Journal: Drug and Alcohol Review, 2026, doi: 10.1111/dar.70192
Authors: Drew A. Westmoreland, Jacob Bleasdale, Gayathri Kothawar, Nichole Scaglione, Liana Hone, Ansley Bravo, & Robert Cook
Abstract:
Introduction: No and low alcohol (NoLo) beverages have experienced significant industry expansion and may be a useful tool in reducing harmful alcohol consumption. However, there is scant research detailing their use and acceptability in the United States (US). The purpose of this study is to determine the prevalence of NoLo use patterns and to describe the use and motivation for use of NoLo products.
Methods: Data were collected using Prolific to recruit a sample (n = 1464) of US adults ≥ 21 years old. Participants completed a 30-min survey about their experiences with NoLo beverages (e.g., if they ever tried them, motivation for use), current alcohol use, psychosocial factors and sociodemographic characteristics. Analyses comprised of descriptive statistics, bivariable comparisons and multivariable logistic regression models assessing factors associated with having ever tried NoLo (dichotomised).
Results: Three-quarters of participants reported having tried NoLo beverages. Frequently reported motivations for NoLo consumption were to decrease alcohol consumption (45.5%), abstain from drinking (37.4%) and avoid the negative effects of alcohol (36.8%). Many sociodemographic factors were associated with having tried NoLo. Notably, people who reported moderate- or high-risk alcohol consumption (AUDIT-10; AOR = 2.0, 95% CI 1.4, 3.0) and people who had tried to quit drinking alcohol (AOR = 2.7, 95% CI 1.9, 3.7) had higher odds of trying NoLo beverages.
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Journal: International Journal of Neuropsychopharmacology, 2026, doi: 10.1093/ijnp/pyag030
Authors: Gabriel P. A. Costa, R. Ross MacLean, Mehmet Sofuoglu, & Joao P. De Aquino
Abstract:
Objective: Cannabis-nicotine co-use is common and may affect cessation outcomes, yet whether recent cannabis exposure alters nicotine’s acute effects in humans remains unclear. We examined whether recent, non-daily cannabis exposure modulates the acute subjective effects of intravenous (IV) nicotine.
Methods: We pooled data from 2 randomized, double-blind, placebo-controlled studies using IV nicotine to isolate nicotine’s pharmacodynamics in adults who smoke tobacco cigarettes (N = 60). Participants completed 3 sessions (placebo, 0.1 mg, 0.2 mg nicotine/70 kg). Recent cannabis exposure was defined a priori (past-30-day use with positive urine 11-nor-9-carboxy-delta-9-tetrahydrocannabinol vs no past-30-day use with negative screen). Primary outcomes were peak Drug Effects Questionnaire (DEQ) composites-stimulatory, pleasurable, aversive-within 10 minutes post-infusion. Secondary outcomes included nicotine self-administration behavior (proportion of nicotine choices) and cardiovascular responses (heart rate, blood pressure). Linear mixed-effects models included dose, cannabis exposure, sex, and FTND.
Results: Nicotine increased all DEQ domains dose-dependently (P < .0001). Aversive effects showed a significant dose x cannabis exposure interaction (χ2 = 13.31, P = .001): participants with recent cannabis exposure reported greater aversive responses at 0.2 mg (Cohen’s d’ = 0.83), with minimal between-group differences at placebo/0.1 mg. Nicotine self-administration did not differ by cannabis exposure status, and no dose x cannabis exposure interactions were observed for cardiovascular responses.
Conclusions: Recent, non-daily cannabis exposure is thus associated with selectively greater aversive responses to a clinically relevant IV nicotine dose, without differential cardiovascular reactivity or altered nicotine choice. These findings support a shift in the aversive limb of nicotine’s dose-response and inform mechanistic and clinical studies on how cannabis exposure shapes nicotine reinforcement and cessation outcomes.
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Journal: Journal Cannabis Research, 2026, doi: 10.1186/s42238-026-00466-0
Authors: S. G. Casavant, N. Kilembe, S. Kinsey, & N. Shook
Abstract:
Background: Cannabis use is increasing, even during pregnancy. The purpose of this study was to investigate how women of childbearing age perceive the safety of cannabis use during pregnancy compared to alcohol and tobacco use.
Methods: Cloud Research recruited a national U.S. cohort of women of childbearing age (N = 622) to complete an anonymous online survey assessing cannabis, alcohol, and tobacco use during pregnancy. Validated tools measured perceptions of safety and risks to fetal, birth, and infant development. Data analyses included descriptive statistics, McNemar’s tests, and repeated-measures ANOVA with post-hoc comparisons.
Results: The average age was 29.47 years (SD = 6.83, range: 18-42). Participants self-identified as White (65.9%, n = 410), Black or African American 28.1% (n = 175), Asian 5.9% (n = 37), American Indian or Alaska Native 3.9% (n = 24), or Other 4.7% (n = 29); 17.7% (n = 110) identified as Hispanic or Latino. Most participants identified as heterosexual (82.0%, n = 510). Among participants who had been pregnant (N = 351), 25.9% reported cannabis use during pregnancy, compared with 23.6% for tobacco and 8.2% for alcohol. The median frequency of prenatal cannabis use was twice weekly, with joints and blunts being the most common methods. Reported reasons for use included relief of nausea, anxiety, sleep disturbance, and pain. We used a five-point Likert scale to determine whether they thought cannabis, alcohol, and tobacco were safe to use during pregnancy, where 1 = not at all safe, and 5 = completely safe. Prenatal cannabis use was rated as safer (M = 3.85, SD = 1.46) than alcohol. (M = 4.86, SD = 0.54, p < .001) or tobacco (M = 4.79, SD = 0.63, p < .001).
Conclusion: Findings indicate that women of childbearing age perceive cannabis as relatively safe during pregnancy, particularly for symptom management. These perceptions underscore the need for targeted education, accurate messaging, and consideration of the social, cultural, and emotional factors that influence substance use during pregnancy to safeguard maternal and fetal health.
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Journal: Substance Use & Addiction Journal, 2026, doi: 10.1177/2976734 2261460411
Authors: Rachel French, Karen Alexander, Anjalee Sharma, Jan Gryczynski, Allison Schachter, & Robert Schwartz
Abstract:
Background: Ongoing cocaine use is common during methadone treatment and is associated with poorer outcomes. Digital health tools offer promising new ways to enhance methadone treatment through remote delivery of adjunctive behavioral health interventions. The experiences of patients on methadone who also use cocaine are under-represented in the recent literature. This qualitative study of recently admitted patients on methadone who also used cocaine examines their experiences and views on drug use and treatment.
Methods: Twenty-one participants were purposively sampled from the intervention arm of an ongoing multi-site clinical trial of a digital behavioral intervention. Qualitative interviews were carried out approximately 3 months after randomization into the parent study.
Results: Three themes emerged from the analysis: (1) Cocaine Use as a Response to Physical and Emotional Factors; (2) Cycles of Use and Recommitment to Treatment; and (3) Active Efforts to Sustain Engagement in Treatment. Participants were able to identify and share reasons for entering treatment and their persistent cocaine use. Many participants emphasized a hope that methadone treatment would be temporary. Several participants highlighted the role of internal factors (e.g., stress, shame, and desire for stability) related to treatment engagement, and the role of adjunctive behavioral supports in targeting internal factors.
Conclusions: Individuals with opioid and cocaine use enter methadone treatment for different reasons, often with co-occurring substance use disorders. Aligning care with their individual goals can potentially improve outcomes. Grounding treatment strategies in individuals’ lived experiences can deepen understanding of how adjunctive digital behavioral interventions can best support engagement, retention, and recovery during the critical early phases of treatment, especially as the illicit drug supply becomes more complex.
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Journal: Tobacco Control, 2026, doi: 10.1136/tc-2026-060115
Authors: Louisiana Montserrat Sanchez, Richard A. Miech, Dayoung Bae, Junhan Cho, Yi-Chun Chang, Caroline North, … & Adam M. Leventhal
Abstract:
Background: ZYN brand and non-tobacco-flavoured products capture most of the US nicotine pouch market. Evidence of which nicotine pouch flavours and brands US youth use is critical for informing youth regulatory protections, but currently lacking.
Methods: We analysed data from adolescents reporting lifetime nicotine pouch use in the 2025 Monitoring the Future study, a nationally representative, in-school, cross-sectional annual survey of US 8th-grade, 10th-grade and 12th-grade students. Prevalences of nicotine pouch flavours and brands adolescents reported using most often were estimated in the overall sample and stratified by demographic characteristics and past-30-day pouch use patterns.
Results: Among 472 youth who used nicotine pouches in their lifetime, 97.0% (95% CI 94.6% to 98.4%) reported using nicotine pouches with a non-tobacco flavour most often; non-tobacco flavoured pouch use prevalence exceeded 93% across all demographic and past-30-day pouch use-frequency categories studied. Mint was the most commonly reported flavour used (58.6%), followed by fruit (16.0%); use of original/unflavoured pouches was rare (3.0%). ZYN was the most common brand used, reported by 79.7% (95% CI 74.1% to 84.4%) of youth. Use prevalence of ZYN versus other pouch brands was lower among non-Hispanic Black versus non-Hispanic White, but did not vary by sex, grade, population density or pouch use frequency.
Conclusions: Among US adolescents reporting lifetime use of nicotine pouches in 2025, use of non-tobacco flavoured pouch products was nearly universal and ZYN was the predominant brand used. Prioritising regulatory policies on flavoured pouches, especially ZYN brand products, merits consideration to reduce youth nicotine pouch use.
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