The challenges of investigating derived psychoactive cannabis product brand quality: Using a popular brand as an example

With widely divergent state and federal regulations and a history of suspect brands and illicit markets, derived psychoactive cannabis products (DPCPs) face contested discourse as to their content, quality, and safety. We conducted exploratory research on public-health related factors related to brand quality including assessing potential counterfeit products, website and social media presence, third party laboratory testing, distribution practices, and consumer experiences on social media. Findings indicate the difficulty consumers face in finding information related to DPCP brands, and the questionable quality of popularly branded products. We recommend regulation and oversight to ensure product safety

Age as a Moderator of the Association Between Anticipated Regret and the Posting and Deleting of Alcohol-Related Content on Social Networking Sites Among Adolescents and Young Adults

Research demonstrates associations between alcohol consumption and posting alcohol-related content on social networking sites (SNS); less is known regarding motivations behind deleting alcohol content on SNS and differences by age. The present study examined the associations of anticipated regret with posting and deleting alcohol-related content; age was examined as a moderator. Participants (N = 306; 47.1% male) aged 15 – 20 completed a baseline survey for a larger experimental study. Results indicated significant interactions between anticipated regret and age, such that higher levels of both increased the odds of both posting (OR = 1.37) and deleting (OR = 1.30) alcohol-related content on SNS. Specifically, the association between anticipated regret and posting was stronger for younger individuals, whereas the relationship between anticipated regret and deleting was stronger for older individuals. A personalized age-specific intervention aimed at alcohol-related anticipated SNS regret may lead to changes in posting and deleting of alcohol-related SNS content, which may have implications for subsequent alcohol use

Associations between Delta-8 THC and Four Loko retail availability in Fort Worth, Texas

Alcohol and cannabis are two of the most widely used substances among young people, and availability and price are two of the most significant determinants of use. Four Loko products contain up to 5.5 standard alcoholic drinks in a single can, are one of the least expensive ready-to-drink alcohol products on the market and are commonly consumed by underage drinkers. Delta-8 THC is a psychoactive substance with no federal regulations regarding minimum purchase age, ingredients and synthesis, marketing, and testing for potency or contaminants. Delta-8 THC products can be inexpensively synthesized and are sold for low prices. Given that young people often use both products, and use of these products can result in negative consequences, it is important to understand whether these products are being sold in the same stores, which would indicate the presence of niche stores marketing high-risk, youth-oriented substances. This study included 360 locations with off-premise beer or beer/wine licenses in Fort Worth, Texas. Locations were called and asked whether they sold Delta-8 THC. Four Loko’s availability was determined using the manufacturer’s website. A logistic regression model examined associations between the availability of Delta-8 THC and Four Loko. Of the 360 locations, 38% sold Four Loko and 9% sold Delta-8 THC. Delta-8 THC availability was significantly associated with higher odds of Four Loko availability (OR=2.15,95%CI=1.05,4.43). Given the associations between the retail availability of Delta-8 THC and Four Loko, policies that limit access to such products, including near schools and in stores that youth patronize, may be warranted

Organization-Level Factors Associated with Changes in the Delivery of the Five A’s for Smoking Cessation following the Implementation of a Comprehensive Tobacco-Free Workplace Program within Substance Use Treatment Centers

Many adults with a substance use disorder smoke cigarettes. However, tobacco use is not commonly addressed in substance use treatment centers. This study examined how provider beliefs about addressing tobacco use during non-nicotine substance use treatment, provider self-efficacy in delivering tobacco use assessments, and perceived barriers to the routine provision of tobacco care were associated with changes in the delivery of the evidence-based five A’s for smoking intervention (asking, advising, assessing, assisting, and arranging) at the organizational level. The data were from 15 substance use treatment centers that implemented a tobacco-free workplace program; data were collected before and after the program’s implementation. Linear regression examined how center-level averages of provider factors (1) at pre-implementation and (2) post- minus pre-implementation were associated with changes in the use of the five A’s for smoking in substance use treatment patients. The results indicated that centers with providers endorsing less agreement that tobacco use should be addressed in non-nicotine substance use treatment and reporting lower self-efficacy for providing tobacco use assessments at pre-implementation were associated with significant increases in asking patients about smoking, assessing interest in quitting and assisting with a quit attempt by post-implementation. Centers reporting more barriers at pre-implementation and centers that had greater reductions in reported barriers to treatment over time had greater increases in assessing patients’ interest in quitting smoking and assisting with a quit attempt by post-implementation. Overall, the centers that had the most to learn regarding addressing patients’ tobacco use had greater changes in their use of the five A’s compared to centers whose personnel were already better informed and trained. Findings from this study advance implementation science and contribute information relevant to reducing the research-to-practice translational gap in tobacco control for a patient group that suffers tobacco-related health disparities

Experiences of Microaggressions, Attributions, and Impact Among US Young Adults: An Intersectional Perspective Regarding Sexual/Gender and Racial/Ethnic Minorities

BACKGROUND: Understanding discrimination (e.g., microaggressions) toward sexual/gender minorities (SGM) and racial/ethnic minorities (REM) from an intersectional perspective is critical in informing interventions to reduce such experiences and their impacts. PURPOSE: This study examined US young adults identifying as SGM, REM, both, or neither in relation to microaggression experiences, and these factors in relation to mental health. METHODS: Using 2022 data from 932 US adults (M = 27.61) in an online survey study, we compared subgroups (SGM-only, REM-only, both, neither) in relation to microaggression experiences and mental health symptoms, stratified by sex (male, female). Multivariable linear regression examined: 1) sex and intersectional subgroup in relation to number of microaggressions experienced; and 2) sex, subgroup, and number of microaggression experiences in relation to mental health symptoms. RESULTS: Among females (n = 612), 42.0% were SGM-only, 17.3% REM-only, 15.2% both, and 25.5% neither. Among males (n = 320), 25.0% were SGM-only, 25.0% REM-only, 8.4% both, and 41.6% neither. Females (vs. males) reported more microaggressions (M = 5.67, SD = 3.00 vs. M = 3.95, SD = 3.46, p \u3c .001). Those with intersecting minority identities experienced the most microagressions (females: M = 6.98, SD = 2.64; males: M = 6.44, SD = 2.95, respectively). In multivariable analyses, females and those in any of the 3 minority-identifying subgroups experienced more microaggressions; those with intersecting minority identities experienced more microaggressions than SGM-only and REM-only. Identifying as SGM-only or both SGM and REM, as well as experiencing more microaggressions, was associated with greater mental health symptoms. CONCLUSIONS: Intersecting minority identities increase risk for microaggressions and mental health consequences. Multilevel interventions must reduce minority subgroups\u27 experiences of microaggressions and their impacts

A cross-cultural comparison of factors associated with marijuana use among college students in the United States and Sweden

Aims: Marijuana is a popular drug among U.S. college students. In Sweden, the prevalence of marijuana use has been relatively low but is increasing. Brief, personalized interventions have been efficacious in reducing substance use, including marijuana, among college students in the U.S. However, prior to implementation of U.S. interventions in Sweden, it is important to compare factors associated with marijuana use among college students in the two countries. Design, Setting, and Participants: Data are from baseline assessments of two large college student intervention studies in the U.S. (N = 3,753, 39% male) and Sweden (N = 2,280, 35% male). Measures: Past 30-day prevalence and frequency of marijuana use was analyzed in regard to relevant demographic factors. The moderating role of nationality was also examined. Findings: Results support previous findings indicating marijuana use is more common in the U.S. than in Sweden. Most demographic factors were similar across the countries, except for relationship status and work status, in which associations with number of marijuana use days (but not odds of any marijuana use) were stronger for Swedish college students compared to U.S. college students. Conclusions: Based on overall similarities between the U.S. and Sweden, comparable interventions might be recommended in both countries

The impacts of electronic cigarette health warning labels on use intentions and perceptions: A cross-sectional study of US and Israeli adults who use tobacco

BACKGROUND: Health warning labels (HWLs) are evidence-based tobacco control strategies; however, their application to e-cigarettes and related impacts (e.g. on perceived risk), including across countries with different regulations, are understudied. DESIGN AND METHODS: Using 2021 survey data from 927 US and Israeli adults reporting past-month tobacco use, multivariate analyses examined: (1) sociodemographics in relation to self-reported impact of e-cigarette HWLs (i.e. more concerned about e-cigarette use, reassured, no effect) among those who noticed e-cigarette HWLs (multinomial regressions); and (2) HWL impacts in relation to use intentions and perceived addictiveness and harm (linear regressions). RESULTS: Among those who noticed HWLs ( = 835, 90.1%), 34.1% reported HWLs resulted in greater concern about e-cigarette use, 45.5% no effect, and 20.4% reassurance. Factors associated with greater concern (vs no effect) included e-cigarette non-use (vs use; aOR = 1.69, 95% CI:1.22, 2.38), US (vs Israel) resident (aOR = 1.65, 95% CI:1.16, 2.34), age 18-25 (vs 36-45; aOR = 1.72, 95% CI:1.11, 2.67), and more education (aOR = 1.85, 95% CI:1.30, 2.63). Factors associated with being reassured (vs no effect) included use of cigarettes (aOR = 1.71, 95% CI:1.06, 2.75), e-cigarettes (aOR = 2.64, 95% CI:1.77, 3.94), and other tobacco (aOR = 2.11, 95% CI:1.39, 3.21), and Israeli resident (aOR = 2.33, 95% CI:1.47, 3.70). Not noticing HWLs (vs no effect) correlated with lower intentions (β = -0.44, 95% CI:-0.87, -0.01), perceived addictiveness (β = -0.61, 95% CI:-1.05, -0.18), and harm (β = -0.56, 95% CI:-0.95, -0.18); reassurance correlated with greater use intentions (β = 0.48, 95% CI:0.12, 0.83); and greater concern was unassociated with use intentions or perceived risk. CONCLUSION: Effects of differing e-cigarette HWLs in distinct subpopulations warrant research. Despite being noticed, they may have no effect or encourage e-cigarette use

Smoke-free home restrictions in Armenia and Georgia: motives, barriers and secondhand smoke reduction behaviors

BACKGROUND: Promoting smoke-free homes (SFHs) in Armenia and Georgia is timely given high smoking and secondhand smoke exposure (SHSe) rates and recent national smoke-free policy implementation. This study examined theoretical predictors (e.g. motives, barriers) of SFH status, and among those without SFHs, past 3-month SFH attempts and intent to establish SFHs in the next 3 months. METHODS: Multilevel logistic regression analyzed these outcomes using 2022 survey data from 1467 adults (31.6% past-month smokers) in Armenia (n = 762) and Georgia (n = 705). Correlates of interest included SHSe reduction behaviors and SFH motives and barriers; models controlled for country, community, age, sex, smoking status and other smokers in the home. RESULTS: In this sample, 53.6% had SFHs (Armenia: 39.2%; Georgia: 69.2%). Among those without SFHs, one-fourth had partial restrictions, no smokers in the home and/or recent SFH attempts; 35.5% intended to establish SFHs; and ∼70% of multiunit housing residents supported smoke-free buildings. We documented common SHSe reduction behaviors (opening windows, limiting smoking areas), SFH motives (prevent smell, protect children/nonsmokers) and barriers (smokers\u27 resistance). Correlates of SFHs were being from Georgia, other smokers in the home, fewer SHSe reduction behaviors, greater motives and fewer barriers. Among participants without SFHs, correlates of recent SFH attempts were other smokers in the home, greater SHSe reduction behaviors and SFH motives, and fewer barriers; correlates of SFH intentions were being female, greater SHSe reduction behaviors, greater motives, and fewer barriers. CONCLUSIONS: SFH interventions should address motives, barriers and misperceptions regarding SHSe reduction behaviors. Moreover, smoke-free multiunit housing could have a great population impact

Theory-based correlates of cannabis use and intentions among US and Israeli adults: a mixed methods study

Abstract Background In the US and Israel, non-medical (‘recreational’) cannabis use is illegal at the national level; however, use rates are high and decriminalization and legalization is spreading. Thus, theory-based intervention efforts, especially for youth prevention, are crucial. Methods This mixed-methods study of adults in the US (n = 1,128) and Israel (n = 1,094) analyzed: 1) cross-sectional survey data (Fall 2021) to identify theory-based correlates (risk perceptions, social norms) of past-month cannabis use, next-year use intentions, and intentions to use in the home or among children if non-medical cannabis was legal, using multivariable regression; and 2) qualitative interviews regarding perceptions of cannabis policies and use (US n = 40, Israel n = 44). Results 16.7% reported past-month use; 70.5%, 56.3%, and 82.6% indicated “not at all likely” regarding next-year use and use in the home and among children if legal. Lower perceived risk and greater social norms were associated with past-month use, greater use intentions, and greater intentions to use in the home or among children. Past-month use was more prevalent among US (vs. Israeli) participants (22.0% vs. 11.2%); however, in multivariable regression controlling for past-month use, being from Israel was associated with greater use intentions (next-year; in the home/among children). Qualitative themes indicated: concerns about use (e.g., increasing use, health risks, driving-related risks) and legalization (e.g., impact on society/economy, marketing), and perceived benefits of use (e.g., medical) and legalization (e.g., access/safety, economic, individual rights). Conclusions Despite differences in cannabis perceptions and use across countries, perceived risk and social norms are relevant intervention targets regardless of sociopolitical context