Research News Roundup: July 7, 2022

    Individual-, Family- and School-Based Interventions to Prevent Multiple Risk Behaviours Relating to Alcohol, Tobacco and Drug Use in Young People Aged 8-25 Years: A Systematic Review and Meta-Analysis

    Journal: BMC Public Health, 2022, doi: 10.1186/s12889-022-13072-5

    Authors: Laura Tinner, Jennifer C. Palmer, E. Caitlin Lloyd, Deborah M. Caldwell, Georgie J. MacArthur, Kaiseree Dias, Rebecca Langford, James Redmore, Linda Wittkop, Sarah Holmes Watkins, Matthew Hickman & Rona Campbell


    Background: Engagement in multiple substance use risk behaviours such as tobacco smoking, alcohol and drug use during adolescence can result in adverse health and social outcomes. The impact of interventions that address multiple substance use risk behaviours, and the differential impact of universal versus targeted approaches, is unclear given findings from systematic reviews have been mixed. Our objective was to assess effects of interventions targeting multiple substance use behaviours in adolescents.

    Methods: Eight databases were searched to October 2019. Individual and cluster randomised controlled trials were included if they addressed two or more substance use behaviours in individuals aged 8-25 years. Data were pooled in random-effects meta-analyses, reported by intervention and setting. Quality of evidence was assessed using GRADE. Heterogeneity was assessed using between-study variance, τ2 and Ι2, and the p-value of between-study heterogeneity statistic Q. Sensitivity analyses were undertaken using the highest and lowest intra-cluster correlation coefficient (ICC).

    Results: Of 66 included studies, most were universal (n=52) and school-based (n=41). We found moderate quality evidence that universal school-based interventions are likely to have little or no short-term benefit (up to 12 months) in relation to alcohol use (OR 0.94, 95% CI: 0.84, 1.04), tobacco use (OR 0.98, 95% CI: 0.83, 1.15), cannabis use (OR 1.06, 95% CI: 0.86, 1.31) and other illicit drug use (OR 1.09, 95% CI: 0.85, 1.39). For targeted school-level interventions, there was low quality evidence of no or a small short-term benefit: alcohol use (OR 0.90, 95% CI: 0.74-1.09), tobacco use (OR 0.86, 95% CI: 0.66, 1.11), cannabis use (OR 0.84, 95% CI: 0.66-1.07) and other illicit drug use (OR 0.79, 95% CI 0.62-1.02). There were too few family-level (n=4), individual-level (n=2) and combination level (n=5) studies to draw confident conclusions. Sensitivity analyses of ICC did not change results.

    Conclusions: There is low to moderate quality evidence that universal and targeted school-level interventions have no or a small beneficial effect for preventing substance use multiple risk behaviours in adolescents. Higher quality trials and study reporting would allow better evidence syntheses, which is needed given small benefit of universal interventions can have high public health benefit.

    Trial registration: Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD011374. DOI: 10.1002/14651858.CD011374.

    To read the full text of the article, please visit the publisher’s website.


    Modeling the Evolution of the US Opioid Crisis for National Policy Development

    Journal: Proceedings of the National Academy of Sciences, 2022, doi: 10.1073/pnas.2115714119

    Authors: Tse Yang Lim, Erin J. Stringfellow, Celia A. Stafford, Catherine DiGennaro, Jack B. Homer, Wayne Wakeland, Sara L. Eggers, Reza Kazemi, Lukas Glos, Emily G. Ewing, Calvin B Bannister, Keith Humphreys, Douglas C. Throckmorton & Mohammad S. Jalali


    The opioid crisis remains one of the greatest public health challenges in the United States. The crisis is complex, with long delays and feedbacks between policy actions and their effects, which creates a risk of unintended consequences and complicates policy decision-making. We present SOURCE (Simulation of Opioid Use, Response, Consequences, and Effects), an operationally detailed national-level model of the opioid crisis, intended to enhance understanding of the crisis and guide policy decisions. Drawing on multiple data sources, SOURCE replicates how risks of opioid misuse initiation and overdose have evolved over time in response to behavioral and other changes and suggests how those risks may evolve in the future, providing a basis for projecting and analyzing potential policy impacts and solutions.

    To read the full text of the article, please visit the publisher’s website.


    A Community Response Approach to Mental Health and Substance Abuse Crises Reduced Crime

    Journal: ScienceAdvances, 2022, doi: 10.1126/sciadv.abm2106

    Authors: Thomas S. Dee & Jaymes Pyne


    Police officers often serve as first responders to mental health and substance abuse crises. Concerns over the unintended consequences and high costs associated with this approach have motivated emergency response models that augment or completely remove police involvement. However, there is little causal evidence evaluating these programs. This preregistered study presents quasi-experimental evidence on the impact of an innovative “community response” pilot in Denver that directed targeted emergency calls to health care responders instead of the police. We find robust evidence that the program reduced reports of targeted, less serious crimes (e.g., trespassing, public disorder, and resisting arrest) by 34% and had no detectable effect on more serious crimes. The sharp reduction in targeted crimes reflects the fact that health-focused first responders are less likely to report individuals they serve as criminal offenders and the spillover benefits of the program (e.g., reducing crime during hours when the program was not in operation).

    To read the full text of the article, please visit the publisher’s website.

    Passive Exposure to E-Cigarette Emissions is Associated with Worsened Mental Health

    Journal: BMC Public Health, 2022, doi: 10.1186/s12889-022-13470-9

    Authors: Kayla Rae Farrell, Michael Weitzman, Emma Karey, Teresa K. Y. Lai, Terry Gordon & Shu Xu


    Background: Cigarette smoking, secondhand cigarette smoke (SHS) exposure, and e-cigarette use (“vaping”) are each associated with increased rates of depressive symptoms and other internalizing mental health disorders. The prevalence of vaping has increased greatly, yet the mental health correlates of secondhand exposure to e-cigarette emissions are as yet to be investigated. This study examined the potential adverse mental health outcomes associated with different tobacco exposures (direct and passive), with a particular focus on the mental health correlates of secondhand exposure to e-cigarette emissions.

    Methods: The Population Assessment of Tobacco and Health Study data collected from a sample of 16,173 Wave 4 adults were used to test the hypothesis that secondhand e-cigarette emissions exposure is associated with increased odds of internalizing mental health disorders. Individuals were categorized as exclusive cigarette smokers, exclusive e-cigarette users, cigarette and e-cigarette dual users, exclusive noncombustible tobacco users, secondhand smoke exposed non-users, secondhand e-cigarette emissions exposed non-users, and non-users with no current SHS/secondhand e-cigarette aerosol exposure. Adjusted weighted logistic regression analysis was used to investigate the association between exposure type and internalizing problems as assessed by scores on the Global Appraisal of Individual Needs-Short Screener (GAIN-SS), a widely used instrument for assessing mental health problems.

    Results: Cigarette smokers (AOR = 2.53, 95% CI: 2.19-2.92), e-cigarette users (AOR = 3.14, 2.41-4.09), dual users (AOR = 3.37, 2.85-4.00), noncombustible tobacco users (AOR = 1.48, 1.01-2.17), SHS exposed non-users (AOR = 1.63, 1.37-1.94), and secondhand e-cigarette emissions exposed non-users (AOR = 1.43, 1.03-1.99) were each associated with increased odds of moderate to severe internalizing mental health problems as compared to unexposed non-users. Odds of internalizing problems among SHS and secondhand e-cigarette emissions exposed non-users did not differ (p = 0.46).

    Conclusions: This is the first study, to our knowledge, to identify an association between recent secondhand exposure to e-cigarette emissions and mental health problems, and the risk is comparable to that of SHS. Corroboration of this relationship needs further research to explicate directionality and mechanisms underlying this association.

    To read the full text of the article, please visit the publisher’s website.

    Use of Menthol Cigarettes, Smoking Frequency, and Nicotine Dependence among US Youth

    Journal: JAMA Network Open, 2022, doi:10.1001/jamanetworkopen.2022.17144

    Authors: Eric C. Leas, Tarik Benmarhnia, David R. Strong & John P. Pierce


    Importance: Menthol may make cigarette smoke less aversive and could lead youth to smoke more frequently and become more dependent on nicotine.

    Objective: To assess the association of menthol use with cigarette smoking frequency and nicotine dependence (ND) among youth cigarettes users.

    Design, Setting, and Participants: This cohort study used a pooled sample of cohorts of US youth (aged 12-17 years at their baseline and follow-up interviews) in the Population Assessment of Tobacco and Health Study (September 2013 to November 2019). Household interviews were conducted using audio computer-assisted self-interviews. US youth who were past-30-day cigarette smokers at any of wave 2 through wave 5, completed the preceding survey (eg, wave 2 past-30-day cigarette smokers completed wave 1), and indicated whether they used menthol cigarettes were eligible. The association of menthol use with smoking frequency and ND was estimated using inverse probability of treatment weighting adjusted mean differences (aMDs), adjusted risk ratios (aRRs), and corresponding 95% CIs. Data were analyzed from December 2021 to March 2022.

    Exposures: Menthol use and transitions in use (switching to or from menthol cigarettes).

    Main Outcomes and Measures: Main outcomes were the number of days smoked in the past 30 days, the risk of frequent smoking (smoking ≥20 days in the past 30 days), and symptoms of ND.

    Results: There were a total of 1492 observations among 1096 US youth cigarette smokers, of whom 49.4% were female, 67.2% were non-Hispanic White, and 28.7% were aged 12 to 14 years at their baseline survey (all percentages are weighted). Among those who switched from not smoking to smoking (61% of the sample), menthol use was associated with smoking on 3.1 additional days (aMD; 95% CI, 1.9 to 4.2 days), 59% higher risk of being a frequent smoker (aRR, 1.59; 95% CI, 1.23 to 2.06), and 10% higher ND scores (aMD, 1.09; 95% CI, 1.02 to 1.17). Switching from smoking menthol to smoking nonmenthol (vs maintaining menthol use) was associated with smoking on 3.6 fewer days (aMD; 95% CI, −6.3 to −0.9 days) and 47% lower risk of being a frequent smoker (aRR, 0.68; 95% CI, 0.50 to 0.92).

    Conclusions and Relevance: These findings suggest that the addition of menthol to cigarettes is associated with increased smoking frequency and ND among US youth.

    To read the full text of the article, please visit the publisher’s website.



    July 2022