Who wants to remember COVID-19? Social identification and collective remembering-imagining system predict support for pandemic commemorations

Many young adults experience chronic pain and given its wide availability and potential pain reducing properties, young adults may use cannabis to self-medicate for pain. However, little is known about young adult users’ perceptions of potential health risks and benefits of cannabis, and whether these perceptions differ by chronic pain status. As a part of a larger study, young adult recreational cannabis users (N=176, ages 18-29) who reported using at least once a week completed assessments of use frequency and perceived cannabis-related risks and benefits. The sample had a high proportion of participants who met criteria for chronic pain (51.1%). The majority of the sample reported using daily or multiple times daily (80.7%) with an average of 2.68 (SD=1.42) sessions per day across administration modes (e.g. smoking, edibles, tinctures). Participants answered questions about their lifetime chances of experiencing five cannabis-related risks (personal harm, negative health outcome, negative mental health outcome, harming someone else, increased pain) and benefits (personal benefit, positive health outcome, positive mental health outcome, benefitting someone else, decreased pain; 1=Very low to 7=Very high). Overall, young adult users perceived their risk to be very low (M=1.62, SD=.73) and 40.3% of the sample had an average risk score (combined across the five risk items) of 1.00, while only one participant reported an average risk above 4.00. In particular, participants reported a low lifetime chance of experiencing personal harm (M=1.51, SD=.90), harming someone else (M=1.20, SD=.58), or experiencing increased pain (M=1.24, SD=.74) due to their cannabis use. In contrast, young adult users perceived somewhat high chances of experiencing benefits related to their cannabis use (M=4.78, SD=1.46). In particular, participants perceived a high chance of experiencing reduced pain (M=5.88, SD=1.55), personal benefit (M=4.84, SD=1.86), and positive mental health outcomes (M=4.82, SD=1.77). There was no difference based on pain status on frequency of use, average daily sessions, or perceived risks, and only one difference in perceived benefits. Participants without chronic pain anticipated more personal benefit from cannabis use (M=5.15, SD=1.74) than those with chronic pain (M=4.53, SD=1.94, t(171)=2.21, p=.03). Overall, results suggest young adult recreational users perceive very low risks of their cannabis consumption and moderately high benefits, regardless of pain status. Looking at individual areas of potential risk and benefits may yield targets for future health education campaigns. For example, perceptions of low risk/high benefits regarding mental health outcomes may not be accurate for this heavy using sample.

(323) - Marijuana consumption patterns in young adults with and without chronic pain

Pain Relief as a Motivation for Cannabis Use Among Young Adult Users With and Without Chronic Pain

BackgroundIn 2015, 90% of US young adults with Internet access used social media. Digital and social media are highly prevalent modalities through which young adults explore identity formation, and by extension, learn and transmit norms about health and risk behaviors during this developmental life stage.ObjectiveThe purpose of this study was to provide updated estimates of social media use from 2014 to 2016 and correlates of social media use and access to digital technology in data collected from a national sample of US young adults in 2016.MethodsYoung adult participants aged 18-24 years in Wave 7 (October 2014, N=1259) and Wave 9 (February 2016, N=989) of the Truth Initiative Young Adult Cohort Study were asked about use frequency for 11 social media sites and access to digital devices, in addition to sociodemographic characteristics. Regular use was defined as using a given social media site at least weekly. Weighted analyses estimated the prevalence of use of each social media site, overlap between regular use of specific sites, and correlates of using a greater number of social media sites regularly. Bivariate analyses identified sociodemographic correlates of access to specific digital devices.ResultsIn 2014, 89.42% (weighted n, 1126/1298) of young adults reported regular use of at least one social media site. This increased to 97.5% (weighted n, 965/989) of young adults in 2016. Among regular users of social media sites in 2016, the top five sites were Tumblr (85.5%), Vine (84.7%), Snapchat (81.7%), Instagram (80.7%), and LinkedIn (78.9%). Respondents reported regularly using an average of 7.6 social media sites, with 85% using 6 or more sites regularly. Overall, 87% of young adults reported access or use of a smartphone with Internet access, 74% a desktop or laptop computer with Internet access, 41% a tablet with Internet access, 29% a smart TV or video game console with Internet access, 11% a cell phone without Internet access, and 3% none of these. Access to all digital devices with Internet was lower in those reporting a lower subjective financial situation; there were also significant differences in access to specific digital devices with Internet by race, ethnicity, and education.ConclusionsThe high mean number of social media sites used regularly and the substantial overlap in use of multiple social media sites reflect the rapidly changing social media environment. Mobile devices are a primary channel for social media, and our study highlights disparities in access to digital technologies with Internet access among US young adults by race/ethnicity, education, and subjective financial status. Findings from this study may guide the development and implementation of future health interventions for young adults delivered via the Internet or social media sites.

Purpose: Young adults experiencing chronic pain may self-medicate with cannabis. We examined perceived risks and benefits of cannabis use among young adult users by chronic pain status, and identified relationships among perceived risks and benefits, physical and mental health, and cannabis-related problems. Methods: Young adults reporting at least weekly cannabis use (N = 176, 50.9% with chronic pain) reported perceptions of lifetime risks and benefits associated with cannabis use, physical and mental health, and cannabis-related problems. Results: Young adults without chronic pain reported better physical and mental health than those with chronic pain. Cannabis use, problems, and risk and benefit perceptions did not differ by pain status. Risk and benefit perceptions were unrelated to physical health, perceiving fewer risks and more benefits was associated with better mental health, and perceiving more risk was associated with cannabis problems. Chronic pain status moderated the relationship between perceived benefits and outcomes, such that perceiving more benefits was associated with better physical health for those without chronic pain. Further, greater perceived benefits were associated with more cannabis-related problems for those without chronic pain but fewer problems for those with chronic pain. Conclusion: This study offers insight into the perceptions of risks and benefits among young adult cannabis users and associations with physical and mental health and cannabis-related problems. The effects of perceived benefits on physical health and cannabis-related problems differs for young adults with and without pain, suggesting assessment and consideration of pain status may be valuable in intervention contexts.

PurposeThis study compares access to flavoured JUUL and other e-cigarettes from retail, online and social sources among underage and young adult e-cigarette users who live in California jurisdictions that restrict...

The relationship between food insecurity and alcohol use disorder remains unknown. The aim of this study was to determine the association between food insecurity risk and alcohol use disorder in a nationally representative sample of young adults. Cross-sectional nationally representative data of 14,786 US young adults aged 24-32 years old from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health were analyzed to assess a single-item measure of food insecurity risk and Diagnostic and Statistical Manual, 5th Edition (DSM-5) alcohol use disorder. Among young adults, 12% were found to be at risk for food insecurity. Young adults with food insecurity risk had greater odds of moderate (adjusted odds ratio [AOR]: 1.34, 95% confidence interval [CI]: 1.13-1.58) and severe (AOR: 1.67, 95% CI: 1.34-2.07) threshold alcohol use disorder than food-secure young adults, adjusting for age, sex, race/ethnicity, education, income, receipt of public assistance, household size, and smoking. Food insecurity risk was also associated with a 23% higher (95% CI: 11%-37%) number of problematic alcohol use behaviors (e.g., risky behaviors, continued alcohol use despite emotional or physical health problems). Food insecurity risk is associated with problematic patterns of alcohol use. Health care providers should screen for food insecurity and problematic alcohol use in young adults and provide referrals for further resources and treatment when appropriate. This nationally representative study of US young adults is the first to find an association between food insecurity risk and alcohol use disorder using DSM-5 criteria.

Marijuana use predicts onset of current little cigar use in a national sample of US young adults

Many young adults experience chronic pain and may be more likely to self-medicate with cannabis. The present study examined perceptions of personal risks and benefits of cannabis use among young adult users, assessed if these perceptions varied by chronic pain status, and identified relationships among perceived risks and benefits, health-related quality of life, and cannabis-related problems. Young adult regular cannabis users (n=176), half of whom met criteria for chronic pain, reported their perceptions of lifetime risks and benefits associated with cannabis use, as well as their physical and mental health-related quality of life and cannabis-related problems. Overall, participants perceived low risk associated with their cannabis use and moderate benefits. Perceived risks and benefits of cannabis use were associated with mental, but not physical health-related quality of life. Only perceived risk was associated with cannabis-related problems. Cannabis use, problems, risks, and benefits did not differ by chronic pain status. As expected, young adults without chronic pain reported better physical and mental health-related quality of life than those with chronic pain. Finally, chronic pain status moderated the relationships between perceived benefits and physical health-related quality of life and cannabis problems. The current study offers insight into the role of perceived risks and benefits in young adults’ cannabis use and associations with physical and mental health outcomes. The effects of perceived benefits on physical health-related quality of life and cannabis-related problems may be conditional based on chronic pain status. Future research should further explore the relationship of perceived benefits of cannabis use on health outcomes and cannabis-related problems.

Introduction: Almost half of US young adults (aged 18-39 years) have hypertension. This is due to a high prevalence of risk factors, including the fact that most young adults exceed recommended daily sodium intake, alongside underdiagnosis and undertreatment. Cumulative exposure to elevated blood pressure (BP) in young adulthood increases later life risk of cardiovascular disease (CVD), so interventions that reduce BP levels in this age-group could improve population health. Objective: We aimed to estimate the cost and health-related quality of life benefits of two interventions at different points in the pathway of hypertension control in young adults: reducing dietary salt intake (to reduce HTN incidence) and increasing BP screening rates (to increase diagnosis and treatment). Methods: The CVD Policy Model, an established computer simulation model, estimated lifetime costs and quality-adjusted life years (QALYs) associated with BP-reducing interventions in a cohort of 100,000 US young adults. Risk of CVD events in the model was determined by a range of CVD risk factors, including cumulative exposure to systolic BP throughout the lifecourse. We modelled two hypothetical interventions: a population-level policy that reduces average sodium consumption by 1 g/day and an annual hypertension screening program for all young adults. We estimated the maximum price at which each intervention would be cost-effective (incremental cost-effectiveness ratio [ICER] less than $100,000/QALY) compared to usual care. Results: In a cohort of 100,000 US young adults, reducing dietary salt consumption by 1 g/day would produce around 19,300 QALYs and prevent around 1,400 CVD events over a lifetime horizon. For policymakers, it would be cost-effective to invest up to $55 million ($550 per young adult) to achieve this reduction in salt intake. Universal screening would also improve health outcomes (575 QALYs gained, 190 CVD events prevented), but the maximum cost-effective price for this policy was much lower ($17 per young adult). Conclusion: Reducing incidence and improving treatment of hypertension in young adulthood could improve population health substantially.

Recent information on the trends in past-year alcohol abstinence and marijuana abstinence, co-use of alcohol and marijuana, alcohol use disorder, and marijuana use disorder among US young adults is limited. To assess national changes over time in past-year alcohol and marijuana abstinence, co-use, alcohol use disorder, and marijuana use disorder among US young adults as a function of college status (2002-2018) and identify the covariates associated with abstinence, co-use, and marijuana use disorder in more recent cohorts (2015-2018). This study examined cross-sectional survey data collected in US households annually between 2002 and 2018 as part of the National Survey on Drug Use and Health. The survey used an independent, multistage area probability sample for all states to produce nationally representative estimates. The sample included 182 722 US young adults aged 18 to 22 years. The weighted screening and weighted full interview response rates were consistently above 80% and 70%, respectively. Measures included past-year abstinence, alcohol use, marijuana use, co-use, alcohol use disorder, marijuana use disorder, prescription drug use, prescription drug misuse, prescription drug use disorder, and other drug use disorders based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The weighted sample comprised 51.1% males. Between 2002 and 2018, there was an annual increase in past-year alcohol abstinence among young adults (college students: 0.54%; 95% CI, 0.44%-0.64%; non-college students: 0.33%; 95% CI, 0.24%-0.43%). There was an annual increase in marijuana use from 2002 to 2018 (college: 0.46%; 95% CI, 0.37%-0.55%; non-college: 0.49%; 95% CI, 0.40%-0.59%) without an increase in marijuana use disorder for all young adults. Past-year alcohol use disorder decreased annually (college: 0.66%; 95% CI, 0.60%-0.74%; non-college: 0.61%; 95% CI, 0.55%-0.69%), while co-use of alcohol and marijuana increased annually between 2002 and 2018 among all young adults (college: 0.60%; 95% CI, 0.51%-0.68%; non-college: 0.56%; 95% CI, 0.48%-0.63%). Young adults who reported co-use of alcohol and marijuana or met criteria for alcohol use disorder and/or marijuana use disorder accounted for 82.9% of young adults with prescription drug use disorder and 85.1% of those with illicit drug use disorder. More than three-fourths of those with both alcohol use disorder and marijuana use disorder reported past-year prescription drug use (78.2%) and illicit drug use (77.7%); 62.2% reported prescription drug misuse. The findings of this study suggest that US colleges and communities should create and maintain supportive resources for young adults as the substance use landscape changes, specifically as alcohol abstinence, marijuana use, and co-use increase. Interventions for polysubstance use, alcohol use disorder, and marijuana use disorder may provide valuable opportunities for clinicians to screen for prescription drug misuse.

Introduction Young adults are among the populations with the lowest quality diets in the US, and poor sleep could be a contributing factor. Social jetlag, the lack of consistent sleep timing from weekdays to weekends, is also more common among young adults. Our objective was to examine associations between social jetlag and diet quality among US young adults, and to evaluate effect modification by sex or race/ethnicity. Methods The study population included 1,308 adults aged 20-39 who participated in the 2017-2018 National Health and Nutrition Examination Survey. Social jetlag was considered as ≥2-hour difference in sleep midpoint (median of bedtime and wake time) between weekends and weekdays. Diet quality was assessed with the Healthy Eating Index (HEI)-2015, which is comprised of 13 dietary components and ranges from 0 to 100 (higher scores=better diet quality). Scores were binned into three groups based on tertile cutoffs. Ordinal logistic regression analyses were utilized to evaluate the relationship between social jetlag and HEI-2015 scores as well as the individual HEI components, adjusting for age, sex, race/ethnicity, educational attainment, recent tobacco use and physical activity. Effect modification by sex and race/ethnicity were also considered. Results In the analytic sample, 31% of young adults had social jetlag. Overall, there were no associations between social jetlag and diet quality. However, interaction analysis revealed several associations were race-specific (P, interaction< 0.05). Among Black adults, social jetlag was associated with lower overall diet quality (OR = 0.4, 95% CI 0.2, 0.8; i.e., less likely to be in higher diet quality tertiles) and more unfavorable scores on total vegetables (OR = 0.6, 95% CI 0.3, 1.0) and added sugar (i.e., OR = 0.6, 95% CI 0.4, 0.9). For Hispanic adults, social jetlag was associated with higher intakes of sodium (OR=0.6, 95% CI 0.4, 0.9) However, White adults with social jetlag had higher intake of greens and beans (OR = 1.9, 95% CI 1.1, 3.2). Conclusion Within a nationally-representative sample of US young adults, social jetlag was related to certain indicators of lower diet quality among Black and Hispanic Americans. Support (if any) Dr. Jansen was supported by K01HL151673.

Population-based examination of substance use disorders and treatment use among US young adults in the National Survey on Drug Use and Health, 2011–2019

Background Food insecurity, or the limited or uncertain access to food resulting from inadequate financial resources, is associated with poor health outcomes in adulthood. Little is known about these associations specifically in young adulthood. Aim To determine the association between food insecurity and health outcomes including chronic diseases and mental health in a nationally representative sample of US young adults. Methods Cross-sectional nationally representative data of US young adults ages 24-32 years old from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health were analyzed. Multiple logistic regression analysis was conducted with food insecurity as the independent variable and self-reported poor general health, chronic diseases (diabetes, hypertension, hyperlipidemia, obesity, obstructive airway disease, migraine) and mental health (depression, anxiety, suicidality, and poor sleep) outcomes as the dependent variables. Results Of the 14,800 young adults in the sample, 11% were food insecure. Food insecure young adults had greater odds of self-reported poor general health (2.65, 95% Confidence interval [CI] 1.62-4.35) and chronic disease including diabetes (1.67, 95% CI 1.19-2.40), hypertension (1.50, 95% CI 1.22-1.84), ‘very overweight’ (1.21, 95% CI 1.01 – 1.45), obesity (1.14, 95% CI 0.99-1.31), obstructive airway disease (1.44, 95% CI 1.18-1.74), and migraine (1.68, 95% CI 1.39-2.04) compared to young adults who were food secure in models adjusted for age, sex, race/ethnicity, education, income, household size, smoking, and alcohol. Food-insecure young adults had greater odds of mental health problems including depression (1.86, 95% CI 1.55-2.23), anxiety or panic disorder (1.60, 95% CI 1.26-2.02), suicidal ideation in the past 12 months (2.90, 95% CI 2.27-3.71), suicide attempts in the past 12 months (1.69, 95% CI 0.95-2.99), trouble falling asleep (1.69, 95% CI 1.43-2.00), and trouble staying asleep (1.81, 95% CI 1.55-2.11) in adjusted models. Conclusions Food insecurity is a significant social determinant of poor physical and mental health in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate. Future research should examine the association between food insecurity and health outcomes over the life course, and develop early food insecurity interventions to prevent downstream effects on health in later adulthood.

IntroductionThe present study examines the contributions of individual-level health determinants on young adult tobacco use initiation to improve understanding of racial and ethnic distinctions and to inform effective tobacco prevention strategies.MethodsUsing time-to-event analyses, the 10–wave (2011–2016) Truth Initiative Young Adult Cohort, a probability-based, nationally representative sample of the US young adults aged 18–34 years (N = 7 665), provides data to examine differences in variables that influence tobacco uptake, by race and ethnicity.ResultsAmong Non–Hispanic White young adults, having fewer peers who smoke cigarettes is protective against any tobacco initiation, whereas hazard of tobacco initiation increases for males, having low confidence to resist smoking, and having higher proclivity for sensation seeking. Depressive and anxiety symptoms increase uptake hazard most in the Non–Hispanic All Other Races group and least among Non–Hispanic Black individuals. Among Hispanic young adults, being female and perceiving tobacco as harmful are notably protective while being male is a notable uptake hazard. Unlike other groups, higher income levels do not lower hazards among Hispanic individuals. Cannabis use and overestimating the smoking rate among peers increase hazard least among Hispanic individuals. In the Non–Hispanic All Other Races group, aging is least protective; hazard increases notably if individuals engage in regular alcohol or cannabis use.ConclusionsTobacco prevention efforts are critical during young adulthood. Specific tobacco uptake hazard and protective factors exist by race and ethnicity and should be considered when developing selective young adult prevention, particularly among groups with the highest risk for tobacco initiation during this life stage.ImplicationsRising rates of tobacco initiation among the US young adults necessitate expanded efforts to prevent tobacco use initiation and progression beyond youth. Results highlight nuanced and differential tobacco uptake hazards by race and ethnicity for late initiation and sustained non–tobacco use among young adults. The study confirms existing evidence on tobacco use patterns and contributes to new knowledge on risk and protective factors. Tobacco prevention and control interventions, including policies, tailored in more meaningful ways could reduce tobacco use disparities among those most disproportionately affected.