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Publisher: John Wiley and Sons   (Total: 1597 journals)

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Showing 1 - 200 of 1597 Journals sorted alphabetically
Abacus     Hybrid Journal   (Followers: 13, SJR: 0.48, h-index: 22)
About Campus     Hybrid Journal   (Followers: 5)
Academic Emergency Medicine     Hybrid Journal   (Followers: 67, SJR: 1.385, h-index: 91)
Accounting & Finance     Hybrid Journal   (Followers: 49, SJR: 0.547, h-index: 30)
ACEP NOW     Free   (Followers: 1)
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 55, SJR: 1.02, h-index: 88)
Acta Archaeologica     Hybrid Journal   (Followers: 177, SJR: 0.101, h-index: 9)
Acta Geologica Sinica (English Edition)     Hybrid Journal   (Followers: 3, SJR: 0.552, h-index: 41)
Acta Neurologica Scandinavica     Hybrid Journal   (Followers: 5, SJR: 1.203, h-index: 74)
Acta Obstetricia et Gynecologica Scandinavica     Hybrid Journal   (Followers: 14, SJR: 1.197, h-index: 81)
Acta Ophthalmologica     Hybrid Journal   (Followers: 7, SJR: 0.112, h-index: 1)
Acta Paediatrica     Hybrid Journal   (Followers: 56, SJR: 0.794, h-index: 88)
Acta Physiologica     Hybrid Journal   (Followers: 6, SJR: 1.69, h-index: 88)
Acta Polymerica     Hybrid Journal   (Followers: 9)
Acta Psychiatrica Scandinavica     Hybrid Journal   (Followers: 37, SJR: 2.518, h-index: 113)
Acta Zoologica     Hybrid Journal   (Followers: 7, SJR: 0.459, h-index: 29)
Acute Medicine & Surgery     Hybrid Journal   (Followers: 5)
Addiction     Hybrid Journal   (Followers: 36, SJR: 2.086, h-index: 143)
Addiction Biology     Hybrid Journal   (Followers: 15, SJR: 2.091, h-index: 57)
Adultspan J.     Hybrid Journal   (SJR: 0.127, h-index: 4)
Advanced Energy Materials     Hybrid Journal   (Followers: 26, SJR: 6.411, h-index: 86)
Advanced Engineering Materials     Hybrid Journal   (Followers: 28, SJR: 0.81, h-index: 81)
Advanced Functional Materials     Hybrid Journal   (Followers: 51, SJR: 5.21, h-index: 203)
Advanced Healthcare Materials     Hybrid Journal   (Followers: 14, SJR: 0.232, h-index: 7)
Advanced Materials     Hybrid Journal   (Followers: 283, SJR: 9.021, h-index: 345)
Advanced Materials Interfaces     Hybrid Journal   (Followers: 6, SJR: 1.177, h-index: 10)
Advanced Optical Materials     Hybrid Journal   (Followers: 7, SJR: 2.488, h-index: 21)
Advanced Science     Open Access   (Followers: 5)
Advanced Synthesis & Catalysis     Hybrid Journal   (Followers: 18, SJR: 2.729, h-index: 121)
Advances in Polymer Technology     Hybrid Journal   (Followers: 14, SJR: 0.344, h-index: 31)
Africa Confidential     Hybrid Journal   (Followers: 21)
Africa Research Bulletin: Economic, Financial and Technical Series     Hybrid Journal   (Followers: 13)
Africa Research Bulletin: Political, Social and Cultural Series     Hybrid Journal   (Followers: 11)
African Development Review     Hybrid Journal   (Followers: 33, SJR: 0.275, h-index: 17)
African J. of Ecology     Hybrid Journal   (Followers: 16, SJR: 0.477, h-index: 39)
Aggressive Behavior     Hybrid Journal   (Followers: 17, SJR: 1.391, h-index: 66)
Aging Cell     Open Access   (Followers: 11, SJR: 4.374, h-index: 95)
Agribusiness : an Intl. J.     Hybrid Journal   (Followers: 3, SJR: 0.627, h-index: 14)
Agricultural and Forest Entomology     Hybrid Journal   (Followers: 16, SJR: 0.925, h-index: 43)
Agricultural Economics     Hybrid Journal   (Followers: 45, SJR: 1.099, h-index: 51)
AIChE J.     Hybrid Journal   (Followers: 32, SJR: 1.122, h-index: 120)
Alcoholism and Drug Abuse Weekly     Hybrid Journal   (Followers: 7)
Alcoholism Clinical and Experimental Research     Hybrid Journal   (Followers: 7, SJR: 1.416, h-index: 125)
Alimentary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 34, SJR: 2.833, h-index: 138)
Alimentary Pharmacology & Therapeutics Symposium Series     Hybrid Journal   (Followers: 3)
Allergy     Hybrid Journal   (Followers: 50, SJR: 3.048, h-index: 129)
Alternatives to the High Cost of Litigation     Hybrid Journal   (Followers: 3)
American Anthropologist     Hybrid Journal   (Followers: 152, SJR: 0.951, h-index: 61)
American Business Law J.     Hybrid Journal   (Followers: 24, SJR: 0.205, h-index: 17)
American Ethnologist     Hybrid Journal   (Followers: 93, SJR: 2.325, h-index: 51)
American J. of Economics and Sociology     Hybrid Journal   (Followers: 30, SJR: 0.211, h-index: 26)
American J. of Hematology     Hybrid Journal   (Followers: 35, SJR: 1.761, h-index: 77)
American J. of Human Biology     Hybrid Journal   (Followers: 13, SJR: 1.018, h-index: 58)
American J. of Industrial Medicine     Hybrid Journal   (Followers: 16, SJR: 0.993, h-index: 85)
American J. of Medical Genetics Part A     Hybrid Journal   (Followers: 17, SJR: 1.115, h-index: 61)
American J. of Medical Genetics Part B: Neuropsychiatric Genetics     Hybrid Journal   (Followers: 4, SJR: 1.771, h-index: 107)
American J. of Medical Genetics Part C: Seminars in Medical Genetics     Partially Free   (Followers: 6, SJR: 2.315, h-index: 79)
American J. of Physical Anthropology     Hybrid Journal   (Followers: 38, SJR: 1.41, h-index: 88)
American J. of Political Science     Hybrid Journal   (Followers: 300, SJR: 5.101, h-index: 114)
American J. of Primatology     Hybrid Journal   (Followers: 14, SJR: 1.197, h-index: 63)
American J. of Reproductive Immunology     Hybrid Journal   (Followers: 4, SJR: 1.347, h-index: 75)
American J. of Transplantation     Hybrid Journal   (Followers: 19, SJR: 2.792, h-index: 140)
American J. on Addictions     Hybrid Journal   (Followers: 10, SJR: 0.843, h-index: 57)
Anaesthesia     Hybrid Journal   (Followers: 146, SJR: 1.404, h-index: 88)
Analyses of Social Issues and Public Policy     Hybrid Journal   (Followers: 10, SJR: 0.397, h-index: 18)
Analytic Philosophy     Hybrid Journal   (Followers: 20)
Anatomia, Histologia, Embryologia: J. of Veterinary Medicine Series C     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 27)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1, SJR: 0.633, h-index: 24)
Andrologia     Hybrid Journal   (Followers: 2, SJR: 0.528, h-index: 45)
Andrology     Hybrid Journal   (Followers: 2, SJR: 0.979, h-index: 14)
Angewandte Chemie     Hybrid Journal   (Followers: 175)
Angewandte Chemie Intl. Edition     Hybrid Journal   (Followers: 238, SJR: 6.229, h-index: 397)
Animal Conservation     Hybrid Journal   (Followers: 41, SJR: 1.576, h-index: 62)
Animal Genetics     Hybrid Journal   (Followers: 8, SJR: 0.957, h-index: 67)
Animal Science J.     Hybrid Journal   (Followers: 6, SJR: 0.569, h-index: 24)
Annalen der Physik     Hybrid Journal   (Followers: 5, SJR: 1.46, h-index: 40)
Annals of Anthropological Practice     Partially Free   (Followers: 2, SJR: 0.187, h-index: 5)
Annals of Applied Biology     Hybrid Journal   (Followers: 7, SJR: 0.816, h-index: 56)
Annals of Clinical and Translational Neurology     Open Access   (Followers: 1)
Annals of Gastroenterological Surgery     Open Access  
Annals of Human Genetics     Hybrid Journal   (Followers: 9, SJR: 1.191, h-index: 67)
Annals of Neurology     Hybrid Journal   (Followers: 49, SJR: 5.584, h-index: 241)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1, SJR: 0.531, h-index: 38)
Annals of Public and Cooperative Economics     Hybrid Journal   (Followers: 8, SJR: 0.336, h-index: 23)
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5, SJR: 2.389, h-index: 189)
Annual Bulletin of Historical Literature     Hybrid Journal   (Followers: 12)
Annual Review of Information Science and Technology     Hybrid Journal   (Followers: 14)
Anthropology & Education Quarterly     Hybrid Journal   (Followers: 26, SJR: 0.72, h-index: 31)
Anthropology & Humanism     Hybrid Journal   (Followers: 18, SJR: 0.137, h-index: 3)
Anthropology News     Hybrid Journal   (Followers: 15)
Anthropology of Consciousness     Hybrid Journal   (Followers: 11, SJR: 0.172, h-index: 5)
Anthropology of Work Review     Hybrid Journal   (Followers: 11, SJR: 0.256, h-index: 5)
Anthropology Today     Hybrid Journal   (Followers: 94, SJR: 0.545, h-index: 15)
Antipode     Hybrid Journal   (Followers: 54, SJR: 2.212, h-index: 69)
Anz J. of Surgery     Hybrid Journal   (Followers: 8, SJR: 0.432, h-index: 59)
Anzeiger für Schädlingskunde     Hybrid Journal   (Followers: 1)
Apmis     Hybrid Journal   (Followers: 1, SJR: 0.855, h-index: 73)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 74, SJR: 0.754, h-index: 69)
Applied Organometallic Chemistry     Hybrid Journal   (Followers: 7, SJR: 0.632, h-index: 58)
Applied Psychology     Hybrid Journal   (Followers: 170, SJR: 1.023, h-index: 64)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 53, SJR: 0.868, h-index: 13)
Applied Stochastic Models in Business and Industry     Hybrid Journal   (Followers: 5, SJR: 0.613, h-index: 24)
Aquaculture Nutrition     Hybrid Journal   (Followers: 12, SJR: 1.025, h-index: 55)
Aquaculture Research     Hybrid Journal   (Followers: 31, SJR: 0.807, h-index: 60)
Aquatic Conservation Marine and Freshwater Ecosystems     Hybrid Journal   (Followers: 36, SJR: 1.047, h-index: 57)
Arabian Archaeology and Epigraphy     Hybrid Journal   (Followers: 12, SJR: 0.453, h-index: 11)
Archaeological Prospection     Hybrid Journal   (Followers: 12, SJR: 0.922, h-index: 21)
Archaeology in Oceania     Hybrid Journal   (Followers: 13, SJR: 0.745, h-index: 18)
Archaeometry     Hybrid Journal   (Followers: 31, SJR: 0.809, h-index: 48)
Archeological Papers of The American Anthropological Association     Hybrid Journal   (Followers: 15, SJR: 0.156, h-index: 2)
Architectural Design     Hybrid Journal   (Followers: 29, SJR: 0.261, h-index: 9)
Archiv der Pharmazie     Hybrid Journal   (Followers: 3, SJR: 0.628, h-index: 43)
Archives of Drug Information     Hybrid Journal   (Followers: 5)
Archives of Insect Biochemistry and Physiology     Hybrid Journal   (SJR: 0.768, h-index: 54)
Area     Hybrid Journal   (Followers: 13, SJR: 0.938, h-index: 57)
Art History     Hybrid Journal   (Followers: 272, SJR: 0.153, h-index: 13)
Arthritis & Rheumatology     Hybrid Journal   (Followers: 56, SJR: 1.984, h-index: 20)
Arthritis Care & Research     Hybrid Journal   (Followers: 29, SJR: 2.256, h-index: 114)
Artificial Organs     Hybrid Journal   (Followers: 1, SJR: 0.872, h-index: 60)
ASHE Higher Education Reports     Hybrid Journal   (Followers: 15)
Asia & the Pacific Policy Studies     Open Access   (Followers: 17)
Asia Pacific J. of Human Resources     Hybrid Journal   (Followers: 329, SJR: 0.494, h-index: 19)
Asia Pacific Viewpoint     Hybrid Journal   (Followers: 1, SJR: 0.616, h-index: 26)
Asia-Pacific J. of Chemical Engineering     Hybrid Journal   (Followers: 8, SJR: 0.345, h-index: 20)
Asia-pacific J. of Clinical Oncology     Hybrid Journal   (Followers: 6, SJR: 0.554, h-index: 14)
Asia-Pacific J. of Financial Studies     Hybrid Journal   (SJR: 0.241, h-index: 7)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 4, SJR: 0.377, h-index: 7)
Asian Economic J.     Hybrid Journal   (Followers: 8, SJR: 0.234, h-index: 21)
Asian Economic Policy Review     Hybrid Journal   (Followers: 4, SJR: 0.196, h-index: 12)
Asian J. of Control     Hybrid Journal   (SJR: 0.862, h-index: 34)
Asian J. of Endoscopic Surgery     Hybrid Journal   (Followers: 1, SJR: 0.394, h-index: 7)
Asian J. of Organic Chemistry     Hybrid Journal   (Followers: 6, SJR: 1.443, h-index: 19)
Asian J. of Social Psychology     Hybrid Journal   (Followers: 6, SJR: 0.665, h-index: 37)
Asian Politics and Policy     Hybrid Journal   (Followers: 12, SJR: 0.207, h-index: 7)
Asian Social Work and Policy Review     Hybrid Journal   (Followers: 5, SJR: 0.318, h-index: 5)
Asian-pacific Economic Literature     Hybrid Journal   (Followers: 5, SJR: 0.168, h-index: 15)
Assessment Update     Hybrid Journal   (Followers: 4)
Astronomische Nachrichten     Hybrid Journal   (Followers: 3, SJR: 0.701, h-index: 40)
Atmospheric Science Letters     Open Access   (Followers: 29, SJR: 1.332, h-index: 27)
Austral Ecology     Hybrid Journal   (Followers: 15, SJR: 1.095, h-index: 66)
Austral Entomology     Hybrid Journal   (Followers: 9, SJR: 0.524, h-index: 28)
Australasian J. of Dermatology     Hybrid Journal   (Followers: 8, SJR: 0.714, h-index: 40)
Australasian J. On Ageing     Hybrid Journal   (Followers: 6, SJR: 0.39, h-index: 22)
Australian & New Zealand J. of Statistics     Hybrid Journal   (Followers: 14, SJR: 0.275, h-index: 28)
Australian Accounting Review     Hybrid Journal   (Followers: 3, SJR: 0.709, h-index: 14)
Australian and New Zealand J. of Family Therapy (ANZJFT)     Hybrid Journal   (Followers: 3, SJR: 0.382, h-index: 12)
Australian and New Zealand J. of Obstetrics and Gynaecology     Hybrid Journal   (Followers: 46, SJR: 0.814, h-index: 49)
Australian and New Zealand J. of Public Health     Hybrid Journal   (Followers: 13, SJR: 0.82, h-index: 62)
Australian Dental J.     Hybrid Journal   (Followers: 6, SJR: 0.482, h-index: 46)
Australian Economic History Review     Hybrid Journal   (Followers: 6, SJR: 0.171, h-index: 12)
Australian Economic Papers     Hybrid Journal   (Followers: 31, SJR: 0.23, h-index: 9)
Australian Economic Review     Hybrid Journal   (Followers: 6, SJR: 0.357, h-index: 21)
Australian Endodontic J.     Hybrid Journal   (Followers: 3, SJR: 0.513, h-index: 24)
Australian J. of Agricultural and Resource Economics     Hybrid Journal   (Followers: 3, SJR: 0.765, h-index: 36)
Australian J. of Grape and Wine Research     Hybrid Journal   (Followers: 5, SJR: 0.879, h-index: 56)
Australian J. of Politics & History     Hybrid Journal   (Followers: 15, SJR: 0.203, h-index: 14)
Australian J. of Psychology     Hybrid Journal   (Followers: 18, SJR: 0.384, h-index: 30)
Australian J. of Public Administration     Hybrid Journal   (Followers: 441, SJR: 0.418, h-index: 29)
Australian J. of Rural Health     Hybrid Journal   (Followers: 6, SJR: 0.43, h-index: 34)
Australian Occupational Therapy J.     Hybrid Journal   (Followers: 75, SJR: 0.59, h-index: 29)
Australian Psychologist     Hybrid Journal   (Followers: 11, SJR: 0.331, h-index: 31)
Australian Veterinary J.     Hybrid Journal   (Followers: 23, SJR: 0.459, h-index: 45)
Autism Research     Hybrid Journal   (Followers: 38, SJR: 2.126, h-index: 39)
Autonomic & Autacoid Pharmacology     Hybrid Journal   (SJR: 0.371, h-index: 29)
Banks in Insurance Report     Hybrid Journal   (Followers: 1)
Basic & Clinical Pharmacology & Toxicology     Hybrid Journal   (Followers: 11, SJR: 0.539, h-index: 70)
Basic and Applied Pathology     Open Access   (Followers: 2, SJR: 0.113, h-index: 4)
Basin Research     Hybrid Journal   (Followers: 5, SJR: 1.54, h-index: 60)
Bauphysik     Hybrid Journal   (Followers: 2, SJR: 0.194, h-index: 5)
Bauregelliste A, Bauregelliste B Und Liste C     Hybrid Journal  
Bautechnik     Hybrid Journal   (Followers: 1, SJR: 0.321, h-index: 11)
Behavioral Interventions     Hybrid Journal   (Followers: 10, SJR: 0.297, h-index: 23)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 23, SJR: 0.736, h-index: 57)
Berichte Zur Wissenschaftsgeschichte     Hybrid Journal   (Followers: 10, SJR: 0.11, h-index: 5)
Beton- und Stahlbetonbau     Hybrid Journal   (Followers: 2, SJR: 0.493, h-index: 14)
Biochemistry and Molecular Biology Education     Hybrid Journal   (Followers: 6, SJR: 0.311, h-index: 26)
Bioelectromagnetics     Hybrid Journal   (Followers: 1, SJR: 0.568, h-index: 64)
Bioengineering & Translational Medicine     Open Access  
BioEssays     Hybrid Journal   (Followers: 10, SJR: 3.104, h-index: 155)
Bioethics     Hybrid Journal   (Followers: 14, SJR: 0.686, h-index: 39)
Biofuels, Bioproducts and Biorefining     Hybrid Journal   (Followers: 1, SJR: 1.725, h-index: 56)
Biological J. of the Linnean Society     Hybrid Journal   (Followers: 18, SJR: 1.172, h-index: 90)
Biological Reviews     Hybrid Journal   (Followers: 5, SJR: 6.469, h-index: 114)
Biologie in Unserer Zeit (Biuz)     Hybrid Journal   (Followers: 41, SJR: 0.12, h-index: 1)
Biology of the Cell     Full-text available via subscription   (Followers: 9, SJR: 1.812, h-index: 69)
Biomedical Chromatography     Hybrid Journal   (Followers: 7, SJR: 0.572, h-index: 49)
Biometrical J.     Hybrid Journal   (Followers: 5, SJR: 0.784, h-index: 44)
Biometrics     Hybrid Journal   (Followers: 37, SJR: 1.906, h-index: 96)
Biopharmaceutics and Drug Disposition     Hybrid Journal   (Followers: 10, SJR: 0.715, h-index: 44)
Biopolymers     Hybrid Journal   (Followers: 18, SJR: 1.199, h-index: 104)
Biotechnology and Applied Biochemistry     Hybrid Journal   (Followers: 44, SJR: 0.415, h-index: 55)
Biotechnology and Bioengineering     Hybrid Journal   (Followers: 160, SJR: 1.633, h-index: 146)
Biotechnology J.     Hybrid Journal   (Followers: 15, SJR: 1.185, h-index: 51)
Biotechnology Progress     Hybrid Journal   (Followers: 39, SJR: 0.736, h-index: 101)
Biotropica     Hybrid Journal   (Followers: 20, SJR: 1.374, h-index: 71)
Bipolar Disorders     Hybrid Journal   (Followers: 9, SJR: 2.592, h-index: 100)
Birth     Hybrid Journal   (Followers: 38, SJR: 0.763, h-index: 64)
Birth Defects Research Part A : Clinical and Molecular Teratology     Hybrid Journal   (Followers: 2, SJR: 0.727, h-index: 77)
Birth Defects Research Part B: Developmental and Reproductive Toxicology     Hybrid Journal   (Followers: 8, SJR: 0.468, h-index: 47)
Birth Defects Research Part C : Embryo Today : Reviews     Hybrid Journal   (SJR: 1.513, h-index: 55)

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Journal Cover Addiction
  [SJR: 2.086]   [H-I: 143]   [36 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0965-2140 - ISSN (Online) 1360-0443
   Published by John Wiley and Sons Homepage  [1597 journals]
  • Alcohol industry involvement in policy making: A systematic review
    • Authors: Jim McCambridge; Melissa Mialon, Ben Hawkins
      Abstract: AimsTo summarise the substantive findings of studies of alcohol industry involvement in national or supra-national policy-making, and to produce a new synthesis of current evidence.MethodsThis study examined peer-reviewed journal reports published in the English language between 1980-2016 of studies of alcohol industry involvement in policy making. Included studies were required to provide information on data collection and analysis and to have sought explicitly to investigate interventions by alcohol industry actors within the process of public policy making. Eight electronic databases were searched on 27/02/17. The methodological strengths and limitations of individual studies and the literature as a whole were examined. A thematic synthesis using an inductive approach to the generation of themes was guided by the research aims and objectives.ResultsTwenty reports drawn from 15 documentary and interview studies identify pervasive influence of alcohol industry actors in policy making. This evidence synthesis indicates that industry actors seek to influence policy in two principal ways: 1) by framing policy debates in a cogent and internally consistent manner, which excludes from policy agendas issues that are contrary to commercial interests; and 2) by adopting short and long term approaches to managing threats to commercial interests within the policy arena, by building relationships with key actors using a variety of different organisational forms. This review pools findings from existing studies on the range of observed impacts on national alcohol policy decision-making across the world.ConclusionsAlcohol industry actors are highly strategic, rhetorically sophisticated and well organised in influencing national policy-making.
      PubDate: 2018-03-15T02:45:59.223607-05:
      DOI: 10.1111/add.14216
  • Cost-effectiveness of alternative smoking cessation scenarios in Spain:
           results from the EQUIPTMOD
    • Authors: Marta Trapero-Bertran; Celia Muñoz, Kathryn Coyle, Doug Coyle, Adam Lester-George, Reiner Leidl, Bertalan Németh, Kei-Long Cheung, Subhash Pokhrel, Ángel Lopez-Nicolás
      Abstract: AimsTo assess the cost-effectiveness of alternative smoking cessation scenarios from the perspective of the Spanish National Health Service (NHS).DesignWe used the European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD), a Markov-based state transition economic model, to estimate the return on investment (ROI) of: (a) the current provision of smoking cessation services (brief physician advice and printed self-helped material + smoking ban and tobacco duty at current levels); and (b) four alternative scenarios to complement the current provision: coverage of proactive telephone calls; nicotine replacement therapy (mono and combo) [prescription nicotine replacement therapy (Rx NRT)]; varenicline (standard duration); or bupropion. A rate of 3% was used to discount life-time costs and benefits.SettingSpain.ParticipantsAdult smoking population (16+ years).MeasurementsHealth-care costs associated with treatment of smoking attributable diseases (lung cancer, coronary heart disease, chronic obstructive pulmonary infection and stroke); intervention costs; quality-adjusted life years (QALYs). Costs and outcomes were summarized using various ROI estimates.FindingsThe cost of implementing the current provision of smoking cessation services is approximately €61 million in the current year. This translates to 18 quitters per 1000 smokers and a life-time benefit–cost ratio of 5, compared with no such provision. All alternative scenarios were dominant (cost-saving: less expensive to run and generated more QALYs) from the life-time perspective, compared with the current provision. The life-time benefit–cost ratios were: 1.87 (proactive telephone calls); 1.17 (Rx NRT); 2.40 (varenicline-standard duration); and bupropion (2.18). The results remained robust in the sensitivity analysis.ConclusionsAccording to the EQUIPTMOD modelling tool it would be cost-effective for the Spanish authorities to expand the reach of existing GP brief interventions for smoking cessation, provide pro-active telephone support, and reimburse smoking cessation medication to smokers trying to stop. Such policies would more than pay for themselves in the long run.
      PubDate: 2018-03-13T04:00:27.02701-05:0
      DOI: 10.1111/add.14090
  • Estimates of costs for modelling return on investment from smoking
           cessation interventions
    • Authors: Marta Trapero-Bertran; Reiner Leidl, Celia Muñoz, Puttarin Kulchaitanaroaj, Kathryn Coyle, Maximilian Präger, Judit Józwiak-Hagymásy, Kei Long Cheung, Mickael Hiligsmann, Subhash Pokhrel,
      Abstract: Background and aimsModelling return on investment (ROI) from smoking cessation interventions requires estimates of their costs and benefits. This paper describes a standardized method developed to source both economic costs of tobacco smoking and costs of implementing cessation interventions for a Europe-wide ROI model [European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD)].DesignFocused search of administrative and published data. A standardized checklist was developed in order to ensure consistency in methods of data collection.Setting and participantsAdult population (15+ years) in Hungary, Netherlands, Germany, Spain and England. For passive smoking-related costs, child population (0–15 years) was also included.MeasurementsCosts of treating smoking-attributable diseases; productivity losses due to smoking-attributable absenteeism; and costs of implementing smoking cessation interventions.FindingsAnnual costs (per case) of treating smoking attributable lung cancer were between €5074 (Hungary) and €52 106 (Germany); coronary heart disease between €1521 (Spain) and €3955 (Netherlands); chronic obstructive pulmonary disease between €1280 (England) and €4199 (Spain); stroke between €1829 (Hungary) and €14 880 (Netherlands). Costs (per recipient) of smoking cessation medications were estimated to be: for standard duration of varenicline between €225 (England) and €465 (Hungary); for bupropion between €25 (Hungary) and €220 (Germany). Costs (per recipient) of providing behavioural support were also wide-ranging: one-to-one behavioural support between €34 (Hungary) and €474 (Netherlands); and group-based behavioural support between €12 (Hungary) and €257 (Germany). The costs (per recipient) of delivering brief physician advice were: €24 (England); €9 (Germany); €4 (Hungary); €33 (Netherlands); and €27 (Spain).ConclusionsCosts of treating smoking-attributable diseases as well as the costs of implementing smoking cessation interventions vary substantially across Hungary, Netherlands, Germany, Spain and England. Estimates for the costs of these diseases and interventions can contribute to return on investment estimates in support of national or regional policy decisions.
      PubDate: 2018-03-13T03:25:20.906645-05:
      DOI: 10.1111/add.14091
  • Methamphetamine psychosis: insights from the past
    • Authors: Rebecca McKetin
      Abstract: Background and aimsTo review early case reports and experimental inductions of amphetamine and methamphetamine psychosis, prior to the prohibition of these drugs, to gain a better understanding of the nature and aetiology of methamphetamine psychosis.MethodsPapers considered were historical case reports and case series of psychosis relating to the use and misuse of prescription amphetamine, focusing upon papers by Young & Scoville (1938), Connell (1958), and three subsequent experimental studies published in the early 1970s (Griffith 1972, Angrist & Gershon 1970 and Bell 1973), where psychosis was induced in volunteers using high-dose amphetamine and methamphetamine.ResultsHigh-dose methamphetamine and amphetamine can result in a paranoid psychosis which remits rapidly (within days) of discontinuing use. The central feature is paranoia occurring in a clear state of consciousness. This may be accompanied by other psychotic symptoms (e.g. hallucinations). Pre-existing schizophrenia is not necessary, and the syndrome is not due to sleep deprivation.ConclusionsResearch findings from the 1930s to the 1970s suggest that paranoid psychosis should be considered a probable consequence of high-dose methamphetamine use. Individuals who experience psychotic symptoms for any substantive period after intoxication has ended should be suspected of having a functional non-organic psychosis, or a latent vulnerability thereto.
      PubDate: 2018-03-08T01:50:37.941559-05:
      DOI: 10.1111/add.14170
  • Factors associated with the efficacy of smoking cessation treatments and
           predictors of smoking abstinence in EAGLES
    • Authors: Robert West; A. Eden Evins, Neal L. Benowitz, Cristina Russ, Thomas McRae, David Lawrence, Lisa St Aubin, Alok Krishen, Melissa C. Maravic, Robert M. Anthenelli
      Abstract: AimsTo assess 1) how far efficacy of front line smoking cessation pharmacotherapies vary as a function of smoker characteristics, and 2) associations between these characteristics and success of smoking cessation attempts.DesignProspective correlational study in the context of a double blind randomised trial. The outcome was regressed individually onto each covariate after adjusting for treatment, and then a forward stepwise model constructed. Treatment moderator effects of covariates were tested by treatment-by-covariate interactions.SettingHealth service facilities in multiple countries.ParticipantsData came from 8120 smokers willing to make a quit attempt, randomized to varenicline, bupropion, nicotine replacement therapy (NRT) or placebo in Evaluating Adverse Events in a Global Smoking Cessation Study (EAGLES) between November 30, 2011 and January 13, 2015.MeasurementsSmoker characteristics measured at baseline were country, psychiatric history, sex, age, body mass index (BMI), ethnic group, lifetime suicidal ideation/behaviour, anxiety, depression, aggression, psychotropic medication, history of alcohol/substance use disorder, age of starting smoking, cigarette dependence (Fagerström Test for Cigarette Dependence [FTCD]) and prior use of study medicines. Outcome was biochemically confirmed continuous abstinence weeks 9–24 from start of treatment.FindingsNo statistically significant treatment-by-covariate interactions were found. Odds of success were independently positively associated with age (odds ratio [OR] = 1.01; 95% CI = 1.00, 1.01), BMI (1.01; 1.00, 1.02) and age of starting smoking (1.03; 1.02, 1.04). Odds were independently negatively associated with US (versus non-US) study site (0.53; 0.46, 0.61), black (versus white) ethnic group (0.57; 0.45, 0.72), mood disorder (0.85; 0.73, 0.99), anxiety disorder (0.71; 0.55, 0.90) and psychotic disorder (0.73; 0.50, 1.07), taking psychotropic medication (0.81; 0.68, 0.95), FTCD (0.89; 0.87, 0.92) and previous use of NRT (0.78; 0.67, 0.91).ConclusionsWhile a range of smoker characteristics—including psychiatric history, cigarette dependence and prior use of nicotine replacement therapy (NRT)—are associated with lower cessation rates, they do not substantially influence the efficacy of varenicline, bupropion or NRT.
      PubDate: 2018-03-06T02:10:57.054538-05:
      DOI: 10.1111/add.14208
  • Addiction: psychology & treatment by Paul Davis, Robert Patton, & Sue
           Jackson, Hoboken, NJ, USA: Wiley-Blackwell, 2018. ISBN 978-1-118-48975-8
    • Authors: Dmitri Rozgonjuk
      PubDate: 2018-03-05T21:10:35.292549-05:
      DOI: 10.1111/add.14168
  • Associations Between Personality Disorders and Cannabis Use and Cannabis
           Use Disorder: A Population-Based Twin Study
    • Authors: N. A. Gillespie; S. H. Aggen, M. C. Neale, G. P. Knudsen, R. F. Krueger, S. C. South, N. Czajkowski, R. Nesvåg, E. Ystrom, K. S. Kendler, T. Reichborn-Kjennerud
      Abstract: BACKGROUND AND AIMSIndividual differences in DSM-IV personality disorders (PDs) are associated with increased prevalence of substance use disorders. Our aims were to determine which combination of PDs trait scores best predict cannabis use (CU) and cannabis use disorder (CUD), and to estimate the size and significance of genetic and environmental risks in PD traits shared with CU and CUD.DESIGNLinear mixed effects models were used to identify PD traits for inclusion in twin analyses to explore the genetic and environmental associations between the traits and cannabis use.SETTINGCross-sectional data were obtained from Norwegian adult twins in a face-to-face interview in 1999-2004 as part of a population-based study of mental health.PARTICIPANTSSubjects were 1,419 twins (μage=28.2 years, range=19-36) from the Norwegian Institute of Public Health Twin Panel with complete PD and cannabis data.MEASUREMENTSPD traits were assessed using DSM-IV criteria. Lifetime CU and CUD were based on DSM-IV abuse and dependence criteria, including withdrawal and craving.FINDINGSAfter adjusting for age and sex, Antisocial (ß=0.23, 95% CI=0.19 - 0.28) and Borderline PDs (ß=0.20, 95% CI=0.14 - 0.26) were strongly associated with CU. Antisocial (ß=0.26, 95% CI=0.21 - 0.31) and Borderline PDs (ß=0.12, 95% CI=0.06 - 0.18) were also strongly linked to CUD. Genetic risks in Antisocial and Borderline PD traits explained 32-60% of the total variance in CU and CUD. Dependent and Avoidant PDs explained 11% and 16% of the total variance in CU and CUD respectively.CONCLUSIONSIndividual differences in the liability to cannabis use and cannabis use disorder appear to be linked to genetic risks correlated with Antisocial and Borderline personality disorder traits.
      PubDate: 2018-03-03T01:55:22.957388-05:
      DOI: 10.1111/add.14209
  • Extended-release naltrexone (XR-NTX) for opioid use disorder in clinical
           practice: Vivitrol's Cost and Treatment Outcomes Registry
    • Authors: Andrew J. Saxon; Sarah C. Akerman, Chih Chin Liu, Maria A. Sullivan, Bernard L. Silverman, Frank J. Vocci
      Abstract: Background and AimsExtended-release naltrexone (XR-NTX), a μ-opioid receptor antagonist for prevention of relapse to opioid dependence, has demonstrated efficacy compared with placebo and comparative effectiveness with buprenorphine-naloxone. We report outcomes for XR-NTX in Vivitrol's Cost and Treatment Outcomes Registry.DesignObservational, open-label, single-arm, multicenter registry assessing baseline characteristics and clinical and health-related quality-of-life outcomes associated with XR-NTX treatment in clinical practice.Setting32 US treatment centers from 2011 to 2013.ParticipantsPatients with opioid dependence who were prescribed XR-NTX treatment and then enrolled in the registry.MeasurementsMonthly visits were evaluated for the full population and for patient subgroups retrospectively, defined by injection number, focusing on the period between baseline and month 6 (1-, 2/3-, or 6-XR-NTX).FindingsOf 403 enrolled patients, 395 were analyzed. Most patients (n=349) received outpatient care. On average, patients received 5 injections (median 3; range 1-25). The median number of injections administered within 6 months was higher in patients who at baseline were employed (3 vs 2 unemployed, P=0.02) or had private insurance (5 vs 2 self-payment, P=0.005; vs 2 state-funded, P
      PubDate: 2018-03-01T09:00:01.514325-05:
      DOI: 10.1111/add.14199
  • A survey of tobacco dependence treatment guidelines content in 61
    • Authors: Kapka Nilan; Ann McNeill, Rachael L. Murray, Tricia M. McKeever, Martin Raw
      Abstract: AimsTo assess tobacco dependence treatment guidelines content in accordance with Article 14 of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) and its guidelines, and association between content and country income level.DesignCross sectional study.SettingOnline survey from March to July 2016.ParticipantsContacts in 77 countries, including 68 FCTC Parties, six Signatories and three non-Parties which had indicated having guidelines in previous surveys, or had not been surveyed before.MeasurementsA nine item questionnaire on guidelines content, key recommendations, writing and dissemination.FindingsWe received responses from contacts in 63 countries (82%); 61 had guidelines. The majority are for doctors (93%), primary care (92%) and nurses (75%). All recommend brief advice, 82% recording tobacco use in medical notes, 98% nicotine replacement therapy (NRT), 61% quitlines, 31% text messaging, 87% intensive specialist support, and 54% stress the importance of healthcare workers not using tobacco. Only 57% have a dissemination strategy, and 62% have not been updated for five or more years. Compared with high income countries, quitlines are less likely to be recommended in upper middle income countries guidelines, OR 0.15 (95% CI 0.04 - 0.61), and intensive specialist support in lower middle income countries guidelines, OR 0.01 (95%CI 0.00 – 0.20). Guidelines updating is positively associated with country income level (p =0.027).ConclusionsAlthough most tobacco dependence treatment guidelines in the 61 countries assessed in 2016 follow the WHO's Framework Convention on Tobacco Control Article 14 recommendations and do not differ significantly by income level, improvements are needed in keeping guidelines up-to-date, applying good writing practices, and developing a dissemination strategy.
      PubDate: 2018-02-28T02:20:23.611438-05:
      DOI: 10.1111/add.14204
  • Immediate effects on adult drinkers of exposure to alcohol harm reduction
           advertisements with and without drinking guideline messages: experimental
    • Authors: Melanie A. Wakefield; Emily Brennan, Kimberley Dunstone, Sarah J. Durkin, Helen G. Dixon, Simone Pettigrew, Michael D. Slater
      Abstract: AimsTo compare the immediate effects on drinkers of television advertisements focusing upon short- versus long-term harms with and without low-risk drinking guidelines.DesignBetween-participants on-line experiment, with random assignment to view: (a) alcohol product advertisements (ALC control); (b) advertisements unrelated to alcohol (NON-ALC control); (c) advertisements featuring short-term harms (STH) of alcohol; (d) advertisements featuring STH plus a STH guideline (STH+G); (e) advertisements featuring long-term harms (LTH); or (f) advertisements featuring LTH plus a LTH guideline (LTH+G).SettingAustralia, 2016.ParticipantsA total of 3718 drinkers aged 18–64 years (48.5% male).MeasurementsPost-exposure likelihood that participants provided a correct estimate of drinking levels associated with short- and long-term harms; post-exposure intentions to avoid alcohol or reduce consumption.FindingsAfter exposure to STH+G or LTH+G advertisements, participants were more likely to estimate correctly rather than overestimate drinking levels associated with harm, compared with those exposed to STH (P 
      PubDate: 2018-02-27T14:00:02.510579-05:
      DOI: 10.1111/add.14147
  • ”Are The Times A-Changin’”' Trends in Adolescent
           Substance Use in Europe
    • Authors: Ludwig Kraus; Nicki-Nils Seitz, Daniela Piontek, Sabrina Molinaro, Valeria Siciliano, Ulf Guttormsson, Sharon Arpa, Karin Monshouwer, Håkan Leifman, Julian Vicente, Paul Griffiths, Luke Clancy, Fernanda Feijão, Silvia Florescu, Patrick Lambrecht, Alojz Nociar, Kirsimarja Raitasalo, Stanislas Spilka, Konstantin Vyshinskiy, Björn Hibell
      Abstract: AimsTo estimate temporal trends in adolescents’ current cigarette, alcohol and cannabis use in Europe by gender and region, test for regional differences, and evaluate regional convergence.Design and SettingFive waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 28 countries between 1999 and 2015. Countries were grouped into five regions (Northern (NE), Southern (SE), Western (WE), Eastern Europe (EE), the Balkans (BK)).ParticipantsA total of 223,814 male and 211,712 female 15- to 16-year old students.MeasurementsDaily cigarette use, weekly alcohol use, monthly heavy episodic drinking (HED), and monthly cannabis use. Linear and quadratic trends were tested using multilevel mixed-effects logistic regression; regional differences were tested using pairwise Wald tests; mean absolute differences (MD) of predicted prevalence were used for evaluating conversion.FindingsDaily cigarette use among boys in EE showed a declining curvilinear trend, whereas in all other regions a declining linear trend was found. With the exception of BK, trends of weekly drinking decreased curvilinear in both genders in all regions. Among girls, trends in WE, EE and BK differed from trends in NE and SE. Monthly HED showed increasing curvilinear trends in all regions except in NE (both genders), WE and EE (boys each). In both genders, the trend in EE differed from the trend in SE. Trends of cannabis use increased in both genders in SE and BK; differences were found between the curvilinear trends in EE and BK. MD by substance and gender were generally rather stable over time.ConclusionsDespite regional differences in prevalence of substance use among European adolescents from 1999 to 2015, trends showed remarkable similarities with strong decreasing trends in cigarette use and moderate decreasing trends in alcohol use. Trends of cannabis use only increased in Southern Europe and the Balkans. Trends across all substance use indicators suggest no regional convergence.
      PubDate: 2018-02-26T22:30:37.942553-05:
      DOI: 10.1111/add.14201
  • Baclofen: its effectiveness in reducing harmful drinking, craving, and
           negative mood. A meta-analysis
    • Authors: Abigail K. Rose; Andrew Jones
      Abstract: Background and AimsThere are a limited number of pharmacotherapies licensed for alcohol use disorders (AUDs). Baclofen is a GABA-B agonist which is increasingly used as an off label treatment. A meta-analysis of randomised controlled trials (RCTs) was conducted to determine the efficacy of baclofen in reducing drinking behaviour, craving, depression, and anxiety, compared with placebo.MethodsRandom effects meta-analyses were computed on outcome data from 12 RCTs comparing baclofen with placebo. Included RCTs provided data on at least one of the primary outcome measures (drinking related: heavy drinking days, abstinent days, abstinence rates), or secondary outcome measures (craving, anxiety, depression).ResultsBaclofen had a significant effect on abstinence rates when using Intention to Treat analysis (Total N# Baclofen = 307, Total N# Control = 283: OR= 2.67 [95% CI 1.03, 6.93]; Z= 2.01, p = .04, I2= 76%, NNT = 8). No other significant effects of treatment efficacy (e.g. heavy drinking days: SMD= -.26 [95% CI -0.68, 0.15]; Z= 1.24, p= .21, I2= 95%) or mechanism of action (e.g. craving: SMD= -0.13 [95% CI = -0.36, 0.09]; Z= 1.18, p= .24, I2= 87%) were observed. There was substantial heterogeneity in effect sizes across each analysis.ConclusionsAs a treatment for alcohol use disorders (AUDs), baclofen is associated with higher rates of abstinence than placebo. However, there is no superior effect of baclofen on increasing number of abstinent days, or decreasing heavy drinking, craving, anxiety or depression. These results suggest that the current increasing use of baclofen as a treatment for AUDs is premature.
      PubDate: 2018-02-26T04:00:01.154423-05:
      DOI: 10.1111/add.14191
  • Medical marijuana laws and adolescent marijuana use in the United States:
           A systematic review and meta-analysis
    • Authors: Aaron L. Sarvet; Melanie M. Wall, David S. Fink, Emily Greene, Aline Le, Anne E. Boustead, Rosalie Liccardo Pacula, Katherine M. Keyes, Magdalena Cerdá, Sandro Galea, Deborah S. Hasin
      Abstract: AimsTo conduct a systematic review and meta-analysis of studies in order to estimate the effect of US medical marijuana laws (MMLs) on past-month marijuana use prevalence among adolescents.MethodsA total of 2999 papers from 17 literature sources were screened systematically. Eleven studies, developed from four ongoing large national surveys, were meta-analyzed. Estimates of MML effects on any past-month marijuana use prevalence from included studies were obtained from comparisons of pre–post MML changes in MML states to changes in non-MML states over comparable time-periods. These estimates were standardized and entered into a meta-analysis model with fixed-effects for each study. Heterogeneity among the study estimates by national data survey was tested with an omnibus F-test. Estimates of effects on additional marijuana outcomes, of MML provisions (e.g. dispensaries) and among demographic subgroups were abstracted and summarized. Key methodological and modeling characteristics were also described. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.ResultsNone of the 11 studies found significant estimates of pre–post MML changes compared with contemporaneous changes in non-MML states for marijuana use prevalence among adolescents. The meta-analysis yielded a non-significant pooled estimate (standardized mean difference) of −0.003 (95% confidence interval = −0.012, +0.007). Four studies compared MML with non-MML states on pre-MML differences and all found higher rates of past-month marijuana use in MML states pre-MML passage. Additional tests of specific MML provisions, of MML effects on additional marijuana outcomes and among subgroups generally yielded non-significant results, although limited heterogeneity may warrant further study.ConclusionsSynthesis of the current evidence does not support the hypothesis that US medical marijuana laws (MMLs) until 2014 have led to increases in adolescent marijuana use prevalence. Limited heterogeneity exists among estimates of effects of MMLs on other patterns of marijuana use, of effects within particular population subgroups and of effects of specific MML provisions.
      PubDate: 2018-02-22T04:00:01.501255-05:
      DOI: 10.1111/add.14136
  • It is premature to expand access to medicinal cannabis in hopes of solving
           the US opioid crisis
    • Authors: Wayne Hall; Robert West, John Marsden, Keith Humphreys, Jo Neale, Nancy Petry
      PubDate: 2018-02-22T04:00:00.481183-05:
      DOI: 10.1111/add.14139
  • Harms, benefits and the policing of cryptomarkets: a response to
    • Authors: Judith Aldridge; Alex Stevens, Monica J. Barratt
      Abstract: Commentary to: Will growth in cryptomarket drug buying increase the harms of illicit drugs'
      PubDate: 2018-02-21T21:40:31.00328-05:0
      DOI: 10.1111/add.14169
  • Euthanasia and addiction: a comment from the Netherlands
    • Authors: Theo Boer
      Abstract: Commentary to: The need to exercise caution in accepting addiction as a reason for performing euthanasia
      PubDate: 2018-02-21T21:30:39.258188-05:
      DOI: 10.1111/add.14162
  • The effects of prescribing varenicline on two-year health outcomes: an
           observational cohort study using electronic medical records
    • Authors: Neil M. Davies; Gemma M. J. Taylor, Amy E. Taylor, Timothy Jones, Richard M. Martin, Marcus R. Munafò, Frank Windmeijer, Kyla H. Thomas
      Abstract: AimsTo investigate whether smokers prescribed varenicline had lower risks of serious ill-health during the 4 years following treatment compared with those prescribed nicotine replacement therapy (NRT).DesignObservational cohort study of electronic medical records.SettingA total of 370 UK general practices sampled from the Clinical Practice Research Datalink.ParticipantsA total of 126 718 patients aged 18 and over who were issued smoking cessation prescriptions between 1 September 2006 and 31 March 2014.MeasurementsOur primary outcome was all-cause mortality within 2 years of first prescription as indicated by linked Office of National Statistics data. Our secondary outcomes were cause-specific mortality, all-cause, cause-specific hospitalization, primary care diagnosis of myocardial infarction or chronic obstructive pulmonary disease (COPD), body mass index and attendance rate to primary care within 2 years of first prescription. Risk differences and 95% confidence intervals were estimated by multivariable adjusted regression and propensity score matched regression. We used instrumental variable analysis to overcome residual confounding.FindingsPeople prescribed varenicline were healthier at baseline than those prescribed NRT in almost all characteristics, highlighting the potential for residual confounding. Our instrumental variable analysis results found that people prescribed varenicline had a similar risk of mortality at 2 years [risk difference per 100 patients treated = 0.67, 95% confidence interval (CI) = -0.11 to 1.46)] to those prescribed NRT, and there were similar rates of all-cause hospitalization, incident primary-care diagnoses of myocardial infarction and COPD. People prescribed varenicline subsequently attended primary care less frequently.ConclusionsSmokers prescribed varenicline in primary care in the United Kingdom do not appear to be less likely to die, be hospitalized or experience a myocardial infarction or chronic obstructive pulmonary disease during the following 2 years compared with smokers prescribed nicotine replacement therapy, but they gain more weight and attend primary care less frequently.
      PubDate: 2018-02-20T04:00:01.250525-05:
      DOI: 10.1111/add.14146
  • Trajectory Classes of Cannabis Use and Heavy Drinking among Rural African
           American Adolescents: Multilevel Predictors of Class Membership
    • Authors: Allen W. Barton; Gene. H. Brody, Tamika C. B. Zapolski, Trenette C. Goings, Steven M. Kogan, Michael Windle, Tianyi Yu
      Abstract: AimsTo inform research on the etiology and prevention of substance use among rural African American youth by (a) identifying developmental trajectory classes of cannabis use and heavy drinking across adolescence and young adulthood, and (b) examining associations between trajectory class membership and multi-level assessments of risk factors.DesignA prospective study spanning nine years with assessments of cannabis use and heavy drinking, the catecholamines epinephrine and norepinephrine, perceived stress, and psychosocial risk factors.SettingRural communities in the southeastern United States.ParticipantsAfrican American youth (N = 518).MeasurementsParticipants were assessed for cannabis use and heavy drinking at seven assessments beginning at 16 years of age and continuing to 25 years of age. At age 19, participants provided overnight urine voids that were assayed for catecholamines, a biological marker of life stress resulting from sympathetic nervous system activation. At ages 16 and 19, participants provided information on malleable psychosocial risk factors.FindingsLatent class growth models revealed three distinct trajectory classes for cannabis use and for heavy drinking. Higher levels of circulating stress hormones and perceived stress were associated with classes reporting greater substance use over time (all ps < .05). A composite of selected risk factors discriminated class membership (all ps < .05). Trajectory classes characterized by rapid usage increases in early adulthood exhibited the greatest increase in deviant peer affiliations between ages 16 and 19.ConclusionsRural African American youths’ cannabis use and heavy drinking across adolescence and young adulthood demonstrate distinct developmental courses; a small number of risk factors and measures of biological and perceived stress prognostically differentiate class membership. Variability over time in these measures, specifically an increase in deviant peer affiliation, may help to account for steep increases in young adulthood.
      PubDate: 2018-02-17T13:00:22.984403-05:
      DOI: 10.1111/add.14200
  • An investigation of an open-access model for scaling up methadone
           maintenance treatment
    • Authors: Lynn M. Madden; Scott O. Farnum, Kathryn F. Eggert, Andrew R. Quanbeck, Robert Freeman, Samuel A. Ball, Richard S. Schottenfeld, Julia M. Shi, Mary Ellen Savage, Declan T. Barry
      Abstract: AimsTo retrospectively examine patient and programmatic outcomes following the development and implementation of an “open-access” model in which prospective patients were enrolled rapidly in methadone maintenance treatment, irrespective of ability to pay, and provided real-time access to multiple voluntary treatment options.DesignMedical and administrative records were abstracted to compare data for one year before and 9 years after initiating the implementation of an open-access treatment model in May 2007.SettingMethadone maintenance treatment center in Connecticut, USA.ParticipantsIndividuals with opioid use disorder entering treatment between July 2006 and June 2015. In June 2015, 64% (n=2,594) of the sample were men, and 80% (n=3,133) reported that they were White.InterventionThe Network for the Improvement of Addiction Treatment-informed open-access treatment model uses process improvement strategies to imprve treatment access and capacity.MeasurementsCensus, wait time, retention, nonmedical opioid use, patient mortality, and financial sustainability (net income and state-block grants as proportions of revenue).FindingsIn the 9 years following the initial implementation of the open-access model, patient census increased by 183% from 1,431 to 4,051, and average wait-time days decreased from 21 to
      PubDate: 2018-02-17T10:00:24.971783-05:
      DOI: 10.1111/add.14198
  • Formulating more consistent public health policies towards cannabis and
    • Authors: Wayne Hall; Lynn Kozlowski
      Abstract: Commentary to: The diverging trajectories of cannabis and tobacco policies in the United States: reasons and possible implications
      PubDate: 2018-02-17T02:41:15.433798-05:
      DOI: 10.1111/add.14161
  • Alcohol, pattern of drinking and all-cause mortality in Russia, Belarus
           and Hungary: a retrospective indirect cohort study based on mortality of
    • Authors: Pia Horvat; Denes Stefler, Michael Murphy, Lawrence King, Martin McKee, Martin Bobak
      Abstract: AimsTo assess the relationship between alcohol intake frequency and mortality among males and females in three Eastern European populations, and to estimate the additional mortality risk posed by a combination of frequent drinking, binge drinking and other hazardous drinking habits.DesignRetrospective cohort study; the cohort consisted of close relatives of survey participants.SettingMiddle-sized settlements in Russia, Belarus and Hungary.Participants124,150 subjects aged 35-69 years in 1998 and followed-up until 2013.MeasurementsSurvey respondents provided information on their mothers, fathers, siblings and partners of female respondents. This information, including current vital status and dates of birth and death, was used to construct the cohort of relatives. Alcohol consumption indices, reported by survey participants, included drinking frequency, binge drinking and hazardous drinking (consuming non-beverage and/or illicitly-produced alcohol and/or heavy drinking over several days [zapoi in Russian]).FindingsDrinking frequency was positively associated with mortality in all three countries and both genders. At each drinking frequency level, mortality risk increased among those who also engaged in binge and/or hazardous drinking. Regular male drinkers who were also binge drinkers and hazardous drinkers had the highest risk of death; their hazard ratios (HR), compared with non-binge-non-hazardous occasional drinkers, were 2.56 [95% CI 2.27-2.88], 2.14 [1.84-2.48] and 2.11 [1.90-2.35] in Russia, Belarus and Hungary, respectively. In women, the corresponding HRs (using a lower frequency cut-off) were 2.86 [1.99-4.12] in Russia, 3.44 [2.17-5.44] in Belarus and 3.01 [2.26-4.01] in Hungary.ConclusionsDrinking frequency is positively associated with mortality among men and women in Russia, Belarus and Hungary. The mortality risk is higher among frequent drinkers who exhibit binge and hazardous drinking patterns.
      PubDate: 2018-02-15T08:10:27.042675-05:
      DOI: 10.1111/add.14189
  • Neonatal Outcomes after Fetal Exposure to Methadone and Buprenorphine:
           National Registry Studies from the Czech Republic and Norway
    • Authors: Blanka Nechanská; Viktor Mravčík, Svetlana Skurtveit, Ingunn Olea Lund, Roman Gabrhelík, Anders Engeland, Marte Handal
      Abstract: Background and AimsOpioid maintenance treatment (OMT) is recommended to opioid dependent females during pregnancy. However, it is not clear which medication should be preferred. We aimed to compare neonatal outcomes after prenatal exposure to methadone (M) and buprenorphine (B) in two European countries.DesignNationwide register-based cohort study using personalized IDs assigned to all citizens for data linkage.SettingThe Czech Republic (2000–2014) and Norway (2004–2013).ParticipantsOpioid dependent pregnant Czech (N = 333) and Norwegian (N = 235) women in OMT who received either B or M during pregnancy and their new-borns.MeasurementsWe linked data from health registries to identify the neonatal outcomes: gestational age, preterm birth, birth weight, length and head circumference, small for gestational age, miscarriages and stillbirth, neonatal abstinence syndrome (NAS) and Apgar score. We performed multivariate linear regression and binary logistic regression to explore the associations between M and B exposure and outcomes. Regression coefficient (b) and Odds ratio (OR) were computed.FindingsMost neonatal outcomes were more favourable after exposure to B as compared with M, but none of the differences was statistically significant. For instance, in the multivariate analysis birth weight was b = 111.6 g (95% confidence interval (CI) = -10.5 – 233.6) and b = 83.1 g (95% CI = -100.8 – 267.0) higher after B exposure in the Czech Republic and Norway, respectively. Adjusted OR of NAS for B compared with M was 0.94 (95% CI = 0.46 – 1.92) in the Norwegian cohort.ConclusionsTwo national cohorts of women receiving opioid maintenance treatment during pregnancy, showed small but not statistically significant differences in neonatal outcomes in favour of buprenorphine compared with methadone.
      PubDate: 2018-02-14T10:30:22.521373-05:
      DOI: 10.1111/add.14192
  • Fulfilling the promise of choice architecture interventions for addictive
    • Authors: Jalie A. Tucker
      PubDate: 2018-02-12T21:05:31.890713-05:
      DOI: 10.1111/add.14148
  • Corrected US opioid-involved drug poisoning deaths and mortality rates,
    • Authors: Christopher J. Ruhm
      Abstract: Background and AimsMost prior estimates of opioid-involved drug poisoning mortality counts or rates are understated because the specific drugs leading to death are frequently not identified on death certificates. This analysis provides corrected national estimates of opioid and heroin/synthetic opioid-involved counts and mortality rates, as well as changes over time in them from 1999 to 2015.MethodsData on drug poisoning deaths to US residents from 1999 to 2015, obtained from the Centers for Disease Control and Prevention (CDC) Multiple Cause of Death (MCOD) files, were used with the drugs involved in fatal overdoses imputed when not identified on the death certificates.ResultsThe official CDC figure that 33 091 drug deaths involved opioids in 2015 is an undercount, with the actual number being approximately 39 999. Corrected counts and rates of any opioid and heroin/synthetic opioid-involved drug deaths are 20–35% higher in every year than reported figures. The corrections almost always raise the changes estimated to have occurred since 1999, with the largest differences observed in 2011 for any opioids (5677 deaths and 1.7 per 100 000) and in 2015 for heroin/synthetic opioids (3228 deaths and 1.0 per 100 000). However, percentage growth since 1999 is sometimes slower when based on corrected rather than reported fatality data, and with sensitivity to the choice of base years.ConclusionsDeath certificate reports understate the prevalence of and changes over time in opioid and heroin/synthetic opioid-involved drug mortality in the United States. Adjustments imputing the drugs involved for cases where none are identified on the death certificates are likely to provide more accurate estimates.
      PubDate: 2018-02-12T01:05:50.971228-05:
      DOI: 10.1111/add.14144
  • Assessment of cost-effective changes to the current and potential
           provision of smoking cessation services: an analysis based on the
    • Authors: Charlotte Anraad; Kei-Long Cheung, Mickaël Hiligsmann, Kathryn Coyle, Doug Coyle, Lesley Owen, Robert West, Hein Vries, Silvia M. Evers, Subhash Pokhrel
      Abstract: Background and aimsIncreasing the reach of smoking cessation services and/or including new but effective medications to the current provision may provide significant health and economic benefits; the scale of such benefits is currently unknown. The aim of this study was to estimate the cost-effectiveness from a health-care perspective of viable national level changes in smoking cessation provision in the Netherlands and England.MethodsA Markov-based state transition model [European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD)] was used to estimate costs and benefits [expressed in quality-adjusted life years (QALY)] of changing the current provision of smoking cessation programmes in the Netherlands and England. The changes included: (a) increasing the reach of top-level services to increase potential quitters (e.g. brief physician advice); (b) increasing the reach of behavioural support (group-based therapy and SMS text-messaging support) to increase the success rates; (c) including a new but effective medication (cytisine); and (d) all changes implemented together (combined change). The costs and QALYs generated by those changes over 2, 5, 10 years and a life-time were compared with that of the current practice in each country. Results were expressed as incremental net benefit (INB) and incremental cost-effectiveness ratio (ICER). A sequential analysis from a life-time perspective was conducted to identify the optimal change.ResultsThe combined change was dominant (cost-saving) over all alternative changes and over the current practice, in both countries. The combined change would generate an incremental net benefit of €11.47 (2 years) to €56.16 (life-time) per smoker in the Netherlands and €9.96 (2 years) to €60.72 (life-time) per smoker in England. The current practice was dominated by all alternative changes.ConclusionCurrent provision of smoking cessation services in the Netherlands and England can benefit economically from the inclusion of cytisine and increasing the reach of brief physician advice, text-messaging support and group-based therapy.
      PubDate: 2018-02-11T22:20:23.769544-05:
      DOI: 10.1111/add.14093
  • ‘Addressed to you not as a smoker… but as a doctor’: doctor-targeted
           cigarette advertisements in JAMA
    • Authors: Robert K. Jackler; Noel F. Ayoub
      Abstract: Background and aimDuring the mid-20th century tobacco companies placed advertisements in medical journals to entice physicians to smoke their brand and, more importantly, to recommend it to their patients. They have been little studied, in part because advertising sections in medical journals are almost universally discarded before binding. This study aimed to define the themes and techniques used in doctor-targeted tobacco advertisements that appeared in American medical journals in the mid-20th century and determine the motivations and tactics of the tobacco industry in engaging the medical profession in this way.MethodsDoctor-targeted tobacco advertisements from JAMA and the New York State Medical Journal appearing between 1936 and 1953 were studied. These were obtained from the New York Academy of Medicine and the UCSF Truth database of tobacco industry documents. Content analysis of advertising slogans and imagery was conducted. Using internal tobacco industry documents, we examined the relationship between tobacco advertisers and medical journals.ResultsAmong the 519 doctor-targeted advertisements, 13 brands were represented, with two (Philip Morris and Camel) accounting for 84%. Correspondence between tobacco advertisers and medical journal editors reveals the potent influence of revenue to the sponsoring society and personal compensation derived from consulting arrangements. Content analysis of the advertisements revealed much flattery of doctors and arguments professing the harmlessness of the company's brand.ConclusionsAnalysis of doctor-targeted tobacco advertisements in American medical journals from 1936 to 1953 suggest that tobacco companies targeted physicians as a potential sales force to assuage the public's fear of health risks and to recruit them as allies against negative publicity. Tobacco companies also appeared to try, through the substantial advertising revenue passed by journals to their parent medical societies, to temper any possible opposition by organized medicine.
      PubDate: 2018-02-07T20:01:38.059805-05:
      DOI: 10.1111/add.14151
  • Do predictors of smoking relapse change as a function of duration of
           abstinence' Findings from the United States, Canada, United Kingdom
           and Australia
    • Authors: Hua-Hie Yong; Ron Borland, K. Michael Cummings, Timea Partos
      Abstract: AimsTo estimate predictors of time to smoking relapse and test if prediction varied by quit duration.DesignLongitudinal cohort data from the International Tobacco Control Four-Country survey with annual follow up collected between 2002 and 2015.SettingCanada, US, UK and Australia.ParticipantsA total of 9,171 eligible adult smokers who made at least one quit attempt over the study period.MeasurementsTime to relapse was the main outcome. Predictor variables included pre-quit baseline measures of nicotine dependence, smoking and quitting related motivations, quitting capacity, and social influence, and also two post-quit measures, use of stop-smoking medications and quit duration (1-7 days, 8-14 days, 15-31 days, 1-3 months, 3-6 months, 6-12 months, 1-2 years and 2+ years), along with socio-demographics.FindingsAll factors were predictive of relapse within the first six months of quitting but only wanting to quit, quit intentions and number of friends who smoke were still predictive of relapse in the 6-12 months period of quitting (hazard ratios [HR]=1.20, p=.018; 1.13, p=.040; and 1.21, p
      PubDate: 2018-02-06T02:15:23.738721-05:
      DOI: 10.1111/add.14182
  • Estimating the healthcare costs of children born to pregnant smokers in
           England: cohort study using primary and secondary healthcare data.
    • Authors: L. R. Vaz; M. J. Jones, L. Szatkowski, L. J. Tata, S. Petrou, T. Coleman
      Abstract: Background and aimsLittle is known about the long term economic consequences of smoking during pregnancy. We estimated the association between smoking in pregnancy and the costs of delivering healthcare to infants and children in England, and investigated which aspects of care are the key drivers of these costs.MethodsWe used Hospital Episode Statistics (HES) linked with Clinical Practice Research Datalink (CPRD) data in England from January 2003 until January 2015 in children with longitudinal data for at least one, five and ten years after birth. Poisson regression provided rate ratios (RR) and 95% confidence intervals (CIs) comparing healthcare episode rates between those exposed and not exposed to smoking during pregnancy. Linear regression was used to compare estimated costs between groups (£ sterling, 2015 prices) and generalized linear multivariable (GLM) models adjusted for potentially moderating factors.ResultsA total of 93,152 singleton pregnancies with the required data were identified. Maternal smoking in pregnancy was associated with higher primary care, prescription and hospital inpatient episode rates, but lower outpatient visit and diagnostic test rates. Adjusting for year of birth, socio-economic deprivation, parity, sex of child and delivery method showed that maternal smoking in pregnancy was associated with increased child healthcare costs at 1 year (average cost difference for children of smokers, β: £91.18, 95%CI: £47.52-£134.83) and 5 years of age (β: £221.80, 95%CI: £17.78-£425.83), but not at 10 years of age (β: £365.94, 95%CI: -£192.72-£924.60).ConclusionIn England, maternal smoking in pregnancy is associated with increased child healthcare costs over the first five years of life; these costs are primarily driven by greater hospital inpatient care.
      PubDate: 2018-02-03T06:25:21.567261-05:
      DOI: 10.1111/add.14183
  • The relationship between methamphetamine use and heterosexual behaviour:
           Evidence from a prospective longitudinal study
    • Authors: Rebecca McKetin; Dan I. Lubman, Amanda Baker, Sharon Dawe, Joanne Ross, Richard P. Mattick, Louisa Degenhardt
      Abstract: AimsTo estimate the extent to which specific sexual behaviours (being sexually active, having multiple sex partners, casual sex, condomless casual sex, anal sex, and condomless anal sex) change during periods of methamphetamine use.DesignWithin-person estimates for the relationship between methamphetamine use and sexual behaviour were derived from longitudinal panel data from the MATES cohort (2006 to 2010).SettingSydney and Brisbane, Australia.ParticipantsParticipants (N = 319) were recruited through treatment and other health services, self-identified as heterosexual, were aged 17 to 51 years, 75% were male and all were dependent on methamphetamine on study entry.MeasurementsDays of methamphetamine use in the past month, and sexual behaviour in the past month, were both assessed using the Opiate Treatment Index.FindingsWhen using methamphetamine, participants had double the odds of being sexually active compared with when they were not using, after adjustment for demographics and other substance use (Adjusted Odds Ratio [AOR] = 1.9, p = .010). When participants were sexually active, they were more likely to have multiple sex partners (AOR = 3.3, p = .001), casual sex partners (AOR 3.9, p < .001), and condomless casual sex (AOR = 2.6, p .012) when using methamphetamine than when they were not using. During months when participants had a casual sex partner, there was no significant reduction in their likelihood of condom use when they were using methamphetamine. There was no significant change in the likelihood of having anal sex or condomless anal sex during months of methamphetamine use.ConclusionsMethamphetamine use is associated with a dose-related increase in being sexually active, having multiple sex partners and casual sex partners, and having condomless sex with casual partners, but it is not associated with a change in condom use per se.
      PubDate: 2018-02-03T06:00:23.974916-05:
      DOI: 10.1111/add.14181
  • Extended-release injectable naltrexone for opioid use disorder: A
           systematic review
    • Authors: Brantley P. Jarvis; August F. Holtyn, Shrinidhi Subramaniam, D. Andrew Tompkins, Emmanuel A. Oga, George E. Bigelow, Kenneth Silverman
      Abstract: AimsTo review systematically the published literature on extended-release naltrexone (XR-NTX, Vivitrol®), marketed as a once-per-month injection product to treat opioid use disorder. We addressed the following questions: (1) How successful is induction on XR-NTX'; (2) What are adherence rates to XR-NTX'; and (3) Does XR-NTX decrease opioid use' Factors associated with these outcomes as well as overdose rates were examined.MethodsWe searched PubMed and used Google Scholar for forward citation searches of peer-reviewed articles from January 2006 to June 2017. Studies that included individuals seeking treatment for opioid use disorder who were offered XR-NTX were included.ResultsWe identified and included 34 studies. Pooled estimates showed that XR-NTX induction success was lower in studies that included individuals that required opioid detoxification (62.6% [95% CI: 54.5% - 70.0%]) compared with studies that included individuals already detoxified from opioids (85.0% [95% CI: 78.0% - 90.1%]). 44.2% (95% CI: 33.1% - 55.9%) of individuals took all scheduled injections of XR-NTX, which were usually 6 or less. Adherence was higher in prospective investigational studies (i.e., studies conducted in a research context according to a study protocol) compared to retrospective studies of medical records taken from routine care (6-month rates: 46.7% [95% CI: 34.5% - 59.2%] vs. 10.5% [95% CI: 4.6%-22.4%], respectively). Compared with referral to treatment, XR-NTX reduced opioid use in adults under criminal justice supervision and when administered to inmates before release. XR-NTX reduced opioid use compared with placebo in Russian adults, but this effect was confounded by differential retention between study groups. XR-NTX showed similar efficacy to buprenorphine when randomization occurred after detoxification but was inferior to buprenorphine when randomization occurred prior to detoxification.ConclusionsMany individuals intending to start extended-release naltrexone (XR-NTX) do not and most who do start XR-NTX discontinue treatment prematurely, two factors that limit its clinical utility significantly. XR-NTX appears to decrease opioid use but there are few experimental demonstrations of this effect.
      PubDate: 2018-02-03T05:10:21.408668-05:
      DOI: 10.1111/add.14180
  • Four-year follow-up of an internet-based brief intervention for unhealthy
           alcohol use in young men
    • Authors: Nicolas Bertholet; Joseph Studer, John A. Cunningham, Gerhard Gmel, Bernard Burnand, Jean-Bernard Daeppen
      Abstract: AimTo estimate the long-term efficacy of an internet-based brief intervention (IBI) in decreasing alcohol use among men on 1.) number of drinks/week and 2.) monthly or more binge drinking prevalence. In addition, overall changes in alcohol use were assessed.DesignParticipants in a cohort study were recruited in a two parallel-group randomized controlled trial of an IBI versus no-intervention control condition, showing a positive intervention effect at 6 months. As part of the regular cohort assessments, participants were re-assessed 47 months after the initial trial, offering an opportunity to determine long-term efficacy.SettingYoung Swiss men from the general population.ParticipantsOf 737 randomized trial participants with unhealthy alcohol use (>14 drinks/week or ≥ 6 drinks/occasion at least monthly, or Alcohol Use Disorders Identification Test (AUDIT) ≥ 8), 622 completed a cohort assessment at mean (SD) 47.4(2.6) months after their randomized trial baseline assessment.InterventionIBI: normative and personalized feedback on alcohol use, risk indicators, information about alcohol and health, and recommendations. Controls: assessment only.MeasurementsSelf-reported number of drinks/week and monthly or more binge drinking prevalence.FindingsComparisons at follow-up were adjusted for baseline drinking. Missing values were replaced with the last observation carried forward. There was no evidence of differences between the IBI and control group on either the number of drinks/week (IBI: 10.8[14.2]; control: 10.7[14.1], p=0.8) or monthly or more binge drinking prevalence (IBI: 65.1%; control: 63.5%, p=0.5). Although there was no evidence of overall change from baseline in number of drinks/week (9.8[7.9] at baseline, 10.8[14.1] at 47 months, p=0.051), there was evidence that monthly or more binge drinking prevalence had decreased over the follow-up time (84.9% at baseline, 64.3% at 47 months, p
      PubDate: 2018-02-03T04:55:21.118223-05:
      DOI: 10.1111/add.14179
  • Impacts of licensed premises trading hour policies on alcohol-related
    • Authors: Jo-An Atkinson; Ante Prodan, Michael Livingston, Dylan Knowles, Eloise O’Donnell, Robin Room, Devon Indig, Andrew Page, Geoff McDonnell, John Wiggers
      Abstract: Background and aimEvaluations of alcohol policy changes demonstrate that restriction of trading hours of both ‘on’ and ‘off’ license venues can be an effective means of reducing rates of alcohol-related harm. Despite this, the effects of different trading hour policy options over time, accounting for different contexts and demographic characteristics, and the common co-occurrence of other harm reduction strategies in trading hour policy initiatives are difficult to estimate. The aim of this study was to use dynamic simulation modelling to compare estimated impacts over time of a range of trading hour policy options on various indicators of acute alcohol related harm.MethodsAn agent-based model of alcohol consumption in New South Wales, Australia was developed using existing research evidence, analysis of available data, and a structured approach to incorporating expert opinion. Five policy scenarios were simulated, including restrictions to trading hours of on-license venues and extensions to trading hours of bottle shops. The impact of the scenarios on four measures of alcohol-related harm were considered: total acute harms; alcohol-related violence; emergency department presentations; and hospitalisations.ResultsSimulation of a 3am (rather than 5am) closing time resulted in an estimated 12.3 ± 2.4% reduction in total acute alcohol-related harms, a 7.9 ± 0.8% reduction in violence, an 11.9 ± 2.1% reduction in ED presentations, and a 9.5 ± 1.8% reduction in hospitalisations. Further reductions were achieved simulating a 1am closing time including a 17.5 ± 1.1% reduction in alcohol-related violence. Simulated extensions to bottle shop trading hours resulted in increases in rates of all four measures of harm, although most of the effects came from increasing operating hours from 10pm to 11pm.ConclusionsAn agent-based simulation model suggests that restricting trading hours of licensed venues reduces rates of alcohol-related harm and extending trading hours of bottle shops increases rates of alcohol-related harm. The model can estimate the effects of a range of policy options.
      PubDate: 2018-02-03T03:05:34.7297-05:00
      DOI: 10.1111/add.14178
  • Diminishing benefit of smoking cessation medications during the first
           year: a meta-analysis of randomized controlled trials
    • Authors: Laura J. Rosen; Tal Galili, Jeffrey Kott, Mark Goodman, Laurence S. Freedman
      Abstract: Background and aimsAlthough smoking cessation medications have shown effectiveness in increasing abstinence in randomized controlled trials (RCTs), it is unclear to what extent benefits persist over time. This paper assesses whether the benefits of smoking cessation medications decline over the first year.MethodsWe selected studies from three systematic reviews published by the Cochrane Collaboration. RCTs of first-line smoking cessation medications, with 6- and 12-month follow-up, were eligible for inclusion. Meta-analysis was used to synthesize information on sustained abstinence (SA) at 6 versus 12 months and 3 versus 6 months, using the risk difference (RD) (‘net benefit’) between intervention and control group quit rates, the relative risk (RR) and the odds ratio (OR).ResultsSixty-one studies (27 647 participants) were included. Fewer than 40% of intervention group participants were sustained abstinent at 3 months (bupropion: 37.1%; nicotine replacement therapy (NRT): 34.8%; varenicline: 39.3%); approximately a quarter were sustained abstinent at 6 months (bupropion: 25.9%; NRT: 26.6%; varenicline: 25.4%), and approximately a fifth were sustained abstinent at 12 months (bupropion: 19.9%; NRT: 19.8%%; varenicline: 18.7%). There was only a small decline in RR (3 months: 1.95 [95% confidence interval (CI) = 1.74–2.18, P 
      PubDate: 2018-01-29T07:00:02.122724-05:
      DOI: 10.1111/add.14134
  • A utility of model input uncertainty analysis in transferring tobacco
           control-related economic evidence to countries with scarce resources:
           results from the EQUIPT study
    • Authors: Bertalan Németh; Puttarin Kulchaitanaroaj, Adam Lester-George, Mirjana Huic, Kathryn Coyle, Doug Coyle, Subhash Pokhrel, Zoltán Kaló
      Abstract: AimsTo inform the transferability of tobacco control-related economic evidence to resource-poor countries.MethodsWe ran a univariate sensitivity analysis on a return on investment (ROI) model, the European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD), to identify key input values to which the ROI estimates were sensitive. The EQUIPTMOD used a Markov-based state transition model to estimate the ROI of several tobacco control interventions in five European countries (England, Germany, Spain, Hungary and the Netherlands). Base case ROI estimates were obtained through average values of model inputs (throughout the five countries), which were then replaced one at a time with country-specific values. Tornado diagrams were used to evaluate the significance of sensitivity, defined as a ≥ 10% difference in ROI estimates from the base case estimates.ResultsThe ROI estimates were sensitive to 18 (of 46) input values. Examples of model inputs to which ROI estimates were sensitive included: smoking rate, costs of smoking-related diseases (e.g. lung cancer) and general population attributes.ConclusionCountries that have limited research time and other resources can adapt EQUIPTMOD to their own settings by choosing to collect data on a small number of model inputs. EQUIPTMOD can therefore facilitate transfer of tobacco control related economic evidence to new jurisdictions.
      PubDate: 2018-01-28T21:35:21.424711-05:
      DOI: 10.1111/add.14092
  • A Reciprocal Effects Analysis of Cannabis Use and Perceptions of Risk
    • Authors: Naji C. Salloum; Melissa J. Krauss, Arpana Agrawal, Laura J. Bierut, Richard A. Grucza
      Abstract: Background and AimsAdolescents and young adults increasingly view cannabis as a relatively safe drug. Perception of risk associated with cannabis use is negatively correlated with the prevalence of use, but the causal nature of this association is debated. The aim of this study is to quantitate the reciprocal associations between cannabis use and risk perception in a longitudinal panel of emerging adults.DesignObservational study of longitudinal data from the Monitoring the Future longitudinal study using auto-regressive cross-lagged panel analyses to investigate reciprocal associations between cannabis risk perception and frequency of past year cannabis use.SettingSurveys administered to 12th grade students from the United States general population.Participants9,929 12th grade students (95% ages 17-18) who were initially surveyed during the years 2000-2005 and follow-up data through 6 years (3 waves; N=9,929).MeasurementsPerception of risk association with cannabis use and frequency of past-year cannabis use.ResultsAt baseline, 33% of the 12th graders used cannabis in the past year versus 28% by the third follow-up; 83% believed that smoking cannabis regularly carried moderate or great risk versus 78% by the third follow-up. All cross-lagged paths in both directions were statistically significant (all p
      PubDate: 2018-01-27T13:10:20.596789-05:
      DOI: 10.1111/add.14174
  • Unrecorded Alcohol Use: A Global Modelling Study Based on Nominal Group
           Assessments and Survey Data
    • Authors: Charlotte Probst; Jakob Manthey, Aaron Merey, Margaret Rylett, Jürgen Rehm
      Abstract: Background and aimsAlcohol use is among the most important risk factors for burden of disease globally. An estimated quarter of the total alcohol consumed globally is unrecorded. However, partly due to the challenges associated with its assessment, evidence on the magnitude of unrecorded alcohol use is sparse. This study estimated country-specific proportions of unrecorded alcohol used in 2015.DesignA statistical model was developed for data prediction using data on the country-specific proportion of unrecorded alcohol use from nominal group expert assessments and secondary, nationally representative survey data and country-level covariates.SettingEstimates were calculated for the country level, for four income groups and globally.ParticipantsA total of 129 participants from 49 countries were included in the nominal group expert assessments. The survey data comprised 66,538 participants from 16 countries.MeasurementsExperts filled in a standardized questionnaire assessing the country-specific proportion of unrecorded alcohol. In the national surveys, the number of standard drinks of total and unrecorded alcohol use was assessed for the past seven days.FindingsBased on predictions for 167 countries, a population weighted average of 27.9% (95% confidence interval (CI) 10.4%-44.9%) of the total alcohol consumed in 2015 was unrecorded. The proportion of unrecorded alcohol was lower in high (9.4%, 95% CI 2.4%-16.4%) and upper middle income countries (18.3%, 95% CI 9.0%-27.6%) and higher in low (43.1%, 95% CI 26.5%-59.7%) and lower middle income countries (54.4%, 95% CI 38.1%-70.8%). This corresponded to 0.94 (high income), 1.22 (upper middle income), 3.18 (lower middle income), and 1.78 (low income) litres of unrecorded alcohol per capita.ConclusionsA new method for modelling the country-level proportion of unrecorded alcohol use globally showed strong variation among geographical regions and income groups. Lower income countries were associated with a higher proportion of unrecorded alcohol than higher income countries.
      PubDate: 2018-01-27T11:35:20.323219-05:
      DOI: 10.1111/add.14173
  • Cost-effectiveness of possible future smoking cessation strategies in
           Hungary: results from the EQUIPTMOD
    • Authors: Bertalan Németh; Judit Józwiak-Hagymásy, Gábor Kovács, Attila Kovács, Tibor Demjén, Manuel B. Huber, Kei-Long Cheung, Kathryn Coyle, Adam Lester-George, Subhash Pokhrel, Zoltán Vokó
      Abstract: AimsTo evaluate potential health and economic returns from implementing smoking cessation interventions in Hungary.MethodsThe EQUIPTMOD, a Markov-based economic model, was used to assess the cost-effectiveness of three implementation scenarios: (a) introducing a social marketing campaign; (b) doubling the reach of existing group-based behavioural support therapies and proactive telephone support; and (c) a combination of the two scenarios. All three scenarios were compared with current practice. The scenarios were chosen as feasible options available for Hungary based on the outcome of interviews with local stakeholders. Life-time costs and quality-adjusted life years (QALYs) were calculated from a health-care perspective. The analyses used various return on investment (ROI) estimates, including incremental cost-effectiveness ratios (ICERs), to compare the scenarios. Probabilistic sensitivity analyses assessed the extent to which the estimated mean ICERs were sensitive to the model input values.ResultsIntroducing a social marketing campaign resulted in an increase of 0.3014 additional quitters per 1 000 smokers, translating to health-care cost-savings of €0.6495 per smoker compared with current practice. When the value of QALY gains was considered, cost-savings increased to €14.1598 per smoker. Doubling the reach of existing group-based behavioural support therapies and proactive telephone support resulted in health-care savings of €0.2539 per smoker (€3.9620 with the value of QALY gains), compared with current practice. The respective figures for the combined scenario were €0.8960 and €18.0062. Results were sensitive to model input values.ConclusionsAccording to the EQUIPTMOD modelling tool, it would be cost-effective for the Hungarian authorities introduce a social marketing campaign and double the reach of existing group-based behavioural support therapies and proactive telephone support. Such policies would more than pay for themselves in the long term.
      PubDate: 2018-01-25T00:50:51.778491-05:
      DOI: 10.1111/add.14089
  • Motivation to reduce alcohol consumption and subsequent attempts at
           reduction and changes in consumption in increasing and higher-risk
           drinkers in England: a prospective population survey
    • Authors: Frank Vocht; Jamie Brown, Emma Beard, Robert West, Susan Michie, Rona Campbell, Matthew Hickman
      Abstract: AimsTo assess how far motivation to reduce alcohol consumption in increasing and higher-risk drinkers in England predicts self-reported attempts to reduce alcohol consumption and changes in alcohol intake during the following 6 months.MethodsThis study used self-reported data from 2928 higher-risk drinkers in the Alcohol Toolkit Study (ATS): a series of monthly cross-sectional household surveys of adults aged 16+ years of age in England. Alcohol consumption was measured in an initial survey and in a 6-month telephone follow-up interview using the Alcohol Use Disorders Identification Test (AUDIT)-C questionnaire. Motivation was measured in the initial survey using the Motivation to Reduce Alcohol Consumption (MRAC) scale. Attempts to reduce alcohol consumption during the past 6 months were recorded at follow-up. Data were analysed using repeated-measures difference-in-differences and logistic regression models.ResultsParticipants with higher initial motivation to reduce alcohol consumption were more likely to report that they had made an attempt to reduce consumption at follow-up [adjusted odds ratio (ORadj) = 2.39, 95% confidence interval (CI) = 1.75–3.29]. There was an overall reduction in alcohol consumption between initial survey and follow-up (ORadj = 0.72, 95% CI = 0.65–0.79), but there was insufficient evidence of an additional effect of motivation to reduce consumption on subsequent changes in alcohol consumption, with the difference-in-differences effect instead suggesting an average increase (ORadj = 1.37, 95% CI = 1.00–1.88).ConclusionsIncreasing and higher-risk drinkers in England who report greater motivation to reduce their consumption are more likely to report making an attempt to reduce during the next 6 months, but this may not be associated with a reduction in alcohol consumption.
      PubDate: 2018-01-25T00:00:02.689456-05:
      DOI: 10.1111/add.14132
  • Do women with complex alcohol and other drug use histories want women-only
           residential treatment'
    • Authors: Joanne Neale; Charlotte N. E. Tompkins, Alison D. Marshall, Carla Treloar, John Strang
      Abstract: BackgroundWomen-only addiction services tend to be provided on a poorly evidenced assumption that women want single-sex treatment. We draw upon women's expectations and experiences of women-only residential rehabilitation to stimulate debate on this issue.MethodsSemi-structured interviews were undertaken with 19 women aged 25–44 years [currently in treatment (n = 9), successfully completed treatment (n = 5), left treatment prematurely (n = 5)]. All had histories of physical or sexual abuse, and relapses linked to relationships with men. Interviews were audio-recorded, transcribed verbatim, coded and analysed inductively following Iterative Categorization.FindingsWomen reported routinely that they had been concerned, anxious or scared about entering women-only treatment. They attributed these feelings to previous poor relationships with women, being more accustomed to male company and negative experiences of other women-only residential settings. Few women said that they had wanted women-only treatment, although many became more positive after entering the women-only service. Once in treatment, women often explained that they felt safe, supported, relaxed, understood and able to open up and develop relationships with other female residents. However, they also described tensions, conflicts, mistrust and social distancing that undermined their treatment experiences.ConclusionsWomen who have complex histories of alcohol and other drug use do not necessarily want or perceive benefit in women-only residential treatment.
      PubDate: 2018-01-24T22:45:27.279511-05:
      DOI: 10.1111/add.14131
  • Direct-acting antiviral treatment of chronic HCV-infected patients on
           opioid substitution therapy: Still a concern in clinical practice'
    • Authors: Stefan Christensen; Peter Buggisch, Stefan Mauss, Klaus H. W. Böker, Eckart Schott, Hartwig Klinker, Tim Zimmermann, Bernd Weber, Jens Reimer, Yvonne Serfert, Heiner Wedemeyer
      Abstract: Background and aimsThere is limited real-world information on the effectiveness of antiviral treatment of chronic hepatitis C virus (HCV) infection with direct-acting antivirals (DAA) in people on opioid substitution therapy (OST). This study compared sustained virological response (SVR) rates and proportion of lost to follow-up (LTFU) between OST and non-OST patients in the German Hepatitis C-Registry (DHC-R).DesignNational multi-centre prospective real-world registry (German Hepatitis C-Registry, DHC-R). Non-OST patients comprised patients with former/current drug use (non-OST/DU) and patients never consuming drugs (non-OST/NDU).SettingA total of 254 medical centres in Germany, including 123 centres providing OST.ParticipantsA total of 7747 chronic HCV patients started DAA therapy (739 OST and 7008 non-OST; 1500 non-OST/DU; 5508 non-OST/NDU) patients. Five hundred and twenty-eight OST and 5582 non-OST patients had completed antiviral therapy and at least one follow-up documentation [intention-to-treat (ITT) population].MeasurementsStudy outcomes were SVR, proportion of LTFU and safety of treatment.FindingsSVR (ITT) was documented in 85% (450 of 528) OST patients versus 86% (969 of 1126) in non-OST/DU (P = 0.651) and 92% (4113 of 4456) non-OST/NDU (P 
      PubDate: 2018-01-23T04:00:01.475574-05:
      DOI: 10.1111/add.14128
  • Correction to: ‘The effects of cannabis intoxication on motor vehicle
           collision revisited and revised’ (2016)
    • Authors: Ole Rogeberg; Rune Elvik, Michael White
      PubDate: 2018-01-22T21:30:33.108032-05:
      DOI: 10.1111/add.14140
  • Differences in mortality in a cohort of cocaine use disorder patients with
           concurrent alcohol or opiates disorder
    • Authors: Esther Colell; Antònia Domingo-Salvany, Albert Espelt, Oleguer Parés-Badell, M. Teresa Brugal
      Abstract: AimsTo study mortality in a cohort of cocaine use disorder patients, and compare results in those with concurrent alcohol or opiates disorder.Design, Setting and ParticipantsA cohort of 10,539 cocaine use disorder individuals entering drug treatment in public outpatient centres in the city of Barcelona was followed from 1997 to 2011. Participants were divided at baseline into three groups: those with only cocaine use disorder (CUD), those with cocaine and alcohol use disorder, but not opioid (CAUD), and those with cocaine and opioid use disorder (COUD). Mortality was assessed through the Spanish National Mortality Register.MeasurementsCrude mortality rates (CMR), standardised mortality ratios (SMR), and rate ratios (RR) were calculated for each group. A multivariable Cox regression model was fitted to obtain adjusted mortality hazard ratios (aHR) of CAUD and COUD with respect to CUD. Specific mortality causes were also examined.FindingsThe total of 716 deaths registered resulted in a CMR=6.0/1000 person-year (PY); 95% confidence interval (CI): 5.1-7.0 for CUD, CMR=5.8/1000PY (95%CI:4.9-6.7) for CAUD, and CMR=20.7/1000PY (95%CI:18.8-22.8) for COUD, with no significant differences among sexes. Compared with the general population, mortality was four times higher (SMR=4.1, 95%CI:3.5-4.8) among CUD, more than three times among CAUD (SMR=3.4, 95%CI:2.9-3.9) and more than ten times among COUD (SMR=11.6, 95%CI:10.5-12.8), being always higher in women. External injuries, led by overdose, accumulated the biggest percentage of deaths among the three groups, but infectious diseases showed the highest excess mortality. Some differences regarding causes of death were observed between the three groups.ConclusionsMortality risk and excess mortality are significantly greater among those with cocaine and opiates use disorder than among people with only cocaine use disorder or cocaine and alcohol use disorder.
      PubDate: 2018-01-22T13:45:22.991928-05:
      DOI: 10.1111/add.14165
  • Can one simple questionnaire assess substance-related and behavioural
           addiction problems' Results of a proposed new screener for community
    • Authors: Magdalen G. Schluter; David C. Hodgins, Jody Wolfe, T. Cameron Wild
      Abstract: Background and aimsThere is currently no well-validated measure that assesses a broad spectrum of substance-related and behavioural addictions in general populations. This study aimed to develop a brief self-attribution Screener for Substance and Behavioural Addictions (SSBA) to screen for 4 substances and 6 behaviours, and to compare its performance with established individual-behaviour screening instruments.DesignA small, psychometrically optimal set of items to assess self-attributed indicators of addiction across alcohol, tobacco, cannabis, cocaine, gambling, shopping, videogaming, overeating, sexual activity, and over-working were identified from a broader pool that was developed using a lay epidemiology qualitative approach. The suitability of the 4-item single factor solution was tested for each behaviour and scores were compared with those obtained from the sample using individual-behaviour screening instruments.Setting and ParticipantsParticipants (N = 6,000), broadly representative of the Canadian English-speaking adult population, were recruited through the Ipsos Reid Canadian Online Panel.MeasurementsParticipants completed an item pool of 15 indicators of addiction for each target behaviour and a validation instrument for one randomly assigned behaviour.FindingsA set of four items identified using principal component and confirmatory factor analyses demonstrated good fit and excellent internal consistency (α = .87-.95) across behaviours, and good convergent validity (rs = .44 – .8) with extant instruments measuring similar constructs with only one exception (r = .26).ConclusionsThe proposed Screener for Substance and Behavioural Addiction is a reliable and valid measure assessing the lay public's self-attributed indicators of addiction across 10 substances and behaviours.
      PubDate: 2018-01-22T13:45:19.521362-05:
      DOI: 10.1111/add.14166
  • Adolescents’ alcohol use and strength of policy relating to youth
           access, trading hours and driving under the influence: findings from
    • Authors: V. White; D. Azar, A. Faulkner, K. Coomber, S. Durkin, M. Livingston, T. Chikritzhs, R. Room, M. Wakefield
      Abstract: AimsTo determine i) whether strength of Australian alcohol control policy in three domains (youth access, trading hours and drink driving) changed during the 2000s; and ii) estimate associations between these policies and adolescent drinking after adjusting for television alcohol advertising exposures, alcohol outlet density, alcohol price changes, exposure to negative articles about alcohol in daily newspapers and adult drinking prevalence.DesignRepeated cross-sectional surveys conducted triennially from 2002 to 2011. Multilevel modelling examined the association between alcohol control policies and drinking prevalence after adjusting for covariates.SettingFour Australian capital cities between 2002 and 2011ParticipantsStudents aged 12-17 years participating in a triennial national representative school-based survey (sample size range/survey: 9805 to 13119).MeasurementsOutcome measures were: past month drinking and risky drinking (5+ drinks on a day) in the past seven days. Policy strength in each of three domains (youth access, trading hours, drink-driving) were the key predictor variables. Covariates included: past 3-month television alcohol and alcohol-control advertising, alcohol outlet density, alcohol price change, negatively-framed newspaper alcohol articles, adult drinking prevalence and student demographic characteristics.FindingsOver the study period, strength of youth access policies increased by 10%, trading hours policies by 14% and drink-driving policies by 58%. Past-month and risky drinking prevalence decreased (eg, past-month: 2002: 47% to 2011: 26%). Multivariable analyses that included all policy variables and adjusted for year, student and other covariates showed past-month drinking to be inversely associated with stronger trading hours policies (odds ratio [OR]=0.80, 95% confidence interval [CI]:0.69,0.94), but not youth access (OR=0.92 95%CI: 0.81,1.04) or drink-driving (OR=1.00, 95%CI:0.93,1.09). Risky drinking was inversely associated with stronger youth access policies (OR=0.82, 95% CI:0.69, 0.98), but not trading hours (OR=0.85, 95%CI: 0.66,1.09) or drink-driving (OR=1.02, 95%CI: 0.90,1.14) policies.ConclusionsPopulation-directed policies designed to reduce alcohol availability and promotion may reduce adolescents’ alcohol use.
      PubDate: 2018-01-22T11:31:53.373368-05:
      DOI: 10.1111/add.14164
  • Improving recruitment to pharmacological trials for illicit opioid use:
           Findings from a qualitative focus group study
    • Authors: Joanne Neale; Charlotte N. E. Tompkins, Rebecca McDonald, John Strang
      Abstract: AimTo explore potential study participants' views on willingness to join clinical trials of pharmacological interventions for illicit opioid use to inform and improve future recruitment strategies.DesignQualitative focus group study (6 groups: oral methadone [2 groups]; buprenorphine tablets [2 groups]; injectable opioid agonist treatment [1 group]; and former opioid agonist treatment [1 group]).SettingsDrug and alcohol services and a peer support recovery service (London, United Kingdom).Participants40 people with experience of opioid agonist treatment for heroin dependence (26 males, 14 females; ages 33-66 years).MeasurementsData collection was facilitated by a topic guide that explored willingness to enrol in clinical pharmacological trials. Groups were audio-recorded and transcribed. Transcribed data were analysed inductively via Iterative Categorisation.FindingsParticipants' willingness to join pharmacological trials of medications for opioid dependence was affected by factors relating to study burden, study drug, study design, study population, and study relationships. Participants worried that the trial drug might be worse than, or interfere with, their current treatment. They also misunderstood aspects of trial design despite the researchers' explanations.ConclusionsRecruitment of participants for clinical trials of pharmacological interventions for illicit opioid use could be improved if researchers became better at explaining clinical trials to potential participants, dispelling misconceptions about trials, and increasing trust in the research process and research establishment. A checklist of issues to consider when designing pharmacological trials for illicit opioid use is proposed.
      PubDate: 2018-01-22T10:36:28.287668-05:
      DOI: 10.1111/add.14163
  • Investigating causal associations between use of nicotine, alcohol,
           caffeine, and cannabis: A two-sample bidirectional Mendelian randomization
    • Authors: Karin J. H. Verweij; Jorien L. Treur, Jacqueline M. Vink
      Abstract: Background and AimsEpidemiological studies consistently show co-occurrence of use of different addictive substances. Whether these associations are causal or due to overlapping underlying influences remains an important question in addiction research. Methodological advances have made it possible to use published genetic associations to infer causal relationships between phenotypes. In this exploratory study, we used Mendelian randomization (MR) to examine the causality of well-established associations between nicotine, alcohol, caffeine, and cannabis use.MethodsTwo-sample MR was employed to estimate bi-directional causal effects between four addictive substances: nicotine (smoking initiation and cigarettes smoked per day), caffeine (cups of coffee per day), alcohol (units per week), and cannabis (initiation). Based on existing genome-wide association results we selected genetic variants associated with the exposure measure as an instrument to estimate causal effects. Where possible we applied sensitivity analyses (MR-Egger and weighted median) more robust to horizontal pleiotropy.ResultsMost MR tests did not reveal causal associations. There was some weak evidence for a causal positive effect of genetically instrumented alcohol use on smoking initiation and of cigarettes per day on caffeine use, but these did not hold up with the sensitivity analyses. There was also some suggestive evidence for a positive effect of alcohol use on caffeine use (only with MR-Egger) and smoking initiation on cannabis initiation (only with weighted median). None of the suggestive causal associations survived corrections for multiple testing.ConclusionsTwo-sample Mendelian randomization analyses found little evidence for causal relationships between nicotine, alcohol, caffeine, and cannabis use.
      PubDate: 2018-01-15T10:10:19.766432-05:
      DOI: 10.1111/add.14154
  • Increased non-fatal overdose risk associated with involuntary drug
           treatment in a longitudinal study with people who inject drugs
    • Authors: Claudia Rafful; Ricardo Orozco, Gudelia Rangel, Peter Davidson, Dan Werb, Leo Beletsky, Steffanie A. Strathdee
      Abstract: AimTo assess the effect of involuntary drug treatment (IDT) on non-fatal overdose among people who inject drugs (PWID).DesignLongitudinal study.SettingTijuana, Mexico.ParticipantsBaseline sample of 671 PWID included 258 (38.4%) women and 413 (61.6%) men.MeasurementsPrimary independent variables were reported recent (i.e., past 6 months) non-fatal overdose event (dependent variable) and IDT. Substance use the day of the non-fatal overdose was also examined.FindingsFrom 2011 to 2017, 213 participants (31.7%) reported a recent non-fatal overdose and 103 (15.4%) reported recent IDT. Heroin in combination with methamphetamine and tranquilizers were the drugs most reported at the day of the event. IDT significantly increased the odds of reporting a non-fatal overdose event (Adjusted Odds Ratio [AOR]: 1.76; 95% Confidence Interval [CI]: 1.04-2.96). Odds of overdose also independently increased for each additional injection per day (AOR: 1.05; 95% CI: 1.02-1.08), recent tranquilizer use (AOR: 1.92; 95% CI: 1.41-2.61), and using hit doctors (AOR: 1.68; 95% CI: 1.29-2.18), and decreased with age (AOR: 0.97 per year, 95% CI: 0.95-0.99).ConclusionsRecent involuntary drug treatment in Mexico is a risk factor for non-fatal drug overdose.
      PubDate: 2018-01-14T21:35:33.49757-05:0
      DOI: 10.1111/add.14159
  • Diminished Alternative Reinforcement as a Mechanism Linking Conduct
           Problems and Substance Use in Adolescence: A Longitudinal Examination
    • Authors: Rubin Khoddam; Junhan Cho, N. J. Jackson, Adam M. Leventhal
      Abstract: AimsTo determine whether diminished alternative reinforcement (i.e., engagement and enjoyment from substance-free activities) mediated the longitudinal association of conduct problems with substance use in early-mid adolescence.DesignStructural equation modeling tested whether the association between Wave 1 (baseline) conduct problems and Wave 3 (24-month follow-up) substance use outcomes was mediated by diminished alternative reinforcement at Wave 2 (12-month follow-up). Additional analyses tested whether sex and socioeconomic status moderated this association.SettingTen high schools in Los Angeles, CA, USA, 2013-2015.ParticipantsStudents (N=3,396, 53% female, Mean[SD] age at Wave 1 baseline = 14.1[0.42] years).MeasurementsSelf-reported conduct problems (11-item questionnaire), alternative reinforcement (44-item questionnaire), and use of alcohol, marijuana, and combustible cigarettes over the past 6-months (yes/no) and the past 30-days (9-level ordinal response based on days used in past 30).ResultsSignificant associations of wave 1 conduct problems with wave 3 marijuana use over the past six months (β=.25) and past 30 days (β=.25) were mediated by wave 2 diminished alternative reinforcement (βindirect effect: 6 months=.013, 30 days=.017, ps
      PubDate: 2018-01-14T21:35:27.285358-05:
      DOI: 10.1111/add.14160
  • Measuring spatial and temporal trends of nicotine and alcohol consumption
           in Australia using wastewater-based epidemiology
    • Authors: Foon Yin Lai; Coral Gartner, Wayne Hall, Steve Carter, Jake O'Brien, Benjamin J. Tscharke, Frederic Been, Cobus Gerber, Jason White, Phong Thai, Raimondo Bruno, Jeremy Prichard, K. Paul Kirkbride, Jochen F. Mueller
      Abstract: Background and aimsTobacco and alcohol consumption remain priority public health issues worldwide. As participation in population-based surveys has fallen, it is increasingly challenging to estimate accurately the prevalence of alcohol and tobacco use. Wastewater-based epidemiology (WBE) is an alternative approach for estimating substance use at the population level that does not rely on survey participation. This study examined spatio-temporal patterns in nicotine (a proxy for tobacco) and alcohol consumption in the Australian population via WBE.MethodsDaily wastewater samples (n=164) were collected at 18 selected wastewater treatment plants across Australia, covering approximately 45% of the total population. Nicotine and alcohol metabolites in the samples were measured using liquid chromatography-tandem mass spectrometry. Daily consumption of nicotine and alcohol and its associated uncertainty were computed using Monte Carlo simulations. Nationwide daily average and weekly consumption of these two substances were extrapolated using ordinary least squares and mixed effect models.FindingsNicotine and alcohol consumption was observed in all communities. Consumption of these substances in rural towns was three-to-four times higher than in urban communities. The spatial consumption pattern of these substances was consistent across the monitoring periods in 2014-2015. Nicotine metabolites significantly reduced by 14-25% (p=0.001-0.008) (2014-2015) in some catchments. Alcohol consumption remained constant over the studied periods. Strong weekly consumption patterns were observed for alcohol but not nicotine. Nationwide, the daily average consumption per person (aged 15-79 years) was estimated at about 2.5 cigarettes and 1.3-2.0 standard drinks (weekday-weekend) of alcohol. These estimates were close to the sale figure and apparent consumption respectively.ConclusionsWastewater-based epidemiology is a feasible method for objectively evaluating the geographic, temporal and weekly profiles of nicotine and alcohol consumption in different communities nationally.
      PubDate: 2018-01-14T21:35:23.839601-05:
      DOI: 10.1111/add.14157
  • Education is the strongest socioeconomic predictor of smoking in pregnancy
    • Authors: Juho Härkönen; Matti Lindberg, Linnea Karlsson, Hasse Karlsson, Noora M. Scheinin
      Abstract: AimsTo investigate socioeconomic disparities in smoking in pregnancy (SIP) by the mother's education, occupational class, and current economic conditions.DesignCross-sectional analysis with linked survey and register data.SettingSouth-Western Finland.Participants2,667 pregnant women (70% of the original sample (N=3,808)) from FinnBrain, a prospective pregnancy cohort study.MeasurementsThe outcome was smoking during the first pregnancy trimester, measured from the Finnish Medical Birth Register. Education and occupational class were linked from population registers. Income support recipiency and subjective economic well-being were questionnaire-based measures of current economic conditions. These were adjusted for age, partnership status, residential area type, parental separation, parity, childhood socioeconomic background, childhood adversities (the Trauma and Distressing Events During Childhood scale), and antenatal stress (Edinburgh Postnatal Depression Scale). Logistic regressions and attributable fractions (AF) were estimated.FindingsMother's education was the strongest socioeconomic predictor of SIP. Compared with university education, adjusted odds ratios (aOR) of SIP were: 2.2 (95% CI 1.2–3.9; P = 0.011) for tertiary vocational education, 4.4 (95% CI 2.1–9.0; P < 0.001) for combined general and vocational secondary education, 2.9 (95% CI 1.4–6.1; P = 0.006) for general secondary education, 9.5 (95% CI 5.0–18.2; P < 0.001) for vocational secondary education, and 14.4 (95% CI 6.3–33.0; P < 0.001) for compulsory schooling. The total AF of education was 0.5. Adjusted for the other variables, occupational class and subjective economic wellbeing did not predict SIP. Income support recipiency was positively associated with SIP (aOR = 1.8; 95% CI 1.1–3.1; P = 0.022). Antenatal stress predicted SIP (aOR = 2.0; 95% CI 1.4–2.8; P < 0.001), but did not attenuate its socioeconomic disparities.ConclusionsIn Finland, socioeconomic disparities in smoking in pregnancy are primarily attributable to differences in the mother's educational level (low vs high) and orientation (vocational vs general).
      PubDate: 2018-01-14T21:35:21.858334-05:
      DOI: 10.1111/add.14158
  • Euthanasia and the nature of suffering in addiction
    • Authors: Richard E. Ashcroft
      Abstract: Commentary to: The need to exercise caution in accepting addiction as a reason for performing euthanasia
      PubDate: 2018-01-14T20:00:21.503274-05:
      DOI: 10.1111/add.14130
  • How can we protect youth from putative vaping gateway effects without
           denying smokers a less harmful option'
    • Authors: Coral Gartner
      Abstract: Commentary to: Gateway effects and electronic cigarettes
      PubDate: 2018-01-11T21:21:25.866912-05:
      DOI: 10.1111/add.14126
  • The different outcomes of legislative- versus advocacy-led development of
           cannabis policy
    • Authors: Stephen Rolles
      Abstract: Commentary to: The diverging trajectories of cannabis and tobacco policies in the United States: reasons and possible implications
      PubDate: 2018-01-10T20:10:37.03143-05:0
      DOI: 10.1111/add.14124
  • Trends in alcohol-related mortality in East and West Germany, 1980 to
           2014: Age, period, and cohort variations
    • Authors: Daniela Piontek; Ludwig Kraus
      Abstract: Background and aimsSeveral indicators suggest that the extent and trends of alcohol-related mortality differ between East and West Germany. Regional drinking patterns and differences in health care systems are assumed to affect the risk of dying from an alcohol-induced disease. The study addresses two questions: (1) What are the unbiased and independent age, period, and cohort effects on alcohol-related mortality trends in Germany' (2) Do these trends differ between East and West Germany'MethodsData on alcohol-related mortality for East and West Germany came from the national causes of deaths register for the years 1980 to 2014. Analyses included all deaths fully attributable to alcohol based on the International Classification of Diseases (ICD-9 and ICD-10). Gender-stratified age-period-cohort analyses were conducted using the intrinsic estimator model.ResultsAge effects showed a concave pattern with a peak at ages 55-64 in both regions. Incidence rate ratios (IRR) in East Germany were highest in the years 1990-1994 (men and women: IRR = 1.52) and declined thereafter. In West Germany, IRR were lowest in 1980-1984 (men: IRR = 0.81, women: IRR = 0.75) and stabilized around 1.10 since 1995-1999. Cohort effects showed continuously lower IRR for those born after 1955-1959 in the East and those born after 1945-1949 in the West. Patterns for males and females were comparable.ConclusionsThe results suggest that alcohol-related mortality showed different trends in East and West Germany which can partly be explained by different drinking patterns before and changes in the health care system after the reunification.
      PubDate: 2018-01-10T03:01:20.422252-05:
      DOI: 10.1111/add.14152
  • First do no harm: developing interventions that combat addiction without
           increasing inequalities
    • Authors: Clare Bambra
      PubDate: 2018-01-04T22:50:43.92325-05:0
      DOI: 10.1111/add.14116
  • Issue Information - Cover, Editorial Board, Guidelines for submission,
           Title, Aims & Scope
    • Pages: 589 - 590
      Abstract: No abstract is available for this article.
      PubDate: 2018-03-12T01:12:58.726947-05:
      DOI: 10.1111/add.13983
  • Recent Changes to the Editorial Board
    • Pages: 591 - 591
      PubDate: 2018-03-12T01:13:05.183731-05:
      DOI: 10.1111/add.14176
  • Commentary on Egerton-Warburton et al. (2018): Alcohol-related injury in
           the emergency department and the alcohol attributable fraction
    • Authors: Cheryl J. Cherpitel
      Pages: 633 - 634
      PubDate: 2018-03-12T01:13:05.089173-05:
      DOI: 10.1111/add.14142
  • Commentary on Chang et al. (2018): Assessing prescribing volume and
           patient risk—implementation considerations
    • Authors: Suzanne Nielsen; Kari Lancaster
      Pages: 687 - 688
      PubDate: 2018-03-12T01:12:59.488772-05:
      DOI: 10.1111/add.14138
  • New Books
    • Pages: 775 - 777
      PubDate: 2018-03-12T01:13:01.29552-05:0
      DOI: 10.1111/add.14185
  • News and Notes
    • Pages: 778 - 783
      PubDate: 2018-03-12T01:13:01.081739-05:
      DOI: 10.1111/add.14184
  • Issue Information - TOC
    • Pages: 784 - 784
      Abstract: No abstract is available for this article.
      PubDate: 2018-03-12T01:13:01.399812-05:
      DOI: 10.1111/add.13984
  • The associations between psychotic experiences, and substance use and
           substance use disorders: Findings from the World Health Organisation World
           Mental Health Surveys
    • Authors: Louisa Degenhardt; Sukanta Saha, Carmen C. W. Lim, Sergio Aguilar-Gaxiola, Ali Al-Hamzawi, Jordi Alonso, Laura H. Andrade, Evelyn J. Bromet, Ronny Bruffaerts, José M. Caldas-de-Almeida, Giovanni Girolamo, Silvia Florescu, Oye Gureje, Josep M. Haro, Elie G. Karam, Georges Karam, Viviane Kovess-Masfety, Sing Lee, Jean-Pierre Lepine, Victor Makanjuola, Maria E. Medina-Mora, Zeina Mneimneh, Fernando Navarro-Mateu, Marina Piazza, José Posada-Villa, Nancy A. Sampson, Kate M. Scott, Juan C. Stagnaro, Margreet Ten Have, Kenneth S. Kendler, Ronald C. Kessler, John J. McGrath,
      Abstract: Background and aimsPrior research has found bidirectional associations between psychotic experiences (PEs), and selected substance use disorders. We aimed to extend this research by examining the bidirectional association between PEs, and various types of substance use (SU), and substance use disorders (SUDs), and the influence of antecedent mental disorders on these associations.Design, setting, participants and measurementsWe used data from the World Health Organisation World Mental Health surveys. A total of 30,902 adult respondents across 18 countries were assessed for (a) six types of lifetime PEs, (b) a range of types of SU and DSM-IV SUDs, and (c) mental disorders using the Composite International Diagnostic Interview. Discrete-time survival analyses based on retrospective age-at-onset reports examined the bidirectional associations between PEs and SU/SUDs controlling for antecedent mental disorders.FindingsAfter adjusting for demographics, comorbid SU/SUDs and antecedent mental disorders, those with prior alcohol use disorders (OR=1.6, 95% CI=1.2-2.0), extra-medical prescription drug use (OR=1.5, 95% CI=1.1-1.9), alcohol use (OR=1.4, 95% CI=1.1-1.7), and tobacco use (OR=1.3, 95% CI=1.0-1.8) had increased odds of subsequent first onset of PEs. In contrast, those with temporally prior PEs had increased odds of subsequent onset of tobacco use (OR=1.5, 95% CI=1.2-1.9), alcohol use (OR=1.3, 95% CI=1.1-1.6) or cannabis use (OR=1.3, 95% CI=1.0-1.5) as well as of all substance use disorders (ORs ranged between 1.4 and 1.5). There was a dose response relationship between both count and frequency of PEs and increased subsequent odds of selected SU/SUDs.ConclusionsAssociations between psychotic experiences (PEs) and substance use/substance use disorders (SU/SUDs) are often bidirectional, but not all types of SU/SUDs are associated with PEs. These findings suggest that it is important to be aware of the presence of PEs within those with SUDs or at risk of SUDs, given the plausibility that they may each impact upon the other.
      PubDate: 2017-12-28T19:56:41.207645-05:
      DOI: 10.1111/add.14145
  • Screening for problem gambling within mental health services: A comparison
           of the classification accuracy of brief instruments
    • Authors: N. A. Dowling; S. S. Merkouris, V. Manning, R. Volberg, S. J. Lee, S. N. Rodda, D. I. Lubman
      Abstract: Background and aimsDespite the over-representation of people with gambling problems in mental health populations, there is limited information available to guide the selection of brief screening instruments within mental health services. The primary aim was therefore to compare the classification accuracy of nine brief problem gambling screening instruments (2-5 items) with a reference standard among patients accessing mental health services.DesignThe classification accuracy of nine brief screening instruments was compared with multiple cut-off scores on a reference standard.SettingEight mental health services in Victoria, Australia.Participants837 patients were consecutively recruited between June 2015 and January 2016.MeasurementsThe brief screening instruments were the Lie/Bet Questionnaire, Brief Problem Gambling Screen [BPGS] [2-5-item versions], NODS-CLiP, NODS-CLiP2, Brief Biosocial Gambling Screen [BBGS], and NODS-PERC. The Problem Gambling Severity Index (PGSI) was the reference standard.FindingsThe 5-item BPGS was the only instrument displaying satisfactory classification accuracy in detecting any level of gambling problem (low-risk, moderate-risk, or problem gambling) [sensitivity=0.803, specificity=0.982, diagnostic efficiency=0.943]. Several shorter instruments adequately detected both problem and moderate-risk, but not low-risk, gambling: two 3-item instruments (NODS-CLiP, 3-item BPGS) and two 4-item instruments (NODS-PERC, 4-item BPGS) [sensitivity=0.854-0.966, specificity=0.901-0.954, diagnostic efficiency=0.908-0.941]. The 4-item instruments, however, did not provide any considerable advantage over the 3-item instruments. The very brief (2-item) instruments (Lie/Bet and 2-item BPGS) similarly adequately detected problem gambling [sensitivity=0.811-0.868, specificity=0.938-0.943, diagnostic efficiency=0.933-0.934], but not moderate-risk or low-risk gambling.ConclusionsThe optimal brief screening instrument for mental health services wanting to screen for any level of gambling problem is the 5-item Brief Problem Gambling Screen (BPGS). Services wanting to employ a shorter instrument or to screen only for more severe gambling problems (moderate-risk/problem gambling) can employ the NODS-CLiP or the 3-item BPGS. Services that are only able to accommodate a very brief instrument can employ the Lie/Bet Questionnaire or the 2-item BPGS.
      PubDate: 2017-12-23T05:30:25.672823-05:
      DOI: 10.1111/add.14150
  • Estimating the Drink Driving Attributable Fraction of Road Traffic Deaths
           in Mexico.
    • Authors: Dzoara Santoyo-Castillo; Ricardo Pérez-Núñez, Guilherme Borges, Martha Híjar
      Abstract: AimTo estimate the Drink Driving Attributable Fraction (DDAF) of road traffic injury mortality in car occupants in Mexico during 2010-2013.DesignA case-control study was conducted to examine the presence of alcohol in analysed body fluids of car occupants killed in fatal crashes (cases) compared with car drivers tested in alcohol-testing checkpoints who were not involved in a fatal collision (controls). Two datasets were used for the period 2010-2013: The Forensic module of the Epidemiological Surveillance System on Addictions that included car occupants killed in a collision (cases) and a dataset from alcohol-testing at police checkpoints available for matching municipalities (controls).SettingMexico.ParticipantsThe analysed study sample included 1,718 car occupants killed in a traffic collision and 80,656 drivers tested at alcohol police checkpoints, all from 10 municipalities.MeasurementsUnadjusted and adjusted odds ratios (OR) of presence of alcohol in body fluids were obtained stratified by sex and age groups and the interaction with these two variables were assessed. The ORs were used to calculate the DDAF.FindingsIt was estimated that 19.5% of car occupants deaths due to road traffic injuries were attributable to alcohol consumption (95% CI= 19.1-19.9). The adjusted OR of presence of alcohol was 6.84 (95% CI= 6.06-7.71) overall. For males it was 7.21 (95% CI= 6.35-8.18) and for females it was 4.45 (95% CI= 3.01-6.60). The ORs were similar across younger age bands: (10-19 years: 9.61, 95% CI= 6.72-13.73; 20-29 years: 7.70, 95% CI= 6.28-9.45; and 30-49 years: 7.21, 95% CI= 5.98-8.70; and lower but still elevated amongst older people (50+ years: 3.19, 95% CI= 2.19-4.65.ConclusionsAn estimated 19.5% of car occupant deaths in Mexico may have been caused by alcohol in 2010-2013.
      PubDate: 2017-12-23T05:30:23.419354-05:
      DOI: 10.1111/add.14153
  • Brief telephone interventions for problem gambling: A randomised
           controlled trial
    • Authors: Max Abbott; David C. Hodgins, Maria Bellringer, Alain C. Vandal, Katie Palmer Du Preez, Jason Landon, Sean Sullivan, Simone Rodda, Valery Feigin
      Abstract: Background and aimsProblem gambling is a significant public health issue worldwide. There is substantial investment in publicly funded intervention services, but limited evaluation of effectiveness. This study investigated three brief telephone interventions to determine whether they were more effective than standard helpline treatment in helping people reduce gambling.DesignRandomized clinical trial.SettingNational gambling helpline in New Zealand.Participants462 adults with problem gambling.Interventions and comparator(1) Single motivational interview (MI), (2) single motivational interview plus cognitive-behavioural self-help workbook (MI+W) and (3) single motivational interview plus workbook plus four follow-up telephone interviews (MI+W+B). Comparator was helpline standard care (TAU). Blinded follow-up was at 3, 6 and 12 months.MeasurementsPrimary outcomes were days gambled, dollars lost per day and treatment goal success.FindingsThere were no differences across treatment arms although participants showed large reductions in gambling over the 12-month follow-up period (mean reduction of 5.5 days, CI (4.8, 6.2); $38NZD lost ($32, $44; 80.6% improved (77.2%, 84.0%)). Subgroup analysis revealed improved days gambled and dollars lost for MI+W+B over MI or MI+W for a goal of reduction of gambling (vs quitting) and improvement in dollars lost by ethnicity, gambling severity and psychological distress (all p < .01). MI+W+B was associated with greater treatment goal success for higher gambling severity than TAU or MI at 12 months and also better for those with higher psychological distress and lower self-efficacy to MI (all p < .01). TAU and MI were found to be equivalent in terms of dollars lost.ConclusionsIn treatment of problem gambling in New Zealand, brief telephone interventions are associated with changes in days gambling and dollars lost similar to more intensive interventions suggesting that more treatment is not necessarily better than less. Some client subgroups, in particular those with greater problem severity and greater distress, achieve better outcomes when they receive more intensive treatment.
      PubDate: 2017-12-23T05:20:20.927921-05:
      DOI: 10.1111/add.14149
  • Time to acknowledge the mixed effects of cannabis on health: a summary and
           critical review of the NASEM 2017 report on the health effects of cannabis
           and cannabinoids
    • Authors: Janna Cousijn; Adrián E. Núñez, Francesca M. Filbey
      PubDate: 2017-12-21T20:00:20.991962-05:
      DOI: 10.1111/add.14084
  • Euthanasia for what' Attending to the role of stigma in
           addiction-related ‘intractable suffering’ and ‘incurability’
    • Authors: Kate Seear; Suzanne Fraser
      Abstract: Commentary to: The need to exercise caution in accepting addiction as a reason for performing euthanasia
      PubDate: 2017-12-19T21:05:37.288441-05:
      DOI: 10.1111/add.14105
  • Cigarette use is increasing among people with illicit substance use
           disorders in the United States, 2002–14: emerging disparities in
           vulnerable populations
    • Authors: Andrea H. Weinberger; Misato Gbedemah, Melanie M. Wall, Deborah S. Hasin, Michael J. Zvolensky, Renee D. Goodwin
      Abstract: Background and aimsWhile cigarette smoking has declined over time, it is not known whether this decline has occurred similarly among individuals with substance use disorders (SUDs) in the United States (US). The current study estimated trends in smoking from 2002 to 2014 among US individuals with and without SUDs.DesignLinear time trends of current smoking prevalence were assessed using logistic regression models.SettingUnited States; data were drawn from the 2002 to 2014 National Household Survey on Drug Use (NSDUH), an annual US cross-sectional study.ParticipantsA representative, population-based sample of US individuals age 12 yeas and older (total analytical population: n = 723 283).MeasurementsPast-month current smoking was defined as having smoked at least 100 lifetime cigarettes and reporting smoking part or all of at least one cigarette during the past 30 days. Respondents were classified as having any SUD if they met criteria for abuse or dependence for one or more of the following illicit drugs: cannabis, hallucinogens, inhalants, tranquilizers, cocaine, heroin, pain relievers, simulants and sedatives. A second SUD variable included all drugs listed above excluding cannabis use disorder (CUD). An additional variable included respondents who met criteria for cannabis abuse or dependence.FindingsAmong those with any SUD, the prevalence of smoking did not change from 2002 to 2014 (P = 0.08). However, when CUDs were separated from other SUDs, a significant increase in prevalence of smoking was observed among those with SUDs excluding CUDs (P 
      PubDate: 2017-12-19T00:01:02.579436-05:
      DOI: 10.1111/add.14082
  • Cost-effectiveness of increasing the reach of smoking cessation
           interventions in Germany: results from the EQUIPTMOD
    • Authors: Manuel B. Huber; Maximilian Präger, Kathryn Coyle, Doug Coyle, Adam Lester-George, Marta Trapero-Bertran, Bertalan Nemeth, Kei Long Cheung, Renee Stark, Matthias Vogl, Subhash Pokhrel, Reiner Leidl
      Abstract: AimsTo evaluate costs, effects and cost-effectiveness of increased reach of specific smoking cessation interventions in Germany.DesignA Markov-based state transition return on investment model (EQUIPTMOD) was used to evaluate current smoking cessation interventions as well as two prospective investment scenarios. A health-care perspective (extended to include out-of-pocket payments) with life-time horizon was considered. A probabilistic analysis was used to assess uncertainty concerning predicted estimates.SettingGermany.ParticipantsCohort of current smoking population (18+ years) in Germany.InterventionsInterventions included group-based behavioural support, financial incentive programmes and varenicline. For prospective scenario 1 the reach of group-based behavioral support, financial incentive programme and varenicline was increased by 1% of yearly quit attempts (= 57 915 quit attempts), while prospective scenario 2 represented a higher reach, mirroring the levels observed in England.MeasurementsEQUIPTMOD considered reach, intervention cost, number of quitters, quality-of-life years (QALYs) gained, cost-effectiveness and return on investment.FindingsThe highest returns through reduction in smoking-related health-care costs were seen for the financial incentive programme (€2.71 per €1 invested), followed by that of group-based behavioural support (€1.63 per €1 invested), compared with no interventions. Varenicline had lower returns (€1.02 per €1 invested) than the other two interventions. At the population level, prospective scenario 1 led to 15 034 QALYs gained and €27 million cost-savings, compared with current investment. Intervention effects and reach contributed most to the uncertainty around the return-on-investment estimates. At a hypothetical willingness-to-pay threshold of only €5000, the probability of being cost-effective is approximately 75% for prospective scenario 1.ConclusionsIncreasing the reach of group-based behavioural support, financial incentives and varenicline for smoking cessation by just 1% of current annual quit attempts provides a strategy to German policymakers that improves the population's health outcomes and that may be considered cost-effective.
      PubDate: 2017-12-15T04:33:58.480941-05:
      DOI: 10.1111/add.14062
  • Is it cost-effective to provide internet-based interventions to complement
           the current provision of smoking cessation services in the
           Netherlands' An analysis based on the EQUIPTMOD
    • Authors: Kei-Long Cheung; Ben F. M. Wijnen, Mickaël Hiligsmann, Kathryn Coyle, Doug Coyle, Subhash Pokhrel, Hein Vries, Maximilian Präger, Silvia M. A. A. Evers
      Abstract: Background and aimThe cost-effectiveness of internet-based smoking cessation interventions is difficult to determine when they are provided as a complement to current smoking cessation services. The aim of this study was to evaluate the cost-effectiveness of such an alternate package compared with existing smoking cessation services alone (current package).MethodsA literature search was conducted to identify internet-based smoking cessation interventions in the Netherlands. A meta-analysis was then performed to determine the pooled effectiveness of a (web-based) computer-tailored intervention. The mean cost of implementing internet based interventions was calculated using available information, while intervention reach was sourced from an English study. We used EQUIPTMOD, a Markov-based state-transition model, to calculate the incremental cost-effectiveness ratios [expressed as cost per quality-adjusted life years (QALYs) gained] for different time horizons to assess the value of providing internet-based interventions to complement the current package.). Deterministic sensitivity analyses tested the uncertainty around intervention costs per smoker, relative risks, and the intervention reach.ResultsInternet-based interventions had an estimated pooled relative risk of 1.40; average costs per smoker of €2.71; and a reach of 0.41% of all smokers. The alternate package (i.e. provision of internet-based intervention to the current package) was dominant (cost-saving) compared with the current package alone (0.14 QALY gained per 1000 smokers; reduced health-care costs of €602.91 per 1000 smokers for the life-time horizon). The alternate package remained dominant in all sensitivity analyses.ConclusionProviding internet-based smoking cessation interventions to complement the current provision of smoking cessation services could be a cost-saving policy option in the Netherlands.
      PubDate: 2017-12-15T03:09:10.530355-05:
      DOI: 10.1111/add.14069
  • Predictors of smoking cessation during pregnancy: a systematic review and
    • Authors: Muhammad Riaz; Sarah Lewis, Felix Naughton, Michael Ussher
      Abstract: AimTo identify factors found in the research literature to be associated with smoking cessation in pregnancy.MethodsElectronic searches of the bibliographic databases of PubMed, EMBASE, PsycINFO, Elsevier, Scopus and ISI Web of Science were conducted to April 2017. All studies reporting factors associated with smoking cessation or continuing smoking during pregnancy were included and systematically reviewed, irrespective of study design. The Newcastle Ottawa Quality Assessment Scale was used to assess the study quality. The DerSimonian and Laird random effects model was used to conduct meta-analyses, and where effect estimates were reported for factors included in at least three studies.ResultsFifty-four studies including 505,584 women globally who smoked before pregnancy, 15 clinical trials and 40 observational studies, were included in the review and 36 (65.5%) were considered to be of high quality. This review identified 11 socio-demographic, seven socially related, 19 smoking behaviour related, five pregnancy related, six health related and six psychological factors that were significantly associated with smoking cessation during pregnancy. The most frequently observed significant factors associated with cessation were: higher level of education, pooled OR (95% CI): 2.16 (1.80-2.84), higher socio-economic status: 1.97 (1.20-3.24), overseas maternal birth: 2.00 (1.40-2.84), Medicaid coverage or private insurance: 1.54 (1.29-1.85), living with partner or married: 1.49 (1.38-1.61), partner/other members of the household do not smoke: 0.42 (0.35-0.50), lower heaviness of smoking index score: 0.45 (0.27-0.77, lower baseline cotinine level: 0.78 (0.64-0.94), low exposure to second hand smoking: 0.45 (0.20-1.02), not consuming alcohol before and/or during pregnancy: 2.03 (1.47-2.80), primiparity: 1.85 (1.68-2.05), planned breastfeeding:1.99 (1.94-2.05), perceived adequate pre-natal care: 1.74 (1.38-2.19), no depression: 2.65 (1.62-4.30), and low stress during pregnancy: 0.58 (0.44-0.77).ConclusionA wide range of socio-demographics, relationship, social, smoking-related, pregnancy-related, health and psychological factors have been found to predict smoking cessation in pregnancy.
      PubDate: 2017-12-13T01:34:34.031675-05:
      DOI: 10.1111/add.14135
  • Improving Quit Rates of Web-Delivered Interventions for Smoking Cessation:
           Full Scale Randomized Trial of versus
    • Authors: Jonathan B. Bricker; Kristin E. Mull, Jennifer B. McClure, Noreen L. Watson, Jaimee L. Heffner
      Abstract: Background and aimsMillions of people worldwide use websites to help them quit smoking, but effectiveness trials have an average 34% follow-up data retention rate and an average 9% quit rate. We compared the quit rates of a website using a new behavioral approach called Acceptance and Commitment Therapy (ACT; with the current standard of the National Cancer Institute's (NCI) website.DesignA two-arm stratified double-blind individually randomized trial (n = 1319 for WebQuit; n = 1318 for with 12-month follow-up.SettingUSA.ParticipantsAdults (N = 2637) who currently smoked at least 5 cigarettes per day were recruited from March 2014 to August 2015. At baseline, participants were mean (SD) age of 46.2 (13.4), 79% women, and 73% website (experimental) provided ACT for smoking cessation; website (comparison) followed US Clinical Practice Guidelines for smoking cessation.MeasurementsThe primary outcome was self-reported 30-day point prevalence abstinence at 12 months.FindingsThe 12-month follow-up data retention rate was 88% (2309/2637). The 30-day point prevalence abstinence rates at the 12-month follow-up were 24% (278/1141) for and 26% (305/1168) for (OR = 0.91; 95% CI = 0.76, 1.10); p = 0.334) in the a priori complete case analysis. Abstinence rates were 21% (278/1319) for and 23% (305/1318) for (OR = 0.89 (0.74, 1.07); p = 0.200) when missing cases were imputed as smokers. The Bayes Factor comparing the primary abstinence outcome was 0.17, indicating “substantial” evidence of no difference between and had similar 30-day point prevalence abstinence rates at 12 months that were descriptively higher than those of prior published website-delivered interventions and telephone counselor-delivered interventions.
      PubDate: 2017-12-13T00:51:00.272842-05:
      DOI: 10.1111/add.14127
  • Validation of a Contextualized Assessment of Smoking Behavior in Students
    • Authors: Helle Larsen; Elske Salemink, Ilva Grond, Reinout W. Wiers, Kristen G. Anderson
      Abstract: AimsThe aim of this study was to validate an audio simulation of culture-specific social contexts associated with smoking to provide a medium for researchers to investigate social-contextual influences on tobacco use in the laboratory.Methods81 students (34.6% men; n = 28) listened to five audio simulations of peer social contexts where offers to smoke tobacco were made (S-SIDE). For each social scenario, participants answered questions about their willingness to accept the offer to smoke and completed measures of smoking cognitions and tobacco use. Thirty days later, participants completed online assessments of smoking behavior.ResultsWillingness to accept smoking offers in the S-SIDE procedure was related to smoking at both time points (T1: r(81) = .37, p
      PubDate: 2017-12-12T16:35:43.573921-05:
      DOI: 10.1111/add.14133
  • Risk of Amphetamine Use Disorder and Mortality Among Incident Users of
           Prescribed Stimulant Medications in the Veterans Administration
    • Authors: Arthur N. Westover; Paul A. Nakonezny, Ethan A. Halm, Bryon Adinoff
      Abstract: Background and aimsNonmedical use of prescribed stimulant medications is a growing concern. This study's aims were to ascertain the demographics of stimulant medication users compared with nonusers, examine temporal trends of stimulant medication use, and estimate risk factors for development of amphetamine use disorder (AUD) and mortality among new users of stimulant medications.DesignCox proportion hazards regression in a retrospective cohort adjusted by baseline covariates.SettingUnited States, national administrative database of the Veterans Affairs (VA) Healthcare systemParticipantsAdult incident users of stimulant medications (n=78,829) from fiscal years (FY) 2001 to 2012.MeasurementsPrimary outcomes were time-to-event: 1) occurrence of AUD diagnosis and 2) death. Baseline covariates included demographic information, FDA-approved indications for stimulant use, substance use disorders (SUD), and depression.FindingsStimulant users compared with nonusers were younger, more likely non-Hispanic white, and female. Incident stimulant medication users increased 3-fold from FY2001 to FY2012 and 8-fold among adults 18 to 44 years of age. Nearly 1 in 10 incident users in FY2012 had a comorbid baseline SUD. Off-label use was common—nearly 3 of every 5 incident users in FY2012. Comorbid SUDs among incident stimulant medication users were risk factors for occurrence of AUD during follow-up, with adjusted hazard ratio (AHR) estimates ranging from 1.54 to 2.62 (ps
      PubDate: 2017-12-07T09:55:29.742806-05:
      DOI: 10.1111/add.14122
  • E-cigarette Price Sensitivity Among Middle and High School Students:
           Evidence from Monitoring the Future
    • Authors: Michael F. Pesko; Jidong Huang, Lloyd D. Johnston, Frank J. Chaloupka
      Abstract: AimsWe estimate associations between e-cigarette prices (both disposable and refill) and e-cigarette use among middle and high school students in the United States. We also estimate associations between cigarette prices and e-cigarette use.DesignWe use regression models to estimate the associations between e-cigarette and cigarette prices and e-cigarette use. In our regression models, we exploit changes in e-cigarette and cigarette prices across four periods of time and across 50 markets. We report the associations as price elasticities. In our primary model, we control for socio-demographic characteristics, cigarette prices, tobacco control policies, market fixed effects, and year-quarter fixed effects.SettingUnited States of America.Participants24,370 middle and high school students participating in the Monitoring the Future Survey in years 2014 and 2015.MeasurementsSelf-reported e-cigarette use over the last 30 days. Average quarterly cigarette prices, e-cigarette disposable prices, and e-cigarette refill prices were constructed from Nielsen retail data (inclusive of excise taxes) for 50 U.S. markets.FindingsIn a model with market fixed effects, we estimate that a 10% increase in e-cigarette disposable prices is associated with a reduction in the number of days vaping among e-cigarette users by approximately 9.7% (95% CI = -17.7% to 1.8%; p=0.02) and is associated with a reduction in the number of days vaping by the full sample by approximately 17.9% (95% CI=-31.5% to -4.2%; p=0.01). Refill e-cigarette prices were not statistically significant predictors of vaping. Cigarette prices were not significantly associated with e-cigarette use regardless of the e-cigarette price used. However, in a model without market fixed effects, cigarette prices were a statistically significant positive predictor of total e-cigarette use.ConclusionsHigher e-cigarette disposable prices appear to be associated with reduced e-cigarette use among adolescents in the US.
      PubDate: 2017-11-29T01:25:22.039218-05:
      DOI: 10.1111/add.14119
  • Excess overdose mortality immediately following transfer of patients and
           their care as well as after cessation of opioid substitution therapy.
    • Authors: Karolina M. Bogdanowicz; Robert Stewart, Chin-Kuo Chang, Hitesh Shetty, Mizanur Khondoker, Edward Day, Richard D. Hayes, John Strang
      Abstract: AimsTo investigate clustering of all-cause and overdose deaths after a transfer of patients and their care to alternative treatment provider and after the end of opioid substitution therapy (OST) in opioid-dependent individuals in specialist addiction treatment.Design, Setting and ParticipantsMortality data were identified within a sample of 5,445 patients with opioid use disorder who had received OST treatment between 1st April 2008 and 31st December 2013 from a large mental healthcare provider in United Kingdom. We investigated the circumstances and distribution of the 332 deaths identified within the observation window with a specific focus on overdose deaths (n=103) after a planned discharge, drop-out and transfer between services.MeasurementsCrude mortality rates for overdose mortality 7/14/28/180 days after the end of treatment/transfer for overdose mortality.FindingsOf 47 individuals who died from overdose after having been transferred between services, 9 died in the first 2 weeks (crude mortality rate [CMR] 136.4, 64.3 – 243.1 95% CI) and a further 5 died in the first month post-transfer (CMR 79.5, 44.2 – 129.7 95% CI). Of the 32 individuals who died from overdose after planned OST cessation, 5 died in the first 2 weeks (CMR 151.5, 51.1 – 319.0 95% CI) and a further 4 died in the first month post discharge (CMR 82.6, 38.4 – 151.0 95% CI).ConclusionsIn the UK, opioid-dependent people who are transferred to an alternative treatment provider for continuation of their opioid substitution therapy experience high overdose mortality rates, with substantially higher rates in the first month (especially first 14 days) following transfer.
      PubDate: 2017-11-27T19:01:01.78403-05:0
      DOI: 10.1111/add.14114
  • Advancing alcohol research and treatment: contentions and debates about
           treatment intensity, goals and outcomes in the 1970s and 1980s
    • Authors: Steve Allsop
      Abstract: AimsThis narrative exploration of alcohol treatment research focuses on key contentions and advances in alcohol treatment during the critical 1970s and 1980s.MethodsPapers and books which signal some of the major debates and advances in alcohol treatment research were selected from the 1970s and 1980s. The selection process was based on significant debate during this period, and included those that influenced the field in general and this author in particular.ResultsThis was a period where challenges to traditional models and concepts, and the perceived universal need for long-term treatment, were accompanied by contention but also advances in research and treatment approaches. The debates and advances resonate today. These include the recognition that: intensive and long-term treatment is not always required; for dependent drinkers, relapse is a common treatment outcome meriting specific treatment approaches to prevent and reduce this risk; controlled drinking is a treatment option, especially for younger and less dependent drinkers; and an important contributor to enduring change is access to, and realization of, improvements in the quality of life.ConclusionsPioneering research and publications in the 1970s and 1980s, sometimes conducted and produced in contentious contexts, influenced significantly conceptualizations of alcohol-related problems, and laid the foundations for treatment hypotheses and research, improving access to a broader range of evidence-based treatment. These underpinning works influenced the development of stepped-up care from brief to intensive interventions, relapse prevention and treatment options not limited to abstinence, and they identified the need to include a stronger focus on quality of life.
      PubDate: 2017-11-27T04:38:11.80713-05:0
      DOI: 10.1111/add.14064
  • Evaluating clinical stop-smoking services globally: towards a minimum data
    • Authors: Andrew L. Skinner; Robert West, Martin Raw, Emma Anderson, Marcus R. Munafò
      Abstract: Background and aimsBehavioural and pharmacological support for smoking cessation improves the chances of success and represents a highly cost-effective way of preventing chronic disease and premature death. There is a large number of clinical stop-smoking services throughout the world. These could be connected into a global network to provide data to assess what treatment components are most effective, for what populations and in what settings. To enable this, a minimum data set (MDS) is required to standardize the data captured from smoking cessation services globally.MethodsWe describe some of the key steps involved in developing a global MDS for smoking cessation services and methodologies to be considered for their implementation, including approaches for reaching consensus on data items to include in a MDS and for its robust validation. We use informal approximations of these methods to produce an example global MDS for smoking cessation. Our aim with this is to stimulate further discussion around the development of a global MDS for smoking cessation services.ResultsOur example MDS comprises three sections. The first is a set of data items characterizing treatments offered by a service. The second is a small core set of data items describing clients’ characteristics, engagement with the service and outcomes. The third is an extended set of client data items to be captured in addition to the core data items wherever resources permit.ConclusionsThere would be benefit in establishing a minimum data set (MDS) to standardize data captured for smoking cessation services globally. Once implemented, a formal MDS could provide a basis for meaningful evaluations of different smoking cessation treatments in different populations in a variety of settings across many countries.
      PubDate: 2017-11-26T22:50:45.40914-05:0
      DOI: 10.1111/add.14072
  • Communities Mobilizing for Change on Alcohol (CMCA): Secondary Analyses of
           an RCT Showing Effects of Community Organizing on Alcohol Acquisition by
           Youth in the Cherokee Nation
    • Authors: Alexander C. Wagenaar; Melvin D. Livingston, Dallas W. Pettigrew, Terrence K. Kominsky, Kelli A. Komro
      Abstract: AimsWe evaluated the effects of a community organizing intervention, Communities Mobilizing for Change on Alcohol (CMCA), on the propensity of retail alcohol outlets to sell alcohol to young buyers without age identification and on alcohol acquisition behaviors of underage youth.DesignRandom assignment of community to treatment (n=3) or control (n=2). Student surveys were conducted four times per year for three years; the cohort was in 9th and 10th grades in the 2012-13 academic year. Alcohol purchase attempts were conducted every 4 weeks at alcohol retailers in each community (31 repeated waves).SettingThe Cherokee Nation, located in northeastern Oklahoma, USA.Participants1399 high school students (50% male; 45% American Indian) and 113 stores licensed to sell alcohol across 5 study communities.InterventionLocal community organizers formed independent citizen Action Teams to advance policies, procedures and practices of local institutions in ways to reduce youth access to alcohol and foster community norms opposed to teen drinking.MeasurementsPerceptions regarding police enforcement and perceived difficulty of and self-reported actual acquisition of alcohol from parents, adults, peers, and stores.FindingsAlcohol purchases by young-appearing buyers declined significantly, an 18 (95% CI: 3, 33) percentage-point reduction over the intervention period. Student survey results show statistically significant differences in the trajectory of perceived police enforcement, increasing 7 (4, 10) percentage-points, alcohol acquisition from parents, decreasing 4, (0.1, 8) percentage-points, acquisition from 21+ adults, decreasing 6 (0.04, 11) percentage points, from
      PubDate: 2017-11-25T15:35:23.63499-05:0
      DOI: 10.1111/add.14113
  • Lifetime Marijuana Use and Subclinical Atherosclerosis: The Coronary
           Artery Risk Development in Young Adults (CARDIA) Study
    • Authors: Reto Auer; Stephen Sidney, David Goff, Eric Vittinghoff, Mark J. Pletcher, Norrina B. Allen, Jared P. Reis, Cora E. Lewis, Jeffrey Carr, Jamal S. Rana
      Abstract: Background and aimsUnlike tobacco, the effect of marijuana smoke on subclinical atherosclerosis, a surrogate measure for cardiovascular disease, is not known. This study aimed to determine the association between lifetime exposure to marijuana and measures of subclinical atherosclerosis in mid-life.Design, setting and participantsWe used data from the US-based Coronary Artery Risk Development in Young Adults (CARDIA) Study, a cohort of black and white men and women aged 18-30 years at baseline in 1985-86, with up to 7 follow-up exams over 25 years. The number of CARDIA participants included in this study was 3,498.MeasurementsCumulative years of exposure to marijuana (expressed in ‘marijuana-years’, with 1 marijuana-year equivalent to 365 days of use) using repeated assessments every 2-5 years, over 25 years. Abdominal artery calcium (AAC) and coronary artery calcium (CAC) scores measured by computed tomography at Year 25 exam.ResultsAmong 3,117 participants with AAC and CAC measurements, 2,627 (84%) reported past marijuana use and 1,536 (49%) past daily tobacco smoking. Compared with tobacco smokers, of which 46% reported 10 or more pack-years of use, only 12% of marijuana users reported 5 or more marijuana-years of use and only 6% reported having used marijuana daily. We found a significant interaction between never- and ever- tobacco users on the association between cumulative marijuana use and AAC (p=0.05). Among those who never smoked tobacco, cumulative marijuana-years were not associated with AAC or CAC in models adjusted for demographics, cardiovascular risk factors, licit and illicit drug exposure and depression symptoms. However, among ever tobacco smokers, marijuana exposure was associated with AAC and CAC. At 5 marijuana-years of exposure, using AAC=0 and CAC=0 as a reference group, the odds ratio (OR) was 1.97 (95%CI:1.21-3.21,p=0.007) for AAC>0/CAC=0 and 1.83 (95%CI:1.02-3.31,p=0.04) for CAC>0, regardless of AAC. Tobacco smoking was strongly associated with both AAC and CAC.ConclusionMarijuana use appears to be associated with subclinical atherosclerosis, but only among ever tobacco users.
      PubDate: 2017-11-22T22:35:31.397056-05:
      DOI: 10.1111/add.14110
  • Alcohol-related harm in emergency departments: a prospective, multicentre
    • Authors: Assoc Prof Diana Egerton-Warburton; Andrew Gosbell, Katie Moore, Angela Wadsworth, Drew Richardson, Daniel M. Fatovich
      Abstract: BackgroundEmergency department alcohol-related presentation data are not routinely collected. It is likely that previous research has underestimated the numbers of patients presenting with alcohol-related conditions.DesignMulticentre, prospective study. Patients were prospectively screened for alcohol-related presentations over a seven-day period in December 2014. Part one involved screening to determine alcohol positive ED presentations, and data collection of patient demographic and clinical information. Part two involved a consent-based survey conducted with patients aged ≥ 14 years to perform Alcohol Use Disorders Identification Test (AUDIT) scores.SettingEight EDs in Australia and New Zealand, representing differing hospital role delineations.ParticipantsA total of 8652 patients aged ≥ 14 years attended and 8435 (97.5%) were screened.MeasurementsThe main outcome measure was the proportion of patients who had an alcohol-related presentation termed ‘alcohol positive’, using predefined criteria. It included injuries, intoxication, medical conditions and injuries caused by an alcohol-affected third party. Secondary outcomes included demographic and clinical information, the type of alcohol-related presentations and AUDIT scores.Findings801 (9.5%; 95%CI, 8.9%-10.1%) presentations were identified as alcohol positive, ranging between 4.9% and 15.2% across sites. Compared with alcohol negative patients, alcohol positive patients were more likely to be male (OR 1.90) (95% CI 1.63-2.21), younger (median age 37 years vs 46 years, P
      PubDate: 2017-11-20T10:45:22.951632-05:
      DOI: 10.1111/add.14109
  • Incidence and risk factors for mortality after release from prison in
           Australia: A prospective cohort study
    • Authors: Simon J. Forsyth; Megan Carroll, Nicholas Lennox, Stuart A. Kinner
      Abstract: AimsTo estimate the incidence and identify risk factors for mortality in adults released from prisons in the state of Queensland, Australia.DesignProspective cohort study, linking baseline survey data with a national death register.SettingSelected prisons within Queensland, Australia.ParticipantsAdults (N=1320) recruited in Queensland prisons within 6 weeks of expected release, between August 2008 and July 2010, followed for up to 4.7 years in the community.MeasurementsParticipants completed a comprehensive baseline survey covering psychosocial circumstances, physical and mental health, substance use, and health risk behaviours. Clinical data were abstracted from prison medical records and obtained through probabilistic linkage with state-based, community health records. Dates of prison release and reincarceration were obtained from correctional records. Deaths were identified through probabilistic linkage with the National Death Index. Adjusted hazard ratios (AHR) were calculated using proportional hazards regression models. Standardised mortality ratios (SMR) were calculated using the population of Queensland as the reference. General population data were obtained from the Australian Bureau of Statistics.FindingsThe rate of mortality in the cohort was higher than in the age-sex matched general population of Queensland for all causes (SMR=4.0, 95%CI=2.9-5.4) and drug-related causes (SMR=32, 95%CI=19-55). In a multivariable model, adjusting for age, sex and Indigenous status, factors associated with increased mortality risk included expecting to have average or better funds available on release (AHR=2.9, 99%CI=1.2-7.1), poor mental health (AHR=2.6, 99%CI=1.1-6.1), and self-reported lifetime history of overdose (AHR=2.5, 99%CI=1.04-6.2).ConclusionsPeople released from prison in Queensland, Australia are at increased risk of death, particularly due to drug-related causes. Those at greatest risk of death are characterised by poor physical and mental health and a history of risky substance use.
      PubDate: 2017-11-20T07:50:50.291541-05:
      DOI: 10.1111/add.14106
  • The harm reduction impact of cryptomarkets: inequality and opportunity
    • Authors: Harry R. Sumnall
      Abstract: Commentary to: Will growth in cryptomarket drug buying increase the harms of illicit drugs'
      PubDate: 2017-11-19T21:10:20.536572-05:
      DOI: 10.1111/add.14065
  • Opioid Dependence and Pregnancy in Early Twentieth-Century America
    • Authors: Nathan Tauger
      Abstract: Background and AimsResearch on Neonatal Abstinence Syndrome has prompted discussion over how to ensure best outcomes for pregnant women who use drugs and for drug-dependent newborns. Before Neonatal Abstinence Syndrome and the 1980s panic of “crack babies,” turn-of-the-century American medical journals discussed infants born to drug-using mothers. This paper aimed to determine whether women who used drugs while pregnant in early twentieth-century America were subject to the stigma many face today.MethodsRecords from early twentieth century medical journals, narcotic maintenance clinics, prisons that held drug users, and conferences on narcotics were examined. Dr. Charles Terry's outspokenness on drug addiction and pregnancy merited closer examination of his work, particularly The Opium Problem.ResultsSome physicians saw drug-dependent newborns as scientific proof that addiction was a physiological disease and not subject to questions of morality. This theory was discarded in the 1920s. In that decade, beliefs that children born to drug-using parents threatened national well-being proliferated. Following formal medicine's retreat from addiction treatment, research on drug addiction and pregnancy fell into obscurity until decades later.ConclusionsThe precedent that women who use drugs while pregnant deserve humane treatment extends to the early twentieth century in the US. From 1910 to 1930, perceptions of infants of drug-using women changed from hopeful to fearful.
      PubDate: 2017-11-11T09:45:20.708655-05:
      DOI: 10.1111/add.14100
  • Toxicity: exploring and expanding the concept
    • Authors: John Strang; Joanne Neale, Rebecca McDonald, Nicola Kalk
      Pages: 592 - 594
      PubDate: 2017-12-04T00:10:31.684814-05:
      DOI: 10.1111/add.14080
  • The diverging trajectories of cannabis and tobacco policies in the United
           States: reasons and possible implications
    • Authors: Wayne Hall; Lynn T. Kozlowski
      Pages: 595 - 601
      Abstract: AimTo examine briefly the (i) rationales for two policy proposals in the United States to make it mandatory for cigarettes to contain very low levels of nicotine and to legalize cannabis for recreational use by adults; and (ii) possible lessons that participants in each policy debate may learn from each other.MethodWe briefly describe the diverging policies towards cannabis and tobacco in the United States, explain and critically analyse their rationales and discuss possible policy lessons.ResultsAdvocates of cannabis legalization have argued that prohibition has been an ineffective and expensive policy that penalizes ethnic minority users unjustly of a drug that is far less harmful than alcohol. The prohibition of traditional tobacco cigarettes has been advocated as a way to eliminate cigarette smoking. These proposals embody very different attitudes towards the harms of recreational adult drug use. Advocates of nicotine prohibition demand that alternative methods of nicotine delivery must be shown to be completely safe before adults are allowed to use them. Advocates of tobacco prohibition ignore evidence that smokers may not use these products and the likelihood of expanding the illicit tobacco market. Advocates of legalizing and regulating recreational cannabis ignore the need to tax and regulate sales in order to minimize the harms of heavy use.ConclusionsIt is not clear that the prohibition of adult use has a useful role to play in the regulation of either cannabis or tobacco. If both products remain legal, the goals of regulating tobacco and cannabis products should be to restrict youth access, promote the use of the least harmful products, provide users with evidence-based information on both absolute and differential product risks of use and use differential taxes and marketing controls to promote ways of using these products that cause the least harm to their users.
      PubDate: 2017-05-22T21:45:22.70059-05:0
      DOI: 10.1111/add.13845
  • American exceptionalism and the failure to learn from mistakes of the past
    • Authors: Bryce Pardo
      Pages: 602 - 603
      Abstract: Commentary to: The diverging trajectories of cannabis and tobacco policies in the United States: reasons and possible implications
      PubDate: 2017-08-02T22:50:22.54994-05:0
      DOI: 10.1111/add.13917
  • The trajectories of cannabis and tobacco policies in the United States,
           Uruguay, Canada and Portugal: is more cross-substance learning possible
           outside the United States'
    • Authors: Caitlin Elizabeth Hughes
      Pages: 603 - 605
      Abstract: Commentary to: The diverging trajectories of cannabis and tobacco policies in the United States: reasons and possible implications
      PubDate: 2017-08-23T21:40:24.490463-05:
      DOI: 10.1111/add.13954
  • The impact diverging public opinion on cannabis and tobacco regulation has
           on constructive engagement between advocates
    • Authors: Deborah Arnott
      Pages: 605 - 606
      Abstract: Commentary to: The diverging trajectories of cannabis and tobacco policies in the United States: reasons and possible implications
      PubDate: 2017-10-16T21:15:34.910671-05:
      DOI: 10.1111/add.14024
  • Efficacy of a web-based intervention with and without guidance for
           employees with risky drinking: results of a three-arm randomized
           controlled trial
    • Authors: Leif Boß; Dirk Lehr, Michael Patrick Schaub, Raquel Paz Castro, Heleen Riper, Matthias Berking, David Daniel Ebert
      Pages: 635 - 646
      Abstract: AimsTo test the efficacy of a web-based alcohol intervention with and without guidance.DesignThree parallel groups with primary end-point after 6 weeks.SettingOpen recruitment in the German working population.ParticipantsAdults (178 males/256 females, mean age 47 years) consuming at least 21/14 weekly standard units of alcohol (SUA) and scoring ≥ 8/6 on the Alcohol Use Disorders Identification Test.InterventionFive web-based modules including personalized normative feedback, motivational interviewing, goal setting, problem-solving and emotion regulation during 5 weeks. One intervention group received an unguided self-help version (n=146) and the second received additional adherence-focused guidance by eCoaches (n=144). Controls were on a waiting list with full access to usual care (n=144).MeasurementsPrimary outcome was weekly consumed SUA after 6 weeks. SUA after 6 months was examined as secondary outcome, next to numbers of participants drinking within the low-risk range, and general and work-specific mental health measures.FindingsAll groups showed reductions of mean weekly SUA after 6 weeks (unguided: −8.0; guided: −8.5; control: −3.2). There was no significant difference between the unguided and guided intervention (P=0.324). Participants in the combined intervention group reported significantly fewer SUA than controls [B=−4.85, 95% confidence interval (CI)=−7.02 to −2.68, P 
      PubDate: 2017-12-04T20:00:25.610397-05:
      DOI: 10.1111/add.14085
  • Associations between methadone maintenance treatment and crime: a 17-year
           longitudinal cohort study of Canadian provincial offenders
    • Authors: Angela Russolillo; Akm Moniruzzaman, Lawrence C. McCandless, Michelle Patterson, Julian M. Somers
      Pages: 656 - 667
      Abstract: AimsTo estimate and test the difference in rates of violent and non-violent crime during medicated and non-medicated methadone treatment episodes.Design, Setting and ParticipantsThe study involved linkage of population level administrative data (health and justice) for all individuals (n = 14 530) in British Columbia, Canada with a history of conviction and who filled a methadone prescription between 1 January 1998 and 31 March 2015. Methadone maintenance treatment was the primary independent variable and was treated as a time-varying exposure. Each participant's follow-up (mean: 8 years) was divided into medicated (methadone was dispensed) and non-medicated (methadone was not dispensed) periods with mean durations of 3.3 and 4.6 years, respectively.MeasurementsSocio-demographics of participants were examined along with the main outcomes of violent and non-violent offences.FindingsDuring the first 2 years of treatment (≤ 2.0 years), periods in which methadone was dispensed were associated with a 33% lower rate of violent crime [0.67 adjusted hazard ratio (AHR), 95% confidence intervals (CI) = 0.59, 0.76] and a 35% lower rate of non-violent crime (0.65 AHR, 95% CI = 0.62, 0.69) compared with non-medicated periods. This equates to a risk difference of 3.6 (95% CI = 2.6, 4.4) and 37.2 (95% CI = 33.0, 40.4) fewer violent and non-violent offences per 100 person-years, respectively. Significant but smaller protective effects of dispensed methadone were observed across longer treatment intervals (2.0 to ≤ 5.0 years, 5.0 to ≤ 10.0 years).ConclusionsAmong a cohort of Canadian offenders, rates of violent and non-violent offending were lower during periods when individuals were dispensed methadone compared with periods in which they were not dispensed methadone.
      PubDate: 2017-11-19T20:55:24.140817-05:
      DOI: 10.1111/add.14059
  • Impulsivity predicts poorer improvement in quality of life during early
           treatment for people with methamphetamine dependence
    • Authors: Adam J. Rubenis; Rebecca E. Fitzpatrick, Dan I. Lubman, Antonio Verdejo-Garcia
      Pages: 668 - 676
      Abstract: Background and aimsMethamphetamine dependence is associated with heightened impulsivity and diminished quality of life, but the link between impulsivity and changes in quality of life during treatment has not been examined. We aimed to investigate how different elements of impulsivity predict change in quality of life in the 6 weeks after engaging in treatment.DesignLongitudinal, observational cohort study.SettingPublic and private detoxification and rehabilitation facilities in metropolitan Melbourne, Australia.ParticipantsOne hundred and eight individuals with methamphetamine dependence (81 male) tested within 3 weeks of commencing treatment; 80 (74%) were followed-up at 6 weeks.MeasurementsThe Continuous Performance Test-2 measured impulsive action (cognitive and motor impulsivity); the Delay Discounting Task measured impulsive choice. Quality of life was measured with the World Health Organization Quality of Life Scale—Brief, which includes social, psychological, physical and environment domains. Control variables included age, gender, estimated IQ, depression severity score, methamphetamine dependence severity score, cannabis dependence severity score and treatment modality.FindingsWe found that all three forms of impulsivity were significant predictors of change in the social domain: motor impulsivity (β = −0.54, P = 0.013), cognitive impulsivity (β = −0.46, P = 0.029) and impulsive choice (β = −0.26, P = 0.019). Change in the psychological domain was predicted significantly by motor impulsivity (β = −0.45, P = 0.046). Control variables of age and depression were associated significantly with changes in the physical domain.ConclusionsIn Australian methamphetamine-dependent individuals, elevated impulsivity predicts lower improvement of social and psychological quality of life in the first 6–9 weeks of treatment.
      PubDate: 2017-11-19T20:45:31.009054-05:
      DOI: 10.1111/add.14058
  • Relationship between high-risk patients receiving prescription opioids and
           high-volume opioid prescribers
    • Authors: Hsien-Yen Chang; Irene B. Murimi, Christopher M. Jones, G. Caleb Alexander
      Pages: 677 - 686
      Abstract: Aims(1) To characterize the amount of prescription opioids prescribed for high-risk patients by low-volume prescribers; (2) to quantify how high- and low-volume prescribers differ systematically in their prescribing patterns.DesignCross-sectional study using 2015 longitudinal, all-payer QuintilesIMS pharmacy claims. We conducted an aggregated analysis for the first aim and an individual-level analysis for the second aim.SettingCalifornia, Florida, Georgia, Maryland, and Washington, USA.ParticipantsAmong 4 046 275 patients, we identified 375 848 concomitant users (filling more than 30-days of concomitant opioids and benzodiazepines), 150 814 chronic users (using 100+ morphine milligram equivalents (MMEs) per day for more than 90 days), and 3190 patients prescribed opioids by> 3 prescribers and filling opioids at> 3 pharmacies during any 90-day period. Among 192 126 prescribers, we identified 8023 high-volume prescribers, who comprised the highest fifth percentile of opioid volume during four calendar quarters.Measurements(1) MME dose per transaction, (2) days supplied per transaction, (3) total opioid volume per patient and (4) number of prescriptions per patient. We also examined differences in opioid dispensing between high- and low-volume prescribers among patients receiving opioids from both.FindingsLow-volume prescribers accounted for 15–29% of opioid volume and 18–56% of opioid prescriptions for high-risk patients, compared with 28–37% and 53–58% for low-risk patients. After accounting for state of residence, comorbid burden, prescriber specialty and care sequence, patients were more likely to receive higher doses (60.9 versus 53.2 MMEs per day, P 
      PubDate: 2017-11-29T22:04:50.552394-05:
      DOI: 10.1111/add.14068
  • Self-reported marijuana use over 25 years and abdominal adiposity: the
           Coronary Artery Risk Development in Young Adults (CARDIA) Study
    • Authors: Michael P. Bancks; Reto Auer, J. Jeffrey Carr, David C. Goff, Catarina Kiefe, Jamal S. Rana, Jared Reis, Stephen Sidney, James G. Terry, Pamela J. Schreiner
      Pages: 689 - 698
      Abstract: AimsWe investigated the association between cumulative lifetime and current marijuana use with total abdominal adipose tissue (AT), visceral AT, subcutaneous AT, intermuscular AT, and mean liver attenuation (LA) at mid-life.DesignLongitudinal and cross-sectional secondary data analysis of participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study.SettingCARDIA field centers in Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA, USA.ParticipantsCARDIA participants, aged 18–30 years in 1985–1986, who were present at the clinic examination in 2010–2011 (n = 2902).MeasurementsMarijuana use was assessed from responses to self-administered questionnaires at 8 CARDIA examinations over 25 years, determined as cumulative marijuana-years and current use status. Non-contrast computed tomography imaging of the abdomen was obtained in 2010–2011.FindingsIn 2010–2011, 84% of participants reported a history of marijuana use with 11% reporting use within the past 30 days. Before adjustment, we observed greater cumulative marijuana use was associated with lower total abdominal and subcutaneous AT volume and lower LA and current marijuana use was associated with lower subcutaneous AT. However, after adjustment for age, sex, race, field center, cigarette pack-years and current use, regular alcohol consumption, cumulative drink-years, and physical activity, neither cumulative marijuana use nor current use showed an association with any abdominal adipose depot. Our estimates did not differ by age, sex, or race nor after accounting for cohort attrition.ConclusionNeither cumulative marijuana use nor current marijuana use is associated with total abdominal, visceral, subcutaneous, or intermuscular adipose tissue, or liver attenuation in mid-life.
      PubDate: 2017-12-07T01:42:54.858523-05:
      DOI: 10.1111/add.14097
  • The prevalence, incidence, and gender and age-specific incidence of
           problem gambling: results of the Swedish longitudinal gambling study
    • Authors: Max Abbott; Ulla Romild, Rachel Volberg
      Pages: 699 - 707
      Abstract: AimsTo estimate the prevalence, incidence and gender and age-specific incidence of problem gambling in the Swedish adult population.DesignLongitudinal cohort study with linkage to register data.SettingSweden.ParticipantsStratified random sample aged 16–84 years at baseline (n = 8165) re-assessed a year later (n = 6021).MeasurementsProblem gambling (life-time and past 12 months) was measured by the South Oaks Gambling Screen–Revised (SOGS-R). Past 12-month (current) problem gambling was also measured by the Problem Gambling Severity Index (PGSI).FindingsThe SOGS-R combined current pathological and problem gambling prevalence rate (PR) was 2.1 [95% confidence interval (CI) = 1.8–2.4] at baseline and 1.7 (1.4–2.0) at follow-up, approximately half the corresponding life-time estimates.[Correction added on 22 Dec 2017, after first online publication: In the preceding sentence, the SOGS-R combined current pathological and problem gambling prevalence rate (PR) was incorrectly reported as being double the corresponding life-time rate. It has been corrected in this version.] PGSI combined current problem and moderate-risk gambling PRs were 2.2 (1.9–2.5) at baseline and 1.9 (1.6–2.2) at follow-up. Combined incidence rates (IRs) were 1.0 (0.8–1.3) (SOGS-R) and 1.4 (1.1–1.7) (PGSI), with more than three-quarters being new cases. While first-time IRs did not vary by gender, males had a higher relapse IR and proportionately more females were new cases. The young adult IR was more than double the older adult IR; similar proportions were new cases.ConclusionsThe actual incidence of problem gambling relapse in Sweden is likely to be higher than estimated. The profile of problem gambling in Sweden is likely to change over time, with increased proportions of women and older adults.
      PubDate: 2017-11-24T20:20:22.851009-05:
      DOI: 10.1111/add.14083
  • Cost-effectiveness of personal tailored risk information and taster
           sessions to increase the uptake of the NHS stop smoking services: the
           Start2quit randomized controlled trial
    • Authors: Qi Wu; Hazel Gilbert, Irwin Nazareth, Stephen Sutton, Richard Morris, Irene Petersen, Simon Galton, Steve Parrott
      Pages: 708 - 718
      Abstract: AimsTo assess the cost-effectiveness of a two-component intervention designed to increase attendance at the NHS Stop Smoking Services (SSSs) in England.DesignCost-effectiveness analysis alongside a randomized controlled trial (Start2quit).SettingNHS SSS and general practices in England.ParticipantsThe study comprised 4384 smokers aged 16 years or more identified from medical records in 99 participating practices, who were motivated to quit and had not attended the SSS in the previous 12 months.Intervention and comparatorIntervention was a personalized and tailored letter sent from the general practitioner (GP) and a personal invitation and appointment to attend a taster session providing information about SSS. Control was a standard generic letter from the GP advertising SSS and asking smokers to contact the service to make an appointment.MeasurementsCosts measured from an NHS/personal social services perspective, estimated health gains in quality-adjusted life-years (QALYs) measured with EQ-5D and incremental cost per QALY gained during both 6 months and a life-time horizon.FindingsDuring the trial period, the adjusted mean difference in costs was £92 [95% confidence interval (CI) = –£32 to –£216) and the adjusted mean difference in QALY gains was 0.002 (95% CI = –0.001 to 0.004). This generates an incremental cost per QALY gained of £59 401. The probability that the tailored letter and taster session is more cost-effective than the generic letter at 6 months is never above 50%. In contrast, the discounted life-time health-care cost was lower in the intervention group, while the life-time QALY gains were significantly higher. The probability that the intervention is more cost-effective is more than 83% using a £20 000–30 000 per QALY-gained decision-making threshold.ConclusionsAn intervention designed to increase attendance at the NHS Stop Smoking Services (tailored letter and taster session in the services) appears less likely to be cost-effective than a generic letter in the short term, but is likely to become more cost-effective than the generic letter during the long term.
      PubDate: 2017-12-11T00:17:54.486313-05:
      DOI: 10.1111/add.14086
  • Patterns of substance use and mortality risk in a cohort of
           ‘hard-to-reach’ polysubstance users
    • Authors: Linn Gjersing; Anne Line Bretteville-Jensen
      Pages: 729 - 739
      Abstract: AimsTo examine the mortality risk in a cohort of ‘hard-to-reach’ polysubstance users and its putative associations with substance use. Specifically, we estimated all-cause mortality risk as a function of individual substance use indicators, and then as a function of their complex, ‘real-life’ patterns as identified through latent class analysis (LCA).DesignProspective cohort study among street- and low-threshold service-recruited polysubstance users included between September and November 2013 and followed through the National Cause of Death Registry until 31 October 2015.SettingSeven Norwegian cities.ParticipantsA total of 884 users of illegal opioids and/or stimulants. Of these, 357 were in opioid substitution treatment (OST) at the time of inclusion. Forty-four participants died during follow-up.MeasurementsPrimary outcome: all-cause mortality risk. Unadjusted and adjusted Cox proportional hazard (PH) regression models (covariates: male, age, homelessness/shelter use, overdose experience, OST status, years of injecting, individual substance use indicators, city, use patterns). LCA models estimated separately for those in and those not in OST due to measurement invariance.FindingsThe crude mortality rate was 2.52 per 100 person-years. Standardized mortality ratio was 26.11 [95% confidence interval (CI) = 10.06–54.87] for women and 10.71 (95% CI = 6.39–16.81) for men. No single drug use indicator, such as ‘heroin injection’ or ‘number of drugs used’, was associated with the mortality risk. However, meaningful use patterns were identified; three OST and non-OST patterns each. The non-OST patterns ‘polysubstance injectors’ [hazard ratio (HR) = 3.45, 95% CI = 0.98–12.14] and ‘low frequent injectors’ (HR = 3.17, CI = 1.05–9.56) were associated significantly with the mortality risk even when adjusted for other known risk factors.ConclusionsIn a Norwegian prospective cohort study, ‘hard-to-reach’ polysubstance users had a more than 10 times higher mortality risk than the general population. Mortality risk was not a function of any single drug use indicator, but two distinct combinations of substances, frequencies and routes of administration were associated with the mortality risk.
      PubDate: 2017-11-24T20:15:26.450761-05:
      DOI: 10.1111/add.14053
  • The genetic and environmental architecture of substance use development
           from early adolescence into young adulthood: a longitudinal twin study of
           comorbidity of alcohol, tobacco and illicit drug use
    • Authors: Trine Waaktaar; Kees-Jan Kan, Svenn Torgersen
      Pages: 740 - 748
      Abstract: AimsTo investigate how use of alcohol, illicit drugs and tobacco come from substance-specific pathways and from pathways general to all three substances through adolescent development.DesignAnalysis of population-based survey. Adolescent twins reported alcohol use (AU), tobacco use (TU) and illicit drug use (IDU) in three waves (2006, 2008, 2010). Restructuring data by age allowed for variance decomposition into age- and substance-specific and common genetic and environmental variance components.SettingNorway.ParticipantsSeven national twin birth cohorts from 1988 to 1994, totalling 1483 pairs (558 monozygotic; 925 dizygotic, same and opposite sex).MeasurementsSix-point Likert scores of AU, TU and IDU on items from the Monitoring the Future Study.FindingsSubstance use was found to be highly heritable; a2 = 0.73 [95% confidence interval (CI) = 0.61–0.94] for AU, a2 = 0.36 (CI = 0.18–0.52); d2 = 0.49 (95% CI = 0.29–0.62) for IDU and a2 = 0.46 (95% CI = 0.23–0.54); d2 = 0.05 (95% CI = 0.00–0.07) for TU during the whole adolescence period. General substance use (GSU) was also highly heritable at each age and averaged a2 = 0.57 (95% CI = 0.48–0.66). There was a high genetic carry-over from earlier age to later age. Genetic effects on GSU at ages 12–14 years were still detectable 4 years later. New substance (general and specific)-genetic effects also appeared. IDU demonstrated significant non-additive genetic effects (ages 12–14 years). Shared environment had a small impact on AU only. There was almost no non-shared environmental carry-over from age to age, the effect probably due partly to reliability deficiency. Common genetic effects among substance and substance-specific genetic effects were observed at each age-period.ConclusionsAmong Norwegian adolescents, there appear to be strong genetic effects on both substance-specific and comorbid use of alcohol, illicit drugs and tobacco; individual differences in alcohol use can be explained partially by family background.
      PubDate: 2017-11-24T20:15:32.129178-05:
      DOI: 10.1111/add.14076
  • Sexual identity differences in high-intensity binge drinking: findings
           from a US national sample
    • Authors: Jessica N. Fish; Tonda L. Hughes, Stephen T. Russell
      Pages: 749 - 758
      Abstract: AimTo estimate sexual identity differences in high-intensity binge drinking.Design and settingCross-sectional US adult health survey from 2014 and 2015.ParticipantsUS adults aged 18 and older (n = 215 684; n = 203 562 heterosexual, n = 2784 lesbian/gay, n = 2892 bisexual, n = 686 ‘other’ and n = 1947 don't know/unsure).MeasurementsSelf-reported past 30-day standard binge and high-intensity binge drinking. Standard binge drinking cut-off values were 4+/5+ drinks for women and men, respectively. High-intensity binge drinking was measured as two and three times the standard level (8+ and 12+ drinks for women and 10+ and 15+ drinks for men).FindingsLesbian and bisexual women were more likely than heterosexual women to report consuming 4+ drinks (adjusted odds ratio [aOR] =1.57, confidence interval [CI] = 1.18, 2.09 and aOR = 1.83, CI = 1.45, 2.30 for lesbian and bisexual women, respectively); 8+ drinks (aOR = 3.86, CI = 2.39, 6.24, aOR = 2.07, CI = 1.39, 3.07); and 12+ drinks (aOR = 3.81, CI = 1.77, 8.19, aOR = 2.54, CI = 1.25, 5.14) on a single occasion in the past 30 days. Generally, gay and bisexual men were no more likely than heterosexual men to report standard or high-intensity binge drinking. However, bisexual men were more likely than heterosexual men to consume 15+ drinks (aOR = 1.76, 95% CI = 1.01, 3.06). Rates of standard and high-intensity binge drinking were similar between heterosexual and unsure men and women. Men and women who indicated ‘other’ sexual identities were generally less likely than heterosexuals to report standard and high-intensity binge drinking, with the exception of 4+ drinks for women and 10+ drinks for men.ConclusionsIn the United States, sexual minority women are more likely, and sexual minority men are equally likely, to drink at standard and high-intensity binge drinking levels as their heterosexual counterparts.
      PubDate: 2017-11-02T22:20:34.095825-05:
      DOI: 10.1111/add.14041
  • A man before his time: Russell's insights into nicotine, smoking,
           treatment and curbing the smoking problem
    • Authors: Ann McNeill; Debbie Robson
      Pages: 759 - 763
      Abstract: Background and aimsThis narrative review aimed to provide a brief overview of five key research ‘classics’ produced by the innovative and radical thought leader, Professor Michael Anthony Hamilton Russell (1932–2009), drawing upon his other work wherever feasible.MethodsNarrative review. From more than 250 publications, we selected papers we considered seminal texts, published in 1971, 1976, 1978, 1979 and 1991.ResultsRussell was among the first researchers to explain that smoking was a dependence disorder caused by the drug nicotine decades before this was recognized formally. He therefore saw quickly the importance of delivering nicotine in a less harmful format as a way of controlling nicotine withdrawal when stopping smoking, first studying nicotine gum. In addition to pharmacotherapies, Russell's research also explored the role of behavioural support, particularly the role of general practitioners (GPs), alone as well as supported by specialist clinics; this research underpinned initiatives in England to reimburse doctors for giving advice to smokers, and to provide a national network of smoking cessation services. Research on nicotine uptake from other delivery systems and routes led Russell to theorize that the speed and dose of delivery impacted upon the effectiveness of a product to act as a substitute for smoking. He commented on the addictiveness of the high nicotine boli delivered in quick succession when smoking cigarettes and argued that alternative recreational nicotine delivery systems would need to be promoted actively to smokers in order for them to compete with cigarettes, a forerunner for contemporary debates on electronic cigarettes.ConclusionsThe legacy of Russell's landmark research is seen in present-day nicotine science, policy and discourse.
      PubDate: 2017-11-15T02:05:04.025765-05:
      DOI: 10.1111/add.14043
  • Assessing causal relationships using genetic proxies for exposures: an
           introduction to Mendelian randomization
    • Authors: Srinivasa Vittal Katikireddi; Michael J. Green, Amy E. Taylor, George Davey Smith, Marcus R. Munafò
      Pages: 764 - 774
      Abstract: Background and aimsStudying the consequences of addictive behaviours is challenging, with understanding causal relationships from observational data being particularly difficult. For example, people who smoke or drink excessively are often systematically different from those who do not, are less likely to participate in research and may misreport their behaviours when they do. Furthermore, the direction of causation between an addictive behaviour and outcome may be unclear. Mendelian randomization (MR) offers potential solutions to these problems.MethodsWe describe MR's principles and the criteria under which it is valid. We identify challenges and potential solutions in its application (illustrated using two applied examples) and describe methodological extensions in its application.ResultsMR is subject to certain assumptions, and requires the availability of appropriate genetic data, large sample sizes and careful design and conduct. However, it has already been applied successfully to the addiction literature. The relationship between alcohol consumption (proxied by a variant in the ADH1B gene) and cardiovascular risk has been investigated, finding that alcohol consumption increases risk, with no evidence of a cardioprotective effect at moderate consumption levels. In addition, heaviness of smoking (proxied by a variant in the CHRNA5-A3-B4 gene cluster) and risk of depression and schizophrenia have been investigated, with no evidence of a causal effect of smoking on depression but some evidence of a causal effect on schizophrenia.ConclusionsMendelian randomization analyses are already producing robust evidence for addiction-related practice and policy. As genetic variants associated with addictive behaviours are identified, the potential for Mendelian randomization analyses will grow. Methodological developments are also increasing its applicability.
      PubDate: 2017-11-03T00:45:41.385956-05:
      DOI: 10.1111/add.14038
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