This study assessed stakeholder experience with the core processes of The Integrated Community Engagement (ICE) Collaborative, a primary prevention approach addressing adolescent substance use in rural West Virginia, after three years of county-level implementation. Guided by the Icelandic Prevention Model (IPM), the ICE Collaborative aims to enhance cooperation between researchers, policy makers, local practitioners, and community members and facilitate a paradigm shift in youth and community substance use prevention. This shift involves moving away from strategies focused on the repeated allocation of short-term grants that fund time-limited programs to a long-term, holistic, and sustainable approach overseen by local practitioners and coalitions. We conducted qualitative interviews and focus groups with 33 stakeholders during the fall of 2022. Data analyses generated six major themes: 1) It Takes a Village to Prevent Adolescent Substance Use, 2) Improving Understanding and Commitment to Prevention Through Outreach, 3) Enhancing Student Engagement and Program Accessibility, 4) Addressing the Chronic Underfunding of Prevention and Youth Development Programs, 5) Acknowledging Family Contexts and Family Member Substance Use as Risk Factors, and 6) ICE/IPM Inspiring Solution-based Conversations, Goal Setting, and Strategy Selection. Stakeholders reported multiple positive characteristics of ICE for their communities and applauded the long-term focus and access to local data. Several suggestions for improved strategies were also reported. Results are discussed in line with the theoretical underpinnings of the IPM and current discourse around community health promotion in rural areas.

Substance use disorder (SUD) stigma undermines the implementation of effective harm reduction and treatment strategies in the U.S. and can impede individuals from seeking treatment. One research question guided this study: How do personal beliefs regarding SUD, familiarity with SUDs, and culture (religion, political ideology, and urbanicity), shape perceived societal SUD stigma? An online survey was sent to affiliates of a Michigan-based organization, Families Against Narcotics and administrators of Michigan Prepaid Inpatient Health Plan regional entities ( = 1,559). On average respondents viewed society as moderately stigmatizing. The beliefs that drug users can stop whenever they want and that drug users have weak character were significantly associated with greater perceived levels of societal SUD stigma. The effects of religion on perceived stigma may be affected by beliefs of the immorality of drug use, while the effects of political ideology on perceived stigma may differ based on beliefs of the controllability of drug use. The effect of urbanicity may rely on perceived accessibility of treatment. Our findings reflect the intersection of personal beliefs and cultural contexts as they shape perceived societal SUD stigmatization.

Few studies to date have examined the of comorbid substances used alongside Prescription Opioid Misuse (POM) to predict suicidal behaviors among US young adults.

: Stress and repetitive exposures to potentially traumatizing events are inherent to first-responder professions. Firefighters and other crisis responders are often exposed to incidents in their work environments and are at risk of developing acute or posttraumatic symptomatology, depression, and anxiety, as well as harmful patterns of alcohol consumption. Most prior research and theory suggests that many firefighters use alcohol to cope with past and current stressors, and that increased drinking accompanies ongoing exposures to stressful occupational hazards. : The primary aim of this research was to examine alcohol consumption and mental health variables associated in the literature with alcohol misuse. Participants included 546 predominantly male career firefighters in the U.S. Using a cross-sectional design, we examined alcohol misuse in the context of self-reported depression, generalized anxiety, PTSD, and suicidal ideation using previously validated measures. : Based on the AUDIT's recommended cut score of 8, 38.8% of our sample reported drinking at hazardous levels. Hazardous alcohol use was also significantly associated with several mental health indicators with correlations ranging from .28 to .34. Regression analyses revealed that over 14% of the variance in AUDIT scores could be explained by psychological symptom measures, and 29% of the variance in suicide risk was explained by a model using both alcohol and mental health measures. : Findings suggest that psychological distress is associated with hazardous drinking, and that more consistent screening and referral for these issues, as well as multi-level interventions, are needed to effectively address these behavioral health concerns among firefighters.

: Several studies link racism with drug use disparities among systemically marginalized populations. However, few invite Black Americans to discuss how they perceive racism's impact on their drug use. : To examine qualitative accounts from N=40 Black adults reporting non-medical prescription opioid use on their experiences of racism and drug use. : A deductive structural tabular thematic analysis informed by Jones's (2000) levels of racism resulted in two themes: (a) Experiences of Racism (subthemes: Denying Experiences of Racism and Endorsing Experiences of Racism) and (b) Race, Racism, and Drug Use (subthemes: Rejecting Race and Racism's Impact on Drugs and Rejecting Race and Racism's Impact on Drugs). : Participants provided examples of internalized, personally mediated, and institutionalized racism associated with their drug use. Implications for policy, practice, and research are discussed. Specifically, implications detail how to center Black Americans and demonstrate anti-racism when developing treatment strategies and drug policies.

Although previous studies have highlighted the detrimental impact of sexism on other substance use and use-related outcomes among women, limited empirical attention has tested whether sexism is related to worse cannabis-related outcomes. It may be that women use cannabis to cope with negative affect related to experiencing sexism, and thus continue to use despite cannabis-related problems. However, no known studies have tested this hypothesis.

This study investigates the prevalence of exposure to pro- and anti-tobacco advertisements across different sociodemographic groups and sources of exposure in the United States.

Understanding factors associated with early onset of substance use is critical as using alcohol or drugs at a young age is a strong predictor of later substance dependency. Experiencing stressful life events is associated with increased risk for early substance use in youth. Hair cortisol concentration (HCC) is considered a biomarker of psychological stress experienced over longer periods of time. We examined whether HCC could predict early substance use engagement in youth followed over 5 years.

Sexual and gender minority (SGM) individuals report rates of tobacco use that range from 19% to 40% compared to roughly 20% of the general population. Higher rates of tobacco use, compounded by stress from discrimination, contribute to lower cessation rates and worse smoking-related outcomes for SGM individuals. Having multiple stigmatized identities, such as identifying as SGM and being a person who uses cigarettes, may further increase smoking, and decrease the likelihood of cessation. Smoking-related stigma is one relatively unexplored factor that may be related to smoking frequency. The present study sought to examine how smoking stigma was related to smoking frequency, and how discrmination moderates the relationship between smoking stigma and cigarettes per day. A sample of 399 self-identified SGM individuals ( = 36.69) was collected Qualtrics Panels. Participants were primarily White and bisexual. Participants completed a battery of questions, including measures regarding smoking frequency (operationalized in this article as cigarettes per day [CPD]), smoking felt-stigma, smoking self-stigma, and smoking discrimination. Moderation analyses revealed significant interactions of felt- and self-stigma with smoking-related discrimination. For individuals who perceived higher levels of both self- and felt-stigma, experiencing increased smoking discrimination was associated with increased smoking frequency. However, there was no significant interaction with discrimination for individuals who had lower levels of felt- and self-stigma. Results have implications for smoking reduction and cessation. Helping individuals who have higher levels of felt- and self-stigma manage stress related to being stigmatized may motivate individuals to reduce smoking. Ultimately, these findings can play a role in crafting smoking reduction and cessation programs targeted toward SGM communities, particularly individuals who experience high levels of smoking-related stigma.

Rates of cannabis use disorder (CUD) have increased disproportionately among Veterans Administration (VA) patients with psychiatric disorders compared to patients with no disorder. However, VA patient samples are not representative of all U.S. adults, so results on disproportionate increases in CUD prevalence could have been biased. To address this concern, we investigated whether disproportionate increases in the prevalence of cannabis outcomes among those with psychiatric disorders would replicate in nationally representative samples of U.S. adults.

Electronic cigarettes (e-cigarettes) are often marketed as safer alternatives to traditional smoking, yet evidence suggests potential health risks, especially among vulnerable populations. This study examines the immediate adverse events following e-cigarette use in individuals with preexisting health conditions to better understand these risks.

Tobacco brand sharing or brand stretching involves the placement of tobacco brand names, logos, or other distinctive elements of tobacco brands, on nontobacco products, e.g., merchandize, such as clothing, sunglasses, or sporting goods. The Tobacco Master Settlement Agreement (MSA) imposed major restrictions on tobacco company marketing practices in 1999, including banning the sale and distribution of merchandize with combustible cigarette or smokeless tobacco brand names or logos. However, the MSA does not include restrictions on e-cigarette marketing, as these products were not yet on the market at the time of the settlement. Exposure to or use of e-cigarette branded merchandize advertised on social media could contribute to normalization of e-cigarette use by youth.

Electronic nicotine delivery system (ENDS) use is prevalent in the United States, especially among youth and young adults. It is important to monitor current ENDS use and identify at-risk groups, particularly among tobacco naïve individuals. Using data from the 2021 National Survey on Drug Use and Health, we examined the prevalence of past 30-day nicotine/tobacco ENDS use and correlates, stratified by age. The prevalence of past 30-day ENDS use was as follows: ages 12-17 (5.0%), ages 18-20 (13.5%), ages 21-25 (14.6%), ages 26-34 (7.2%), and ages ≥35 (2.5%). Among youth ages 12-17, female respondents were more likely to report past 30-day ENDS use compared to male respondents (aOR = 1.41, 95% CI = 1.01-1.97). Among all adult age groups, current cigarette smoking status was associated with an increased likelihood of current ENDS use, versus never smoking. Among all age groups, those reporting non-Hispanic Black, non-Hispanic Other, and Hispanic race/ethnicity had a decreased likelihood of past 30-day ENDS use versus non-Hispanic White respondents, while past-year drug/alcohol use disorder, versus no use disorder, was associated with an increased likelihood of past 30-day ENDS use. ENDS use was most prevalent among young adults and least prevalent among persons ages ≥35. Most youth who reported ENDS use also reported never smoking cigarettes-compared to adults who reported ENDS use, who primarily reported current or former cigarette smoking. Our findings-which have identified characteristics of those most likely to use ENDS products-have the potential to inform screening and targeted intervention efforts aimed at reducing ENDS use.

Links between social anxiety and risky drinking in college are well documented, but the specifics of this relationship are mixed and likely complex. Impulsivity may play a critical role in enhancing vulnerability for risky drinking in individuals with social anxiety. Here we examined how impulsivity moderates the relationship between social anxiety and alcohol use in college students. 515 undergraduates (18-24 years) who endorsed at least moderate levels of alcohol use were included. Participants completed self-report questionnaires to quantify social anxiety, impulsive personality traits, and alcohol use. A series of correlations and stepwise linear regressions were conducted to examine social anxiety, impulsivity, biological sex, and their interactions as predictors of amount of alcohol use. We found that multiple facets of impulsivity moderated the relationship between social anxiety and amount of alcohol use. Social anxiety was associated with more alcohol use in participants with high lack of premeditation, while social anxiety was associated with less alcohol use in participants with low lack of premeditation, low negative urgency, and high sensation seeking. Sex interacted with social anxiety; low levels of impulsivity seemed to be protective. Our results demonstrate that social anxiety and certain facets of impulsivity (lack of premeditation, sensation seeking) interact to predict alcohol use in undergraduates. These findings highlight the complex and important relationships between social anxiety, impulsivity, and risky drinking in college students.

Neighborhood disadvantage is associated with a higher concentration of tobacco, cannabis and alcohol retailers and greater risk of certain substance use behaviors among youth. Less is known about the impact of subjective neighborhood disorder, which captures distinct exposures that may be relevant to substance use outcomes, including neighborhood social processes, safety, physical characteristics, and neighborhood drug use.

Nicotine gum products from brands like Lucy and Rogue are relatively new arrivals to the tobacco marketplace. While studies of correlates of nicotine gum use are in their nascent stage, data from social media can be used to stay abreast of user experiences with novel tobacco products. This study leveraged machine learning to identify topics of Twitter posts about nicotine gum from the year 2022.

Menthol cigarettes and menthol-flavored electronic nicotine delivery systems (ENDS) are a current focus of US regulatory policy considerations. Informed policy requires understanding how ENDS flavor may influence smoking behavior, and whether this association varies by preferred cigarette flavor.

: The prevalence and dependence of e-cigarettes have increased among young adult college students in recent years. Though several independent risk factors for e-cigarette use and dependence have been identified, research employing theory-informed models to predict e-cigarette use and dependence is limited. : Using Self Determination Theory (SDT), e-cigarette use and dependence may be understood as stemming from need frustration that impairs autonomy, competence, and relatedness, which increases vulnerability for negative health outcomes, including e-cigarette use. Further, need frustration may relate to more e-cigarette use and dependence via higher ruminative thinking, which is known to relate to both need frustration and tobacco use. : This study tested this path model (i.e., SDT need frustration components [autonomy, relatedness, competency]→rumination facets [problem-focused thoughts, counterfactual thinking, repetitive thinking, anticipatory thoughts]→e-cigarette use frequency and dependence outcomes) among 1001 college students (75.3% female; 60.4% White, non-Hispanic; 52% first-year students) who endorsed past-month e-cigarette use. : Within our path model, we found significant indirect effects via problem-focused thoughts on e-cigarette use frequency and e-cigarette dependence. Specifically, higher scores on SDT autonomy, competence, and relatedness frustration were associated with greater problem-focused thoughts, which was associated with higher e-cigarette use frequency and e-cigarette dependence scores. : Results highlight the importance of distinguishing between the unique facets of rumination in understanding relations with e-cigarette use. Further intervention research targeting need frustration and ruminative thinking (particularly problem-focused thoughts) among college student e-cigarette-dependent users is needed.

The unregulated toxic drug crisis continues to be an urgent health issue in North America. Many families of people who use drugs have been significantly impacted by this issue. In addition to the thousands of North Americans who have been bereaved by drug mortality, many families are providing unpaid care to bridge gaps in services while navigating the grief and stress associated with caring for a loved one amidst a heavily politicized and rapidly changing context. Despite the impact on families, few interventions are in place to lessen the burden of the crisis. This commentary presents a call to action to include families of people who use drugs in a public health response to the toxic drug crisis. We emphasize the need for (1) the consideration and involvement of families in all aspects of policy and program decision making, (2) the recognition of families of people who use drugs within national caregiving and bereavement strategies; (3) increased supports and services for families; and (4) additional research and public health monitoring on the impact of the toxic drug crisis on families.

 The use of e-cigarettes can worsen mental health symptoms in young adults. However, little is known about how young adults' mental health may relate to their reasons for using e-cigarettes (vaping). We examined the association of mental health and vaping reasons among young adults who currently vape.  Data were analyzed from a sample of young adults who vape ( = 436, M=25.19) who participated in an online survey assessing mental health (stress, anxiety, and depression) and vaping reasons (vape for tension reduction or relaxation, user experience, product or substance, or utility). We conducted multiple regressions and ANCOVAs, controlling for age, gender, past 30-day e-cigarette use, and past 30-day cigarette smoking.  Experiencing higher levels of stress, anxiety, and depression were associated with vaping for tension reduction or relaxation among young adults who vape ( < 0.001) and for those who dual use e-cigarettes and cigarettes ( < 0.01). Experiencing severe anxiety level was associated with vaping for tension reduction or relaxation than among those experiencing minimal, mild or moderate anxiety ( < 0.05).  Findings show that higher stress, anxiety, and depression are associated with greater likelihood of vaping for tension reduction or relaxation. More research should examine the association of stress, anxiety, and depression on vaping in young adults to identify and determine appropriate interventions to help with vaping cessation.

Contingency management involves rewarding individuals based on objective evidence of behavioral changes. This study explores preferences for financial incentives in vaping cessation programs.