) media portrayals of alcohol are perceived to be based in reality but are at times exaggerated, (e) adolescent and adult alcohol use is portrayed differently in entertainment media, and (f) the extent to which adolescents are influenced by the media may depend on their preexisting attitudes, beliefs, and education. CONCLUSIONS: Adolescents have awareness of media portrayals of alcohol, both positive and negative, and their associated impacts. Findings highlight the need for much more work to understand the conditions under which, and for whom, exposure to different types of positive portrayals of alcohol in the media translate into positive expectancies about alcohol or drinking motives. Such work may ultimately inform intervention targets to reduce early initiation and/or risky drinking among adolescents. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Patient perceptions regarding alcohol use after bariatric surgery.

INTRODUCTION: Patients who have undergone bariatric surgery are at increased risk of an alcohol use disorder. Though patients understand this risk, the majority engage in post-surgical alcohol use. This suggests that education alone is not sufficient to reduce post-surgical drinking. To prevent development of post-surgical alcohol use disorders, we need better understanding of the reasons patients use alcohol following surgery. The purpose of this study was to identify factors associated with post-surgical alcohol use. METHOD: Patients (N = 20) who were 1-3 years post-bariatric surgery and were consuming alcohol at least twice monthly participated in a 60-min interview. Participants responded about their knowledge regarding risk of post-surgical alcohol use and reasons why patients may start drinking. Deductive and inductive coding were completed by two independent raters. RESULTS: Although nearly all participants were aware of the risks associated with post-surgical alcohol use, most believed that lifelong abstinence from alcohol was unrealistic. Common reasons identified for using alcohol after bariatric surgery included social gatherings, resuming pre-surgical use, and addiction transfer. Inductive coding identified three themes: participants consumed alcohol in different ways compared to prior to surgery; the effect of alcohol was substantially stronger than pre-surgery; and beliefs about why patients develop problematic alcohol use following surgery. CONCLUSION: Patients consume alcohol after bariatric surgery for a variety of reasons and they do not believe recommending abstinence is useful. Understanding patient perceptions can inform interventions to minimize alcohol use after bariatric surgery. Modifications to traditional alcohol relapse prevention strategies may provide a more robust solution to decreasing negative outcomes experienced by individuals undergoing bariatric surgery.

A qualitative examination of positive and negative consequences young adults experience from simultaneous alcohol and cannabis use.

OBJECTIVE: Alcohol and cannabis are two of the most commonly used substances among young adults, and most individuals who use both substances use them simultaneously, that is, on the same occasion such that their effects overlap. Given the high prevalence of simultaneous alcohol and cannabis use, it is important to understand the relationship between simultaneous use and consequences. This study presents a qualitative examination of positive and negative consequences of simultaneous use. METHOD: We conducted individual interviews among 36 young adults who engage in simultaneous use (23 women, 12 men, 1 trans man). Interviews included open-ended questions examining negative and positive consequences of simultaneous use and how simultaneous use differed from single substance use (alcohol only use, cannabis only use). Interviews were analyzed using applied thematic analysis. RESULTS: Young adults reported numerous negative and positive consequences of simultaneous use, many overlapping with single substance use. Yet, they also reported unique combinations of positive consequences not experienced by single substance use. Young adults discussed patterns of use that were sometimes approached intentionally (e.g., quantity of substances used, order) that influenced consequences. CONCLUSIONS: Together these findings provide further insight into young adults' simultaneous use experiences. Next steps should include quantitative exploratory research to identify and determine the frequency of specific consequences experienced during simultaneous use and examine the relationship between simultaneous use consequences and particular patterns of use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A qualitative examination of the decision-making process of simultaneous alcohol and cannabis use: Intentions and willingness.

BACKGROUND: Alcohol and cannabis use are common among young adults and most young adults who use both substances have used them simultaneously (i.e., using both substances so their effects overlap). Because simultaneous use is associated with a greater number and severity of consequences than single substance use, research is needed to examine the decision-making process of engaging in this high-risk behavior. We conducted a qualitative examination of intentions (i.e., plans) and willingness (i.e., one's openness to engage in the behavior if an opportunity presents itself) to engage in simultaneous use from the perspective of young adults who frequently report this substance use behavior. METHODS: We recruited 36 young adults who reported simultaneous use and heavy drinking (4+/5+ drinks for women/men; 64% women, ages 18 to 25) to participate in semi-structured interviews. All interviews were double coded for thematic analysis and both novel and a priori themes were found. RESULTS: Young adults distinguished between intending to engage in simultaneous use and being willing to engage in simultaneous use. They reported that intentions and willingness varied from occasion to occasion. They also reported that context and alcohol consumption influenced their willingness to engage in simultaneous use. Peer pressure or offers increased their willingness to use cannabis while drinking and having current or next-day responsibilities decreased their willingness to engage in simultaneous use. Additionally, planned simultaneous use occasions were characterized as being special events where young adults consumed more substances, but were more likely to monitor their use than unplanned occasions. CONCLUSIONS: Intentions and willingness may be important proximal predictors of simultaneous use of alcohol and cannabis. Building off this qualitative work, quantitative research should identify which factors influence the decision-making process to engage in simultaneous use and determine when intentions and willingness are most predictive of risky simultaneous use behavior.

The Impact of Reducing Nicotine Content on Adolescent Cigarette Smoking and Nicotine Exposure: Results From a Randomized Controlled Trial.

INTRODUCTION: As the science base around the potential benefits of a reduced-nicotine standard for cigarettes grows, information on the potential effects on adolescent smokers is a high priority. The aim of this randomized trial was to test the influence of 3-week exposure to reduced nicotine cigarettes in a sample of adolescent daily smokers. AIMS AND METHODS: In this double-blind, two-arm, randomized controlled trial (NCT0258731), following a 1-week baseline, adolescent daily smokers not currently intending to quit (ages 15-19 years, n = 66 randomized) were urn randomized to use either very low nicotine content (VLNC; 0.4 mg/g; n = 33) or normal nicotine content (NNC, 15.8 mg/g; n = 33) research cigarettes for 3 weeks. Participants attended five study sessions at our clinical laboratory. The primary outcome was average total cigarettes smoked per day (CPD; including both study and non-study cigarettes) at week 3. RESULTS: Stepwise regression results demonstrated that compared with NNC cigarettes (n = 31), assignment to VLNC cigarettes (n = 29), was associated with 2.4 fewer CPD on average than NNC assignment (p < .05) week 3 when controlling for covariates (p < .01, Cohen's d = 0.52 n = 60 completed all procedures). VLNC cigarettes were also associated with lower levels of craving reduction than NNC cigarettes (Questionnaire on Smoking Urges Factor 2, p < .05). No group differences were found for secondary outcomes. CONCLUSIONS: Adolescent participants assigned to VLNC use for 3 weeks smoked fewer total CPD relative to the NNC group. Overall, data suggest that a VLNC policy would reduce cigarette smoking in adolescents who smoke, but high rates of incomplete adherence suggest that youth may seek alternative sources of nicotine in this scenario. IMPLICATIONS: The US Food and Drug Administration may enact a reduced-nicotine product standard that would affect all commercially available cigarettes. One important population affected by this policy would be adolescents who smoke. This study, the first clinical trial of VLNC cigarettes in adolescents, demonstrates that adolescents switched to VLNC cigarettes for 3 weeks reduced their CPD relative to the normal-nicotine cigarette control group, without leading to increased respiratory symptoms or increased withdrawal. Biomarkers indicated the use of other sources of nicotine, suggesting that such a policy will need to consider approaches to assist in transitioning away from smoking.

Real-time and next-morning correlates of subjective alcohol consequence evaluations.

OBJECTIVE: There is considerable variation in how college student drinkers evaluate alcohol-related consequences across time and consequence type. Previous qualitative work suggested that students perceive consequences less negatively under certain circumstances (i.e., higher intoxication, when less time has passed, positive mood, after discussing with friends). The present study sought to confirm these patterns, using ecological momentary assessment (EMA) during drinking episodes paired with retrospective next-day assessments. METHOD: For 28 days, heavy-drinking college students (n = 90, 50% female) completed self-reports during drinking episodes and the next morning. Measures included alcohol use, subjective intoxication, mood, negative consequences (e.g., being aggressive) and positive consequences (e.g., new friend), and consequence-specific evaluations. RESULTS: Consistent with hypotheses, multilevel models revealed that during drinking events compared to the next morning, average evaluations of negative and positive consequences were less negative and more positive, respectively. During drinking events, neither subjective intoxication nor estimated blood alcohol concentration (eBAC) was associated with positive or negative evaluations. In morning reports, more positive mood was associated with less negative evaluations of negative consequences and more positive evaluations of positive consequences. Next-day discussion with friends was not significantly associated with consequence evaluations. CONCLUSIONS: This study is the first to assess subjective consequence evaluations in real time as well as retrospectively, for the same events. Findings continue to support the role of context (timing, mood) on subjective consequence evaluations, and suggest that ecological momentary interventions targeting alcohol consequences and related cognitions might best be delivered the morning after drinking, to capitalize on relatively more negative perceptions of one's drinking experiences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Insights into the context of simultaneous alcohol and cannabis use among young adults.

Simultaneous alcohol and cannabis use (simultaneous use) is common among young adults and is associated with a greater number of substance use-related consequences compared to single substance use. Understanding what drives simultaneous use among young adults is crucial. This study aimed to gather qualitative data on physical, social, and situational characteristics of simultaneous use among young adults. Participants were 36 heavy drinking young adults (Mage = 21.79) who engaged in simultaneous use at least twice during the past 30 days. Individual semistructured interviews were conducted via Zoom videoconferencing. Thematic analyses were used to analyze interview data. Findings indicated that young adults are selective of where and with whom they engage in simultaneous use with. Physical characteristics associated with simultaneous use included being in familiar and safe locations. Young adults were less likely to engage in simultaneous use in public spaces. Social characteristics associated with simultaneous use included being at parties, being around close peers, and if others are approving of and/or also using alcohol and cannabis so their effects overlap. Being around family or being alone decreased the likelihood of simultaneous use. Situational characteristics associated with simultaneous use included having access to alcohol and/or cannabis, being a weekend and/or evening, pregaming, and using cannabis at the end of a drinking occasion. Young adults based their decision to engage in simultaneous use on a range of physical, social, and situational contextual factors. Future research should examine multiple characteristics of the context in order to identify specific context with an increased risk of simultaneous use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Adolescent (mis)perceptions of peer alcohol posts on social media: Prospective associations with alcohol attitudes and use.

BACKGROUND: Social media is a central context in which teens interact with their peers, creating opportunities for them to view, post, and engage with alcohol content. Because adolescent peer interactions largely occur on social media, perceptions of peer alcohol content posting may act as potent risk factors for adolescent alcohol use. Accordingly, the preregistered aims of this study were to (1) compare perceived friend, typical person, and an adolescent's own posting of alcohol content to social media and (2) examine how these perceptions prospectively relate to alcohol willingness, expectancies, and use after accounting for offline perceived peer alcohol use. METHODS: This longitudinal study included 435 adolescents (Mage  = 16.91) in 11th (48%) and 12th grade (52%). Participants completed measures of alcohol content social media posts, perceived peer alcohol use, willingness to drink alcohol, alcohol expectancies, and alcohol use at two time points, 3 months apart. RESULTS: Consistent with preregistered hypotheses, adolescents reported that 60.3% of the typical person their age and 30.6% of their friends post alcohol content on social media. By contrast, only 7% of participants reported that they themselves posted such content to social media. After accounting for offline perceived peer drinking norms, neither perceived friend nor typical person alcohol content social media posts were prospectively associated with willingness to drink or positive or negative alcohol expectancies. Perceived friend alcohol content posts were prospectively positively associated with past 30-day alcohol consumption even after controlling for offline perceived peer drinking norms. CONCLUSIONS: Adolescents misperceived the frequency of alcohol-related posting to social media among their peers, and perceptions of friend alcohol content posts prospectively predicted alcohol use. Given the results from the current study and the ubiquity of social media among adolescents, prevention efforts may benefit from addressing misperceptions of alcohol-related posting to social media.

Event-level contextual predictors of high-intensity drinking events among young adults.

BACKGROUND: Drinking events are characterized by social and physical contexts that are associated with level of alcohol consumption. Ecologically valid data is needed to delineate aspects of the drinking context that are most likely to precipitate excessive alcohol consumption. METHODS: We utilized event-level data from a longitudinal study that included repeated daily surveys administered in two 28-day bursts. Data from 341 college student past-month alcohol and cannabis users (Mage=19.79; 53 % women; 74 % White) produced a total of 4107 alcohol use days. Generalized linear mixed effects models were used to predict drinking level (moderate: 1-3/1-4 for women/men; heavy-episodic drinking (HED): 4-7/5-9; high-intensity drinking (HID), 8+/10+) by social (e.g., with friends) and physical (e.g., at a party) contexts. We conducted analyses for the first and last drink reported, controlling demographic and study characteristics. RESULTS: Being at a party, friend's house, or with strangers at the last drink reported were associated with HID compared to HED, while being at home, alone, or with family were protective for HID. No first drink contexts were associated with HID relative to HED. Witnessing others who were intoxicated was consistently associated with HID. CONCLUSIONS: Social settings such as parties and those with intoxicated persons were associated with risk for HID. The context of drinks at the end of an event are salient signals of level of alcohol consumption. Preventive interventions, particularly those that deliver strategies in real time, should consider accounting for contextual risk factors to reduce harms associated with excessive alcohol consumption.

Introduction to special section for Angela K. Stevens.

This special section is dedicated to some of the recent work by Dr. Angela Stevens, who passed away unexpectedly last year. She is dearly missed by those fortunate enough to have known her, but her legacy lives on through the lives she touched and her research. Since the beginning of her undergraduate training, Dr. Angela Stevens has dedicated her professional life to improving the lives of people who use drugs and alcohol through research. During her doctoral training at Texas Tech University, her research program focused on risk and protective factors which influence alcohol and cannabis use based on the theory of planned behavior. Dr. Stevens' master's thesis utilized daily diary methodology to examine the within-person intention-behavior relation for alcohol use among a sample of young adults (Stevens et al., 2017). This work indicated that individuals higher in phenotypes related to problematic drinking (i.e., impulsigenic traits) had stronger intentions to drink, which in turn predicted higher levels of alcohol consumption. Building on this work, her dissertation (Stevens et al., 2020) involved a psychometric evaluation of a momentary impulsivity scale across two intensive longitudinal samples using ecological momentary assessment (EMA). This work informed the assessment of state-level factors relevant to substance use. (PsycInfo Database Record (c) 2022 APA, all rights reserved).