Journal: American Journal of Preventive Medicine, 2026, doi: 10.1016/j.amepre .2026.108314
Authors: Pamela M. Ling, Chen Joanne Lyu, Nadra E. Lisha, NhungNguyen, Valerie Gribben, & Danielle Ramo
Abstract:
Introduction: E-cigarettes are the most frequently used tobacco product among adolescents and young adults. Over 40% of adolescents who used e-cigarettes tried quitting in 2023, but few programs support them, particularly on social media.
Objective: Test the efficacy of e-cigarette cessation support groups on Instagram in a randomized controlled trial.
Study Design: 500 participants were randomized to intervention or active control with baseline, 5 week (end of program), 3 and 6 month follow up surveys in 2022-2024.
Setting: Healthy volunteers in California were recruited via social media advertisements.
Participants: Participants reported age 13-21 years, English literacy, using social media at least 4 days per week, using e-cigarettes at least weekly, access to device with photo capability, considering quitting within 6 months.
Interventions: Instagram direct message support groups for 5 weeks provided motivational interviewing, social support, skill building, and group quit attempts. Controls were referred to state quitline resources including telephone, online, texting or mobile app.
Main Outcome: 7-day point prevalence abstinence from e-cigarette use.
Results: Data was analyzed in 2024-2025. Mean age was 18.9 years, 39.8% female, 51.2% male; 41.1% non-Hispanic white, 17.2% Hispanic, and 27.4% multiracial; 35.1% sexual minority. 70.4% used e-cigarettes daily, and 78.2% within 30 minutes of waking. Retention rates were 43.6% at 5 weeks, 23.0% at 3 months and 28.0% at 6 months. Generalized linear mixed models (GLMM) in a time-averaged difference examined 7-day point prevalence abstinence accounting for repeated measures and clustering effects. Intention to treat analysis counting missing as vaping found greater abstinence in the intervention group (18.2% vs 11.8%) (OR = 2.15, 95% CI = 1.1, 4.2, p=0.025). Complete case analysis also found greater abstinence over 6 months for intervention (53.9%) compared to control (40.4%) (OR = 2.07, 95%CI = 1.21, 3.52, p=0.008). There were no differences in vaping reduction, attitudes, or use of evidence-based methods. Intervention participants reported higher social support with no difference in overall program evaluation.
Conclusions: Social media support groups were acceptable to diverse young people and improved abstinence rates on average over 6 months compared to quitline referral.
Trial Registration: Clinicaltrials.gov (protocol # NCT04707911).
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Journal: Substance Use & Misuse, 2026, doi: 10.1080/1082608 4.2026.2632181
Authors: Amanda M. Bunting, Brittany Griffin, Adam Rubens, Daniel Lima, Victoria Lam, & Matheus Bender
Abstract:
Background: Cognitive interviewing is a methodological technique to elicit feedback on item comprehension and response categories by the target population. This method can be particularly relevant when working with vulnerable populations, such as people who use drugs, and for complex behaviors, including the use of multiple drugs (i.e., polysubstance use). While cognitive interviewing is recognized as an important technique, few case studies of the method have been published.
Objective: The current manuscript details the cognitive interview method employed as part of the development of a novel polysubstance assessment tool.
Results: Participants (n=28) with recent polysubstance use provided qualitative feedback using an iterative study design. Results detail the decision-making process of the study team to improve comprehension of complex behaviors, specifically simultaneous and same-day polysubstance use. Notably, the administration modality changed from self to interviewer-administered to facilitate participant understanding.
Conclusions: Findings highlight the utility of the cognitive interview method in improving assessments of substance use.
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Journal: Health Services Research, 2026, doi: 10.1111/1475-6773.70094
Authors: Zoe Lindenfeld, Amanda I. Mauri, Sachini Bandara, Jonathan H. Cantor, Ryan K. McBain, & Abigail Winiker
Abstract:
Objective: To assess the potential of opioid settlement dollars disbursed to state and local governments to replace or supplement federal substance use disorder (SUD) funding.
Study Setting and Design: For each state, we calculated the percentage of Substance Use and Mental Health Services Administration (SAMHSA) SUD funding for each state that can be offset by settlement funds.
Data Sources and Analytic Sample: We estimated annual opioid settlement distributions (2022–2038) from KFF Health News and SAMHSA-funded SUD awards (2024) from SAMHSA’s website and the Tracking Accountability in Government Grants System.
Principal Findings: Across states, the mean difference between SAMHSA SUD funds and settlement funds was $56.83 (SD: $53.76) per capita, and the mean percentage of SAMHSA SUD funding that could be replaced by settlement funds was 51.16 (SD: 28.46) per capita. Oregon was the only state where settlement disbursements exceeded SAMHSA SUD funding.
Conclusions: Substantial gaps remain between current federal SUD funding and what opioid settlement funds can offset. Our findings underscore that opioid settlement funds are not a viable replacement for federal funding, both because they were never intended to serve this purpose, and because they are insufficient in scale.
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Journal: Healthcare, 2026, doi: 10.3390/healthcare14050564
Authors: Nicholas J. Lawler, Bipasha Sobhani, Ejura Yetunde Salihu, Hannah Muller, Jordan Edwards, Megan Ringo, & Randall Brown
Abstract:
Traumatic injuries represent a significant public health challenge, affecting millions worldwide annually and necessitating acute pain management that frequently involves the use of opioid analgesics to mitigate discomfort and facilitate recovery. Although opioids remain an integral part of post-traumatic injury pain management, their use exposes trauma survivors to the risk of developing persistent use, misuse, or opioid use disorder (OUD). Pre-injury health determinants, such as age, gender, psychiatric conditions, medical conditions, and substance use history, may interact with injury-related factors to acutely escalate the risk for misuse and addiction. Despite the growing recognition of these potential vulnerabilities, there remains a lack of evidence-based clinical decision support on modifiable and non-modifiable risk factors specific to post-traumatic injury opioid risk trajectories. This review summarizes the literature related to the multifactorial contributors to opioid misuse and addiction following traumatic injury such as patient-level (e.g., demographics, behavioral health), injury-related (e.g., severity, type), and system-level (e.g., prescribing patterns) characteristics. A comprehensive literature search, inclusive of the literature from 1995 to November 2025, was performed in PubMed/MEDLINE, Scopus, and Google Scholar using combinations of terms related to “opioids,” “misuse,” “addiction,” “trauma,” and “injury.” Search keywords and operators were developed in collaboration with a university librarian. Reference lists of articles were searched and synthesized. Case reports, case series, editorials, mini-reviews, letters to editor without original data, and qualitative studies were excluded. The findings of the review are expected to provide insight into clinical-decision making as it relates to the management of pain, pain-related distress and functional impact, and co-occurring conditions that may impact injury-related outcomes and the potential likelihood of substance misuse and addiction.
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Journal: Substance Abuse and Rehabilitation, 2026, doi: 10.2147/SAR.S560350
Authors: Tyler S. Oesterle, & Nicholas L. Bormann
Abstract:
Background: Substance use disorders (SUDs) are highly prevalent, chronic conditions that often go untreated. Technology-driven interventions, including digital therapeutics, web-based programs, and mobile applications, have expanded treatment access. The COVID-19 pandemic accelerated the adoption of digital approaches, and national policy calls for enhanced use of telehealth and app-based recovery support. However, user engagement with SUD apps remains a challenge.
Objective: This narrative review summarizes evidence on digital interventions for SUDs, emphasizing mobile apps. It examines what differentiates effective interventions, drawing on insights from the broader context of general mobile app use. It also proposes strategies to enhance engagement in digital therapeutics.
Methods: We reviewed the literature (2013–2025) on SUD digital interventions, including randomized trials, systematic reviews, and large observational studies of SUD-focused apps. Key findings on clinical efficacy and engagement were extracted, along with examining engagement tactics from mobile gaming and other app domains to inform potential improvements.
Results: Several apps have demonstrated efficacy in reducing substance use or supporting abstinence, particularly those that integrate evidence-based therapy content, provide personalized feedback, offer craving-management tools, and facilitate connectivity to peer or clinician support. In contrast, apps with minimal interactive content often show no added benefit. A major barrier is sustaining user engagement, as many SUD apps experience a steep drop-off in use after the initial download. Strategies such as gamification, contingency management (utilizing incentives), social networking features, and integration with ongoing care can significantly enhance engagement. Early data suggest that blending these strategies into SUD apps yields higher retention and better clinical results.
Conclusion: Mobile apps are emerging as valuable adjuncts for SUD treatment, but their real-world impact depends on users’ engagement with compelling content. By incorporating tangible rewards, personalized and timely interventions, social support, and provider involvement, digital therapies for SUDs enhance engagement and, consequently, improve long-term recovery outcomes.
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