Use Of Addictive Substances Research Articles

Patterns of drugs and alcohol abuse among youth

The study attempted to answer several questions: Does the cultural and social background of immigrant youth from the Former Soviet Union (FSU) affect their use of addictive substances? Do these youth show distinctive patterns of drug and alcohol abuse? Do the addictive substances used by these teenagers share similar characteristics? Are the patterns of drug abuse and alcohol abuse different? Do students in different educational frameworks demonstrate different consumption patterns? Can “critical moments” explain the presence or absence of alcohol and drug abuse?

The association of health-related factors with quality of life among the elderly population in the Jaffna district of Sri Lanka

BackgroundThe proportion of elderly individuals is increasing globally. They should be well cared for to enable them to enjoy their full lifespans. Good health is a vital component of one’s overall quality of life. Our study aimed to assess the association of health-related factors with quality of life among elderly individuals in the Jaffna District of Sri Lanka.MethodsWe conducted a community-based, cross-sectional study among 813 elderly individuals in the Jaffna district of Sri Lanka. Sociodemographic factors and the patterns of health conditions were recorded through an interviewer-administered questionnaire. Quality of life was measured through the World Health Organisation Quality of Life-Bref (WHOQOL-Bref) questionnaire.ResultsThere were slightly more male respondents (53.5%) than females in the study. The median age of the participants was 70 (11) years. Approximately one-third of them had at least one chronic health condition. Musculoskeletal complaints were found to be the most common health condition, followed by diabetes, hypertension, vision problems, and asthma. Among the respondents, 20.1% were attending regular follow-up visits in a clinic, and 24% of them were meeting a doctor at least monthly. Among them, 6.8% had at least one limitation in their activities of daily living. However, the majority (58.6%) reported that they were satisfied with their health status. The following factors were found to be significantly associated with worse quality of life: the presence of health conditions, the presence of musculoskeletal conditions, hearing impairment, vision impairment, bronchial asthma, limitations in activities of daily living, and the use of addictive substances. Satisfaction with health, regular follow-up visits in a clinic, meeting a doctor at least monthly, and having diabetes were significantly associated with better quality of life.ConclusionMinimising the limitations of daily living, abstaining from using addictive substances, preventing diseases, and improving access to health services may enhance the quality of life of elderly individuals. Furthermore, these factors should be considered by policy makers seeking to improve the quality of life of elderly individuals.

Knowledge and Attitudes of Maternity Nurses and Ancillary Team Members about Substance Addiction during Pregnancy and Postpartum.

To describe knowledge and attitudes of maternity nurses and other ancillary direct caregivers about addictive substance use by pregnant women and new mothers and to evaluate their perceptions of role preparation, resources available, and educational needs. We surveyed maternity nurses and ancillary members of the maternity care team to assess knowledge and attitudes about caring for women with addictive substance use. Data were analyzed using descriptive, parametric, and nonparametric statistics. Respondents (N = 109) from a southwestern Magnet community hospital were 100% female, predominantly nurses (89%), and worked mostly on mother-baby or labor and delivery units. They had high average knowledge scores and most had positive attitudes. When asked about preparation to care for pregnant women and new mothers with addictive substance use, some perceived that they were not able to carry out their role due to lack of knowledge. Findings suggest most maternity nurses have the knowledge and skills they believe are needed to care for women who use addictive substances during pregnancy and postpartum. Most have positive attitudes, but approximately one third may need interventions to encourage and further support empathy and acceptance. Education and skill-building for maternity nurses and other team members related to caring for women using addictive substances may be worth consideration; however, there is minimal evidence of their efficacy. Evaluations of these types of programs are needed in maternity settings.

Loneliness in patients with schizophrenia

Background: The treatment goals for patients with schizophrenia are to address subjective well-being, quality of life, and recovery in recent decades. Loneliness is a negative subjective feeling and related to social isolation, which is thought to be a barrier to recovery. Few research exist to study loneliness in-depth in patients with schizophrenia. Methods: In this review, the authors intend to address the issues of the prevalence, the impacts, the associated factors, and the interventions of loneliness in patients with schizophrenia. Results: Studies showed that patients with schizophrenia have a greater degree of loneliness than those without. The physical and mental health problems associated with loneliness in patients with schizophrenia include hypertension, high blood level of glycated hemoglobin, activated hypothalamus–pituitary–adrenal axis, poor subjective quality of life, depression, anxiety, suicide, use of addictive substances, high perceived stress, low self-esteem, low sense of pleasure, pessimism, and low resilience. From an ecological approach, loneliness in patients with schizophrenia is associated with several personal disease factors, personal cognitive factors, personal socioeconomic factors, community integration, and residence. Social prescribing projects, cognitive behavioral therapy, mindfulness, and positive psychology interventions have been used to reduce loneliness in patients with schizophrenia. Conclusion: Loneliness is an important indicator of the physical and mental health in patients with schizophrenia. Several factors associated with loneliness in patients with schizophrenia have been identified in the past studies. Further intervention research are required for establish effective methods to reduce loneliness in patients with schizophrenia.

A Decarceral Cadence: Neurologic Music Therapy as an Abolitionist Project

Because police and prison abolition must be approached while simultaneously improving quality of life, and thus reducing harm, abolitionist discourse should include health policies that regard the (de)regulation, use, and culture of addictive substances. This Essay calls for research into neurologic music therapy as a response to addiction, improving quality of life and paving the way for police and prison abolition.

Prevalence of Reproductive Tract Infections/Sexually Transmitted Infections among Rural Married Women – A Community Based Study Using Syndromic Approach

Introduction: Reproductive Tract Infections (RTIs) and Sexually transmitted infections (STIs) continue to be a major public health problem and affecting women's health. Objectives: To estimate the prevalence of RTIs/STIs among married women aged 18-49 years in rural areas and to determine the factors associated with these conditions. Method: A community-based cross-sectional study was carried out among 308 eligible married women aged 18-49 years in rural areas in District Sonipat, Haryana using the WHO-Syndromic Approach for diagnosis of RTIs/STIs. Results: The mean age of study subjects in our study was 32.1 years (SD = ± 8.3 years) with a range from 18 to 49 years. The overall RTIs/STIs prevalence was 49.3%. The most frequent symptom was vaginal discharge (55.3%) followed by pain during micturition (34.2%), dyspareunia (26.9%), pain lower abdomen (24.3%) and vulval itching (16.4%). RTI/STI symptoms were found significantly more among women who had history of any chronic disease, who had irregular menstrual cycles, used cloths as sanitary pads and among those whose husbands were substance users. Conclusions: This study revealed a high prevalence (49.3%) of RTIs/STIs. Awareness about symptoms of RTIs, menstrual and personnel hygiene, raising literacy level of women, drive against use of addictive substances etc. by husbands is needed for control and prevention of RTIs. Primary health care services in respect of reproductive health should be strengthened and raising awareness among women about reproductive health issues through suitable communication strategies in order to bring about a positive behavior change for effective control of STIs.

Factors affecting problematic use of psychoactive substances among Bachelor level students: A mixed methods study from Hill and Terai of Nepal

Introduction: Adolescents start experimenting with licit substances which later worsen to use of more addictive illicit substances. Genetic and environmental vulnerabilities affect use of psychoactive substances with family support, competence, and psychological well-being acting as protective factors. This study aimed to identify the prevalence of problematic use of psychoactive substances among Bachelor level students and factors affecting the problematic use.
 Method: A cross-sectional study was conducted among 50 Bachelor level students selected purposively from a private college of Kathmandu metropolitan city and five In-depth and Key Informant interviews of Bachelor level students, guardian, and teachers from Kohalpur municipality. Cronbach’s alpha was calculated for each of the tools used and prevalence of problematic use of psychoactive substances was assessed.
 Result: Prevalence of problematic use of psychoactive substances among lifetime users was 51.4%. The factors significantly associated with problematic use of psychoactive substances were sex and social discrediting by peers. Qualitative analysis identified many risk and protective factors at individual, interpersonal, and socio-cultural level.
 Conclusion: High prevalence of lifetime psychoactive substance use and high percentage of problematic use of psychoactive substances among substance users requires intervention at different socio-ecological level.

Food Addiction and Tobacco Use Disorder: Common Liability and Shared Mechanisms

As food addiction is being more commonly recognized within the scientific community, parallels can be drawn between it and other addictive substance use disorders, including tobacco use disorder. Given that both unhealthy diets and smoking are leading risk factors for disability and death, a greater understanding of how food addiction and tobacco use disorder overlap with one another is necessary. This narrative review aimed to highlight literature that investigated prevalence, biology, psychology, and treatment options of food addiction and tobacco use disorder. Published studies up to August 2020 and written in English were included. Using a biopsychosocial lens, each disorder was assessed together and separately, as there is emerging evidence that the two disorders can develop concurrently or sequentially within individuals. Commonalities include but are not limited to the dopaminergic neurocircuitry, gut microbiota, childhood adversity, and attachment insecurity. In addition, the authors conducted a feasibility study with the purpose of examining the association between food addiction symptoms and tobacco use disorder among individuals seeking tobacco use disorder treatment. To inform future treatment approaches, more research is necessary to identify and understand the overlap between the two disorders.

Depression, anxiety, and stress among Ugandan university students during the COVID-19 lockdown: an online survey.

COVID19 pandemic forced most countries to lockdown, leading to the prolonged closure of many learning institutions. This dramatic shift led to increase of mental illness symptoms among university students. To determine the prevalence and factors associated with symptoms of depression, anxiety, and stress among Uganda's university students during the COVID-19 lockdown. We conducted a one-month online survey using the Depression Anxiety and Stress Scale (DASS-21). Participants n=321 were enrolled with mean age, 24.8(SD=5.1) years and 198(61.7%) were males. The prevalence of mental health symptoms among participants was 80.7%, 98.4%, and 77.9% for depression, high levels of anxiety, and stress, respectively. Statistically significant association between mental health symptoms on multi-logistic regression was found with Males (depression=2.97[1.61-5.48] and stress=1.90[1.07-3.35]), engagement in leisure activity (depression= 1.87[1.01-3.49] and stress=1.98[1.10-3.56]), and being finalist (stress=0.55[0.31- 0.97]). Use of addictive substances seem to potentially alleviate symptoms of depression, anxiety and stress in the short term. The findings of this study suggest a high prevalence of symptoms of depression, anxiety and stress among university students during the COVID-19 lockdown. Students' mental health should be monitored by all stakeholders, especially as the pandemic progresses.

Can policy affect initiation of addictive substance use? Evidence from opioid prescribing

Drug control policy can have unintended consequences by pushing existing users to alternative, possibly more dangerous substances. Policies that target only new users may therefore be especially promising. Using commercial insurance claims data, we provide the first evidence on a set of new policies intended to reduce opioid initiation in the form of limits on initial prescription length. We also provide the first evidence on the impact of must-access prescription drug monitoring programs (MA-PDMPs), laws that do not target new users, on initial opioid use. Although initial limit policies reduce the average length of initial prescriptions, they do so primarily by raising the frequency of short prescriptions, resulting in increases in opioids dispensed to new users. In contrast, we find that MA-PDMPs reduce opioids dispensed to new users, even though they do not explicitly set out to do so. Neither policy significantly affects extreme use such as doctor shopping among new patients, because such behavior is very rare.

Commentary on Notley et al. : Understanding transitions in the use of nicotine and tobacco products-the value of qualitative longitudinal research.

Qualitative longitudinal research is an underused methodology in addiction research, but can provide valuable insights into transitions in the use of addictive substances, including e-cigarettes and tobacco smoking. Uncertainty concerning the efficacy of e-cigarettes as a smoking cessation aid has resulted in an increasing number of longitudinal studies measuring transitions in e-cigarette use and smoking status over time [1-3]. However, quantitative studies are limited in being able to determine what factors prompt individuals to make or maintain changes over time [4]. For this, we need narrative accounts of changes over time in nicotine and tobacco use. The paper by Notley, Ward & Dawkins [5] published in Addiction addresses this gap in the literature by presenting the results of a qualitative longitudinal study with 37 UK e-cigarette users who were using e-cigarettes to quit smoking, interviewing them twice approximately 12 months apart. This research demonstrates the type of insights that can result from qualitative longitudinal research. One key finding was that attitudinal differences about nicotine dependence seemed to influence continued use of e-cigarettes. The study found that those who were still using e-cigarettes and not smoking at 12 months thought long-term use of e-cigarettes was acceptable if it prevented relapse to smoking. However, those who had quit smoking and e-cigarettes (abstainers), and those who had relapsed to smoking, were uncomfortable with maintaining nicotine dependence. This aligns with quantitative research showing that while many e-cigarette users intend to continue using the products as a harm reduction strategy, others see it as a smoking cessation strategy and want to quit [6-8]. In order to identify e-cigarette users at risk of relapse to smoking, it may be helpful for health-care vprofessionals to ask users for their views on long-term nicotine dependence. Notley et al. [5] state that those who wish to quit e-cigarettes will need evidence-based information about how to do this while reducing the risk of relapse to smoking. However, research to inform recommendations for quitting using e-cigarettes is currently very limited. Some e-cigarette users report reducing nicotine concentration over time to reduce nicotine dependence, with the goal of eventually ceasing e-cigarette use [9]. An interesting finding of Notley and colleagues [5] is that some participants in their study who had continued to use e-cigarettes and remain abstinent from smoking had reduced their nicotine concentrations in order to ‘test’ their dependence. The effect of reducing nicotine concentrations over time is unknown, and randomized trials are needed to assess whether this is an effective means of quitting e-cigarette use without relapsing to smoking. A small number of studies have asked e-cigarette users whether they would like support in e-cigarette quit attempts, or whether they have sought such support when making quit attempts. In one survey study, Etter [6] found that of those who intended to quit vaping, 27% thought a health professional could assist them, 33% would visit a ‘vaping cessation service’ and 23% would use nicotine medications. A US survey study [8] found that of those who had attempted to cease e-cigarette use in the last year, 25% sought support from family or friends and 11% sought counselling or self-help materials. They also found that those who had used nicotine replacement therapy or cessation medications recommended their use [8]. The research by Notley et al. [5] also reveals factors that combine to influence trajectories of e-cigarette and tobacco use. Attitudes towards nicotine dependence, feelings of satisfaction with e-cigarettes, social exposure to smoking and vaping and life stressors all influenced individual trajectories. These are the complexities and nuances of individual lives that are difficult to capture using quantitative research. The value of qualitative longitudinal research for the addiction field is that it can explore the development of ‘narrative over time’ [10], and how these narratives are linked to the use of addictive substances. This has long been recognized in the ethnographic tradition of addiction research [11]; however, most qualitative studies in the addiction field remain cross-sectional. There are barriers to conducting qualitative longitudinal research [10]. Collecting and analyzing the data is resource and time intensive. Participant retention is critical due to the smaller sample sizes involved in qualitative research, although Notley et al. [5] demonstrate that very high retention rates are possible for nicotine and tobacco research. It would be of value to continue qualitative longitudinal research over periods longer than 1 year. This could be facilitated by embedding a qualitative component in longitudinal quantitative studies, where a subset of participants are interviewed to increase the depth of the study findings. The research reported by Notley et al. [5] shows that for research on smoking and e-cigarettes, longitudinal qualitative research is feasible and high retention rates are possible. The findings increase our depth of understanding of whether and why people transition between smoking, vaping and becoming nicotine-free. None.

Fifty Years of Research on Prenatal Substances: Lessons Learned for the Opioid Epidemic.

Current efforts to design research on developmental effects of prenatal opioid exposure can benefit from knowledge gained from 50 years of studies of fetal alcohol and prenatal drug exposures such as cocaine. Scientific advances in neurobiology, developmental psychopathology, infant assessments, genetics, and imaging support the principles of developmental neurotoxicology that guide research in prenatal exposures. Important to research design is accurate assessment of amount, frequency, and timing of exposure which benefits from accurate self-report and biomarkers of exposure. Identifying and control of pre- and postnatal factors that impact development are difficult and dependent on appropriate research design and selection of comparison groups and measurement of confounding, mediating, and moderating variables. Polysubstance exposure has increased due to the number of prescribed and nonprescribed substances used by pregnant women and varying combinations of drugs may have differential effects on the outcome. Multiple experimental and clinical assessments of infant behavior have been developed but predicting outcome before 18-24 months of age remains difficult. With some exceptions, prenatal substance exposure effect sizes have been small, and cognitive and behavioral effects tend to be specific rather than global. Studies require large sample sizes, adequate retention, and support for social services in at-risk samples. The ethical and legal contexts and stigma associated with drug/alcohol use disorder should be considered in order to prevent harm to families in research programs. Recognition of the pervasive use of addictive substances in this nation should lead to broad scientific efforts to understand how substances affect child outcomes and to initiate prevention and intervention where needed.

EFEKTIVITAS REHABILITASI TERHADAP PELAKU PENYALAHGUNAAN NARKOBA (STUDI DI BADAN NARKOTIKA NASIONAL KOTA CIREBON)

Drug use is a crime that has brought about victims of drug use in the community. Ideally, narcotics are required in the world of health and science, but in the same time the use of illegal narcotics is a very dangerous one, so that legal devices aimed at controlling the distribution and use of such addictive substances are indispensable. The method of approach used in this research is a qualitative method with a sociological juridical approach (Sosio-legal research). The specification of this research is descriptive according to the problems and objectives in this research. Primary data sources and secondary data sources and are analyzed in a qualitative method. The efforts to implement rehabilitation conducted by the Government against narcotics users pursuant to article 54 Juncto Article 55 Act number 35 year 2009 about narcotics is doing various measures to prevent narcotic abuse, by means of rehabilitation can help the victims, rehabilitation there are two: medical rehabilitation and social rehabilitation, and counseling.

Neck pain among smartphone users: an imminent public health issue during the pandemic time

Neck pain among smartphone users: an imminent public health issue during the pandemic time

Opioid analgesic use and its sequelae: Opioid and other substance use disorders.

While use of opioids is a well-established risk factor for opioid use disorder (OUD), its association with lifetime use of other addictive substances and the emergence of other lifetime substance use disorders (SUDs) has not been studied. We used data from 36 309 US adults in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III to identify those with lifetime opioid use (n=4090; 11.3%). Of these individuals, we quantified use of other addictive substances; development of OUD and other SUDs; and whether use of opioids and development of OUD came before or after use of other substances and the emergence of other SUDs. Of the 11.3% of adults who reported any opioid use, 98.2% of such users reported use of other addictive substances. Of these opioid users, 18.1% met criteria for lifetime OUD but only 3.5% had OUD alone; 47.6% had SUDs other than OUD and 14.6% had OUD plus another SUD. In most instances, opioid use followed use of other substances and OUD followed development of other SUDs. Opioid use is typically linked to use of multiple substances and while less than 20% developed OUD, more than half developed either OUD or another SUD. Opioid use and OUD most often followed other substance use and the emergence of other SUDs. Early intervention in OUD should consider potential complications of other present or past SUDs, and both prevention and treatment development efforts should focus on the multi-morbid dimensions of the current opioid epidemic.

Consistent administration of cetuximab is associated with favorable outcomes in recurrent/metastatic head and neck squamous cell carcinoma in an endemic carcinogen exposure area: a retrospective observational study.

BackgroundThis study aimed to analyze the clinical outcomes associated with patients with recurrent/metastatic head and neck squamous cell carcinoma (RM HNSCC) who received cetuximab-based chemotherapy in a real-world clinical setting.MethodsClinical data were extracted from RM HNSCC patients diagnosed between 2016 and 2019. Kaplan–Meier survival estimates and Cox proportional hazards model were used for survival analyses.ResultsOf 106 RM HNSCC patients (mean age = 55.1 years), 38.7% exhibited recurrent disease and 61.3% had metastatic disease. The majority of patients showed a habit of addictive substance use, including alcohol (67.0%), betel nuts (71.7%), or tobacco (74.5%). The primary tumor sites included the oral cavity (64.1%), hypopharynx (19.8%), and oropharynx (16.0%). The median number of cetuximab cycles for the 106 patients was 11 (2–24). The disease control rate (DCR) was 48.1%, and the overall response rate (ORR) was 28.3%. The median progression-free survival (PFS) and overall survival (OS) were 5.0 and 9.23 months, respectively. Patients treated with more than 11 cycles of cetuximab exhibited a longer median PFS and median OS than did patients treated with less than 11 cycles (median PFS: 7.0 vs. 3.0 months, p < 0.001; OS: 12.43 vs. 4.46 months, p = 0.001). Patients without previous concurrent chemoradiotherapy (CRT) had a better median PFS than did those with previous CRT (6.0 vs. 4.0 months, p = 0.046). Multivariable analysis revealed that perineural invasion and fewer cycles of cetuximab (<11 cycles) were independent risk factors associated with disease progression. In addition, the reduction in treatment cycles of cetuximab and advanced lymph node metastasis were independent prognostic factors predicting poorer overall survival.ConclusionOur study provides important real-world data regarding cetuximab-containing treatment in RM HNSCC. Consistent administration of cetuximab could be associated with more favorable outcomes in RM HNSCC in endemic carcinogen exposure areas.

Characteristics of smoking behavior in adolescents, Sousse, Tunisia

Abstract Background and aims Adolescence is a period of physical, psychological and socio-cultural transformation, but also of curiosity, experimentation and acquisition. It is mainly during adolescence that people are introduced to the use of legitimate psychoactive substances, such as alcohol and tobacco, as well as illicit substances such as cannabis. We aimed to determine the prevalence of smoking among high school students in the region of Sousse and to specify its characteristics. Methods We conducted a cross-sectional study in two public schools in the governorate of Sousse during the 2017/2018 school year. The data were collected by anonymous self-administered questionnaire, then processed and analyzed using the SPSS software version 20. Results A total of 294 students were included. The sex ratio was 0.78 with mean age of 17.03 years (standard deviation = 1.51). Results showed that 27.6% of students reported having already tasted tobacco. Among them, 61.8% of their parents did not know they were smoking. 17.28% started before the age of 14. Only 26% of them tried to stop but failed. Boys smoked twice as much as girls (p = 0.001). In addition, 63% of young smokers used chicha, 48.1% drank alcohol, and 35.8% used cannabis at least once. Conclusions The prevalence of smoking among these adolescents is worrying. Knowledge of related factors is important for program planning to prevent the tobacco epidemic in schools. Key messages Adolescence is the age of initiation for addictive substance use specially, Tobacco use. Knowledge of related factors is important for prevention program planning.

Psycho-Social Correlates of Opioid Use Disorder among the US Adult Population: Evidence from the National Survey on Drug Use and Health, 2015–2018

Background The United States (US) has experienced an opioid epidemic over the last two decades. Drug overdose deaths increased by 21% from 2015 to 2016, with two-thirds of these deaths attributed to opioid use disorder (OUD). This study assessed the psycho-social correlates associated with OUD over 2015–2018 in the US. Methods: This study used data collected from 171,766 (weighted = 245,838,163) eligible non-institutionalized US adults in the pooled National Survey on Drug Use and Health from 2015–2018. Survey-weighted descriptive, bivariate, and multivariable analyses were performed to assess the psycho-social correlates of OUD. Results: About 0.85% of the respondents reported having OUD in the past year. About one-quarter (26.3%), one-sixth (14.8%), and half (47.3%) of the respondents with OUD reported alcohol, marijuana, and nicotine dependence, respectively. One-sixth (16.7%) had a criminal justice involvement history, and almost one-third (30.8%) experienced a major depressive episode (MDE) in the past year. In multivariable analysis, ≤64 years, White race, male gender, lower educational attainment, unemployment, large metro area residence, history of alcohol, marijuana, nicotine use disorder, history of criminal justice involvement, and MDE in previous year were associated with higher odds of OUD. In contrast, being married, non-Hispanic African American, non-Hispanic Other, and Hispanic ethnicity, good physical health, private health insurance, and higher risk perception about addictive substance use were associated with lower odds of OUD. Conclusions: OUD is more prevalent among certain sociodemographic groups in the US. Targeted interventions focusing on young, White, unmarried, male, and uninsured/Medicaid/Medicare populations should be implemented to reduce the OUD.

Association of Smokeless Tobacco Use With the Use of Other Illicit Drugs in the United States

BackgroundThere has been an increase in the use of smokeless tobacco recently. Whether smokeless tobacco use may predispose individuals to use other addictive substances is unknown. The use of multiple addictive substances may compound an individual's adverse health effects. MethodsIn a cross-sectional analysis, we used the 2016-2017 Behavioral Risk Factor Surveillance System (BRFSS) survey database to identify all individuals who reported the use of smokeless tobacco and extracted data regarding baseline and demographic patterns, as well as information regarding the use of other addictive substances. Weighted multivariable logistic regression models adjusting for age, gender, race/ethnicity, poverty level, education, employment status, and marital status were used to determine the odds ratios (ORs) for use of alcohol, cigarettes, e-cigarettes, and marijuana among smokeless tobacco users. ResultsWe identified 30,395 (3.38%) individuals in our study population who reported smokeless tobacco use. Compared with non-users, smokeless tobacco users were more likely to be unmarried, male, Caucasian, belonging to the lower socioeconomic strata, and did not have a formal college education (P <0.01). In multivariable analyses, smokeless tobacco use was associated with a higher likelihood of cigarettes use (OR: 1.76 [95% confidence interval {CI}: 1.66-1.86, P <0.01]), e-cigarette use (OR: 1.61 [95% CI: 1.52-1.71, P <0.01]), and heavy alcohol consumption (OR:2.36 [95% CI: 2.17-2.56, P <0.01]) but not marijuana use (OR: 1.11 [95% CI: 0.90-1.38, P = 0.33]). ConclusionIn a large, nationally representative sample, smokeless tobacco use was associated with the increased use of cigarettes, e-cigarettes, and alcohol. Simultaneous use of these substances may compound the adverse health effects of smokeless tobacco use. Public health interventions addressing this concerning trend are warranted.

Brief Report: Increased Addictive Internet and Substance Use Behavior During the COVID-19 Pandemic in China.

Background and ObjectivesThe COVID‐19 pandemic and control measures may have increased the risk of abusing addictive substances as well as addictive behaviors.MethodsWe present an initial online survey in 6416 Chinese about the relation between the COVID‐19 pandemic and addictive behavior in China.ResultsDuring the COVID‐19 pandemic, 46.8% of the subjects reported increased dependence on internet use, and 16.6% had longer hours of internet use. The prevalence (4.3%) of severe internet dependence rose up to 23% than that (3.5%) before the COVID‐19 pandemic occurred, and their dependence degree rose 20 times more often than being declined (60% vs 3%). Relapses to abuse from alcohol and smoking abstinence were relatively common at 19% and 25%, respectively. Similarly, 32% of regular alcohol drinkers and 20% of regular smokers increased their usage amount during the pandemic.Conclusion and Scientific SignificanceThese three coping behaviors (internet, alcohol, and smoking) during this COVID‐19‐related crisis appear to have increased the risk for substance use disorders and internet addiction. (Am J Addict 2020;00:00–00)