Characterizing Polytobacco Use Trajectories and Their Associations With Substance Use and Mental Health Across Mid-Adolescence.

Background:Polytobacco product use is suspected to be common, dynamic across time, and increase risk for adverse behavioral outcomes. We statistically modeled characteristic types of polytobacco use trajectories during mid-adolescence and tested their prospective association with substance use and mental health problems. Methods:Adolescents (N = 3393) in Los Angeles, CA, were surveyed semiannually from 9th to 11th grade. Past 6-month combustible cigarette, e-cigarette, or hookah use (yes/no) over four assessments were analyzed using parallel growth mixture modeling to identify a parsimonious set of polytobacco use trajectories. A tobacco product use trajectory group was used to predict substance use and mental health at the fifth assessment. Results:Three profiles were identified: (1) tobacco nonusers (N = 2291, 67.5%) with the lowest use prevalence (<3%) of all products across all timepoints; (2) polyproduct users (N = 920, 27.1%) with moderate use prevalence of each product (8-35%) that escalated for combustible cigarettes but decreased for e-cigarettes and hookah across time; and (3) chronic polyproduct users (N = 182, 5.4%) with high prevalence of each product use (38-86%) that escalated for combustible cigarettes and e-cigarettes. Nonusers, polyproduct users, and chronic polyproduct users reported successively higher alcohol, marijuana, and illicit drug use and ADHD at the final follow-up, respectively. Both tobacco using groups (vs. nonusers) reported greater odds of depression and anxiety at the final follow-up but did not differ from each other. Conclusions:Adolescent polytobacco use may involve a common moderate risk trajectory and a less common high-risk chronic trajectory. Both trajectories predict substance use and mental health symptomology. Implications:Variation in use and co-use of combustible cigarette, e-cigarette, and hookah use in mid-adolescence can be parsimoniously characterized by a small set common trajectory profiles in which polyproduct use are predominant patterns of tobacco product use, which predict adverse behavioral outcomes. Prevention and policy addressing polytobacco use (relative to single product use) may be optimal tobacco control strategies for youth, which may in turn prevent other forms of substance use and mental health problems

Neuroscience-informed classification of prevention interventions in substance use disorders : an RDoC-based approach

Neuroscience has contributed to uncover the mechanisms underpinning substance use disorders (SUD). The next frontier is to leverage these mechanisms as active targets to create more effective interventions for SUD treatment and prevention. Recent large-scale cohort studies from early childhood are generating multiple levels of neuroscience-based information with the potential to inform the development and refinement of future preventive strategies. However, there are still no available well-recognized frameworks to guide the integration of these multi-level datasets into prevention interventions. The Research Domain Criteria (RDoC) provides a neuroscience-based multi-system framework that is well suited to facilitate translation of neurobiological mechanisms into behavioral domains amenable to preventative interventions. We propose a novel RDoC-based framework for prevention science and adapted the framework for the existing preventive interventions. From a systematic review of randomized controlled trials using a person-centered drug/alcohol preventive approach for adolescents, we identified 22 unique preventive interventions. By teasing apart these 22 interventions into the RDoC domains, we proposed distinct neurocognitive trajectories which have been recognized as precursors or risk factors for SUDs, to be targeted, engaged and modified for effective addiction prevention.Peer reviewe

Improving substance use prevention efforts with executive function training

AbstractBackgroundExecutive function (EF) includes emotional regulation, planning and decision-making, and behavioral impulse control. Improving youth substance use (SU) prevention by targeting EF poses challenges including determining whether specific sub-domains of EF are more associated with SU than others, whether EF is related to some types of SU more than others, and whether EF programs might be enhanced by inclusion of mindfulness training.MethodsData were drawn from two studies from the Pathways to Health project: a randomized controlled trial of 4th–6th graders and a cross-sectional pilot study of the relationship of EF to specific types of SU in a sample of 7th graders. Survey measures included assessment of the EF subdomains of inhibitory control (IC), emotional control, working memory, organization/planning, lifetime SU (tobacco and alcohol use), and mindfulness. Analyses included multivariate and multiple group path analysis.ResultsResults suggested that the EF sub-domain of IC was the strongest and most consistent predictor of SU, particularly cigarette and e-cigarette use, though emotional control was predictive of alcohol use among late-elementary school students. In the 7th grade sample, IC was predictive of alcohol, cigarette, and e-cigarette use only among students in the low 75% of mindfulness.ConclusionsFindings from the present studies suggest that improvements in SU prevention efforts may result from increased curricular emphasis on IC and its application to multiple substance use prevention, and systematically integrating mindfulness with EF skills training. Future research should examine whether EF–SU relationships vary across patterns of SU and types of measures used to assess EF

High Calorie, Low Nutrient Food/Beverage Intake and Video Gaming in Children as Potential Signals for Addictive Behavior

Little is known about the co-occurrence of health risk behaviors in childhood that may signal later addictive behavior. Using a survey, this study evaluated high calorie, low nutrient HCLN intake and video gaming behaviors in 964 fourth grade children over 18 months, with stress, sensation-seeking, inhibitory control, grades, perceived safety of environment, and demographic variables as predictors. SEM and growth curve analyses supported a co-occurrence model with some support for addiction specificity. Male gender, free/reduced lunch, low perceived safety and low inhibitory control independently predicted both gaming and HCLN intake. Ethnicity and low stress predicted HCLN. The findings raise questions about whether living in some impoverished neighborhoods may contribute to social isolation characterized by staying indoors, and HCLN intake and video gaming as compensatory behaviors. Future prevention programs could include skills training for inhibitory control, combined with changes in the built environment that increase safety, e.g., implementing Safe Routes to School Programs

High Calorie, Low Nutrient Food/Beverage Intake and Video Gaming in Children as Potential Signals for Addictive Behavior

Little is known about the co-occurrence of health risk behaviors in childhood that may signal later addictive behavior. Using a survey, this study evaluated high calorie, low nutrient HCLN intake and video gaming behaviors in 964 fourth grade children over 18 months, with stress, sensation-seeking, inhibitory control, grades, perceived safety of environment, and demographic variables as predictors. SEM and growth curve analyses supported a co-occurrence model with some support for addiction specificity. Male gender, free/reduced lunch, low perceived safety and low inhibitory control independently predicted both gaming and HCLN intake. Ethnicity and low stress predicted HCLN. The findings raise questions about whether living in some impoverished neighborhoods may contribute to social isolation characterized by staying indoors, and HCLN intake and video gaming as compensatory behaviors. Future prevention programs could include skills training for inhibitory control, combined with changes in the built environment that increase safety, e.g., implementing Safe Routes to School Programs