Journal: Journal of Adolescent Health, 2024, doi: 10.1016 /j.jadohealth.2024.10.032
Authors: M. A. Rifat, Nicola Orsini, Basra Qazi, & Maria Rosaria Galanti
Abstract:
This study aims to determine the effect and equity outcomes of smoking prevention or smoking cessation interventions for children and adolescents involving parents. A systematic literature search was conducted between 24 November 2022 and 27 November 2023 in PubMed, Medline, Web of Science, Embase, PsycINFO, Google Scholar, ClinicalTrials.gov, EU Clinical Trials Register, and the WHO international clinical trials registry. Experimental or quasi-experimental studies reporting smoking initiation among never smokers, smoking cessation among smokers, and differential effects in socio-economic subgroups with a follow-up of at least 6 months were selected. Information was extracted concerning setting, study design, sample size, type of parental intervention, follow-up time, and relative risk estimates of intervention effects (risk ratios, odds ratios, and hazard ratios). Random effect model was used for meta-analysis of 24 studies, with the remaining studies included in a narrative synthesis. After screening 6,748 records, 36 studies, based on 29 unique interventions (27 smoking prevention and 2 smoking cessation), were included. The summary estimate of relative risk of smoking initiation among children and adolescents participating in smoking prevention interventions involving parents compared to control conditions was 0.84 (95% CI: 0.76, 0.94). Results concerning smoking cessation and equity aspects were inconclusive due to the paucity of studies. Smoking prevention interventions for children and adolescents where parents are actively involved appear to be effective, but the overall quality of evidence was moderate. No conclusion was possible to be drawn on the effects of interventions involving parents on offspring’s smoking cessation. Equity aspects of these interventions remain to be studied.
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Journal: Journal of the American Pharmacists Association, 2024, doi: 10.1016/j.japh.2024. 102318
Authors: Thomas J. Reese, Nana Addo Padi-Adjirackor, Kevin N. Griffith, Bryan Steitz, Stephen W. Patrick, Ashley A. Leech, … Jessica S. Ancker
Abstract:
Background: Policy changes during the COVID-19 pandemic allowed buprenorphine to be prescribed for opioid use disorder (OUD) via telemedicine without an in-person visit. A recently proposed change will limit buprenorphine access to 30 days without an in-person visit. Given that people living in rural areas may be disproportionally impacted by this change, we sought to better understand how buprenorphine adherence may be impacted by requiring in-person visits.
Objective: Compare buprenorphine adherence after telemedicine to adherence after in-person visits for patients who live in rural and urban areas.
Methods: In this retrospective cohort study, we used electronic health record data from a large medical center. The cohort included all adult patients prescribed buprenorphine for opioid use disorder during 2017-2022. The primary outcome was adherence, characterized by the Medication Possession Ratio (MPR) and gaps in buprenorphine treatment at 30 and 180 days. We conducted a longitudinal analysis at visit level, stratified by patient urbanicity, and controlled for patient, prescriber, prescription, and setting characteristics.
Results: From 511 patients, we followed 3302 in-person and 519 telemedicine visits. Compared to in-person visits we observed no difference in the adherence following telemedicine visits overall. However, telemedicine was associated with higher MPR for rural patients (30 days: adjusted marginal effects [AME], 3.7%; 95% CI, 2.0 to 5.5; P < .001 and 180 days: AME, 8.5%; 95% CI 5.7 to 11.3; P < .001) and fewer gaps (30 days: AME, -6.7%; 95% CI, -9.9 to -0.1; P < .001 and 180 days: AME, -9.4%; -14.0 to -4.5; P < .001) compared to in-person visits.
Conclusions: These findings suggest that telemedicine is a viable alternative to in-person visits, especially for patients living in rural areas, which should help guide future policies that preserve or increase access to buprenorphine in a manner that can reduce barriers for patients.
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Journal: Drug and Alcohol Dependence, 2025, doi: 10.1016/j.drugalcdep.2024.112516
Authors: Jiaxi Wu, Lynsie R. Ranker, Juan Manuel Origgi, Jianqi Ma, Deyan Hao, Emelia J. Benjamin, … Traci Hong
Abstract:
Introduction: Swisher Sweets, a leading brand of little cigars and cigarillos in the United States, switched its Twitter account to protected status, limiting access to its tweets. This study examines how the protected status of Swisher Sweets tweets influences post engagement, aiming to inform regulatory strategies for branded tobacco promotions on social media.
Method: Using natural language processing, we predicted the demographics of individuals replying to Swisher Sweets’ public and protected tweets. Engagement with public versus protected tweets was compared using a Mann-Whitney U test, and a mixed-effects logistic regression assessed the likelihood of different demographics replying to each tweet type. Chi-square analyses examined word frequencies related to any flavor, concept flavors, and characterizing flavor in replies to public and protected tweets.
Results: Overall, 16 % of individuals replying to Swisher Sweets’ tweets were predicted to be under 21, and 65 % were Black. No significant difference was found in average reply counts to public versus protected tweets (p = .78). Black individuals were 2.61 times more likely than White individuals to engage with protected tweets after the status change (OR = 2.61, 95 % CI [1.36, 5.06], p = .004). Replies to protected tweets contained more words related to any flavor (adjusted p < .001) and concept flavors (adjusted p < .001) compared to public tweet replies.
Conclusions: Our study suggests that the protected status on Twitter was ineffective in preventing underage engagement with Swisher Sweets’ branded tweets and may facilitate targeted marketing among Black individuals.
Implications: More stringent age verification procedures and promotional regulatory measures are needed to prevent targeted tobacco brand marketing on social media.
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Journal: Journal of Affective Disorders, 2025, doi: 10.1016/j.jad.2024.09.114
Authors: Alysha A. Sultan, Benjamin I. Goldstein, Carlos Blanco, Kody G. Kennedy, Kevin P. Conway, Jian-Ping He, & Kathleen Merikangas
Abstract:
Background: Despite evidence regarding prevalence and correlates of cannabis use (CU) and cannabis use disorder (CUD) in major depressive disorder (MDD) and bipolar disorder (BD) in adults, little is known about this topic among adolescents.
Methods: Data are from the 2001-2004 National Comorbidity Survey-Adolescent Supplement, an in-person, cross-sectional epidemiologic survey of mental disorders. Participants included adolescents, ages 13-18 years, with MDD (n = 354 with CU, n = 70 with CUD, n = 688 with no CU), BD (n = 79 with CU, n = 32 with CUD, n = 184 with no CU), or adolescents without mood disorders (n = 1413 with CU, n = 333 with CUD, n = 6970 with no CU). Analyses examined prevalence and correlates of CU and CUD within MDD and BD groups.
Results: CU was most prevalent in adolescents with MDD followed by adolescents with BD then controls. CUD was most prevalent in adolescents with BD followed by adolescents with MDD then controls. In covariate-adjusted ordinal logistic regression models, within MDD and BD, CU and CUD groups had significantly higher odds of lifetime suicidal ideation/attempts, as well as other significant indicators of clinical severity.
Limitations: Based on changes in cannabis acceptance, potency, and availability in the two decades since this study was conducted, present findings may underestimate adverse cannabis associations.
Conclusion: CU and CUD are both associated with adverse clinical characteristics in a community-based sample of adolescents with MDD and BD. Evidence that risks of cannabis use extend across the spectrum of use is important for adolescents with MDD and BD, in whom cannabis-related consequences tend to be more severe.
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Journal: Pediatric Obesity, 2025, doi: 10.1111/ijpo.13187
Authors: Brianna F. Moore, Noel T. Mueller, Wei Perng, Katherine A. Sauder, Emily T. Hébert, Adrienne T. Hoyt, Erica M. Wymore, … Dana Dabelea
Abstract:
Background: Prenatal exposure to cannabis (or more specifically, delta 9-tetrahydrocannabinol [Δ9-THC]) has been consistently linked to low birthweight. Animal models further show that Δ9-THC is associated with rapid postnatal growth. Whether this association is modified by breastfeeding is unknown.
Methods: In this exploratory study, we followed 128 mother-child pairs through 3 years. Urinary Δ9-THC and cannabidiol (CBD) were measured mid-gestation. Generalized linear models estimated the associations between Δ9-THC and neonatal body composition. A mixed-effects model estimated the association between Δ9-THC and body mass index (BMI) z-score trajectories. Interaction was assessed by a three-way product term (Δ9-THC × breastmilk months × age).
Results: Fifteen children (12%) had Δ9-THC exposure; three had concomitant CBD exposure. Prenatal exposure to Δ9-THC alone was associated with lower fat mass (-95 g, 95% confidence interval [CI]: -174, -14) and neonatal adiposity (-2.1%; 95% CI: -4.2, -0.4) followed by rapid postnatal growth (0.42 increase in BMI z-score per square root year; 95% CI: 0.12, 0.72). Breastfeeding modified this association (p = 0.04), such that growth was similar for those breastfed for 5 months whereas a shorter duration of breastfeeding was associated with 1.1 higher BMI z-score at 3 years (95% CI: 0.21, 2.05).
Conclusions: Our study suggests that prenatal exposure to Δ9-THC may alter early-life growth. Breastfeeding may stabilize rapid postnatal growth, but the impact of lactational exposure requires further investigation.
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