Journal: Infancy, 2026, doi: 10.1111/infa.70107
Authors: Maria Balaceanu, Stephanie M. Engel, & Amanda M. Ramos
Abstract:
Early temperament, particularly regulation and reactivity, is critical to neurodevelopment and can be shaped by early biological and environmental factors. Prenatal substance exposure is one such influencing factor, often associated with lower regulation and heightened reactivity in infants. However, positive parenting may help mitigate these effects. This study examined how prenatal exposure to alcohol, tobacco, and marijuana influences infant temperament at 24 months, and whether maternal warmth at 12- and 24-months moderates or mediates these relationships. Participants were 404 mother-child dyads from a prospective, ethnically diverse urban cohort. Results showed prenatal alcohol and tobacco exposure was directly associated with poorer child regulation and reactivity, while marijuana was not independently linked to these outcomes. Maternal warmth at 12 and 24 months moderated some of the negative effects of prenatal tobacco and marijuana exposure, but not alcohol. These moderating effects varied by child outcome, timing, and frequency of substance use. No evidence was found for maternal warmth mediating any of the associations between prenatal substance use and child outcomes. Findings highlight the differential impact of substance type, timing, and frequency on child outcomes and underscore the importance of early parenting support as a resilience factor.
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Journal: Bipolar Disorders, 2026, doi: 10.1111/bdi.70157
Authors: Gi Jung Shin, Jesse D. Hinckley, Amanda E. Guyer, & Manpreet K. Singh
Abstract:
Background: Aberrant thalamic structure has been documented in youth with bipolar disorder (BD) and linked with cannabis use, which commonly co-occurs with BD. However, the timeline of when these associations evolve remains unclear. This study aimed to longitudinally compare thalamic volume among youth with and without first episode mania who do or do not use cannabis and other substances.
Methods: Demographic and magnetic resonance imaging (MRI) data from youth (13-18 years old) with BD (n = 22) were compared to similarly aged healthy youth (n = 23) at baseline and 12-month follow-up. Clinical group status, including BD and substance misuse and dependence, was evaluated using semistructured interviews. Multivariate analyses accounting for total brain volume and baseline age were conducted to evaluate baseline and longitudinal group differences in thalamic volume.
Results: At 12 months, BD youth had significantly smaller left thalamus volumes compared to healthy youth (p = 0.009). Lifetime cannabis use was associated with smaller left thalamus volumes for all youth (p < 0.001) and for youth with BD compared to healthy controls (p < 0.001) across time. Among BD youth, co-occurring lifetime substance use was associated with significant volumetric reductions in the left thalamus from baseline to follow-up (p = 0.004), but not among healthy youth (p = 0.517). No significant group differences or changes were observed in the right thalamus.
Conclusions: BD is associated with smaller left thalamic volume after the first manic episode. Cannabis use may compound thalamic volume reductions in youth with BD. Investigations with larger sample sizes are needed to replicate these findings and examine clinical correlates of cannabis use alongside long-term thalamic trajectories.
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Journal: JAMA Network Open, 2026, doi: 10.1001/jamanetworkopen .2026.22543
Authors: Rachel L. Denlinger-Apte, Ziyu Ji, Emily A. Harwood, Darcy Lockhart, Neal L. Benowitz, Dana Mowls Carroll, … & Joseph S. Koopmeiners
Abstract:
Importance: The US Food and Drug Administration (FDA) is pursuing a low-nicotine product standard for cigarettes and other combusted tobacco. Very low nicotine content cigarettes (VLNCs) contain approximately 95% less nicotine than standard cigarettes. A key concern is that people who smoke may increase their smoking to compensate for the reduced nicotine levels, which would be a major unintended consequence of the regulation.
Objective: To examine whether people who smoke increase their smoking behavior and/or smoke exposure when smoking VLNCs for extended periods.
Data sources: A comprehensive search was performed across multiple databases (eg, PubMed Medline, Embase, Web of Science, Cochrane Library, and CINAHL) on July 5, 2024, to identify randomized clinical trials (RCTs) evaluating VLNCs.
Study selection: Eligible RCTs reported treatment conditions comprising smoking VLNCs for 3- to 20-week periods. Control conditions varied but typically included smoking normal nicotine content cigarettes (NNCs).
Data extraction and synthesis: This study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Two investigators performed the data extraction.
Main outcomes and measures: Outcomes included the total number of cigarettes smoked per day and exhaled breath carbon monoxide (CO) exposure at the end of the intervention.
Results: Seventeen RCTs (16 from the US and 1 from New Zealand) published between 2010 and 2024 met inclusion criteria, representing 5500 adolescents and adults who smoked cigarettes daily or nondaily, with or without quit interest. The pooled meta-analysis included a subset of 2454 participants from 7 US trials. No trials reported increases in the mean number of cigarettes smoked per day or CO exposure at the end of the intervention among participants assigned to VLNCs vs NNCs. It was estimated that 0.8% of participants could expect an increase in smoking, with a maximum expected increase of 3.3 cigarettes smoked per day, and 8.1% could expect an increase in CO exposure, with a maximum expected increase of 4.2 parts per million 6 weeks after randomization if assigned VLNCs vs NNCs.
Conclusions and relevance: This systematic review and meta-analysis of VLNC RCTs found minimal evidence of compensation among people assigned to smoke VLNCs. The findings suggest that widespread compensatory smoking is unlikely to occur if the FDA implements a low-nicotine product standard for cigarettes and other combusted tobacco.
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Journal: Psychological Medicine, 2026, doi: 10.1017/S0033291726104802
Authors: Katherine T. Foster, Daniel J. O. Roche, William G. Iacono, Matt McGue, & Brian M. Hicks
Abstract:
Background: Alcohol, nicotine, and cannabis use problems have a poorer prognosis when they co-occur with internalizing distress (INT). One hypothesis to account for the association between INT and alcohol and substance use problems (SUP) is that people engage in heavy substance use to reduce aversive affective states characteristic of INT (e.g. affective reinforcement). Whether INT operates as a cause or a shared liability with SUP (e.g. shared genetic and environmental risk) over and above an alternative cause (e.g. externalizing problems, EXT) remains unclear.
Methods: We tested INT as a developmental pathway for SUP by applying a prospective, co-twin control approach to the Minnesota Twin and Family Study sample (n = 1881 twin pairs). A multilevel modeling framework was used to estimate the between-twin pair effect and the within-twin pair effect of INT over and above EXT on separate SUP outcomes (i.e. alcohol, nicotine, and cannabis use problems) from adolescence (age 14) to young adulthood (age 29).
Results: We failed to detect any non-familial causal effects of INT on SUPs. Instead, their associations were due to common genetic and shared environmental influences. In contrast, EXT had consistent non-familial causal influences on alcohol and cannabis use in adolescence and young adulthood.
Conclusions: The link between INT and SUPs is primarily due to shared, familial influences while EXT likely serves as a unique determinant, with elevated EXT increasing selection into situations that pose SUP risk (e.g. peer environments that normalize and sustain heavy use) over and above common genetic influences.
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Journal: Drug & Alcohol Dependence Reports, 2026, doi: 10.1016/j.dadr.2026.100461
Authors: Rachel Sayko Adams, Sharon Reif, Yassir Mohamed, Maureen T. Stewart, Marc R. LaRochelle, Dennis Heaphy, … Jake R. Morgan
Abstract:
Purpose: Epidemiologic survey studies suggest that people with disabilities are vulnerable to excessive alcohol use and alcohol use disorder (AUD), yet little is known about potential differences in clinical AUD diagnosis by disability status. Our objective was to examine trends in annual AUD diagnoses in the US from 2016 to 2023 among adults with commercial insurance, and to investigate potential differences by disability status/type, and by disability status/type and sex.
Methods: Retrospective cross-sectional study using MarketScan commercial insurance claims from 2016 to 2023. Population-based sample of adults age 18-64 with commercial insurance across all 50 states. AUD diagnoses were identified with ICD-10 diagnosis codes. Age-adjusted annual AUD diagnosis rates per 10,000 population, stratified by disability status/type, and disability status/type and sex. Average annual percentage change of AUD rates over time.
Results: The rate of AUD increased steadily from 85/10,000 persons in 2016 to 128/10,000 persons in 2023; average annual percentage change of 5.41% per year (CI 3.82% – 7.03%). Adults with disability had greater than threefold higher rates of AUD, and males and females with disabilities had a persistently higher rate of AUD compared to non-disabled males and females. Adults with serious mental illness and acquired brain injury were particularly likely to have AUD; rates were over 10 and 5 times higher than adults without these types of disabilities, respectively.
Conclusions: Adults with disabilities had higher than three times the rate of AUD diagnoses compared to adults without disabilities. Interventions are needed inclusive of person-centered care for disabled people with comorbid AUD.
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