Binge Drinking Research Articles

Lingering Effects of Loss? Widowhood and Substance Use in the LGB Population

Little is known about widowhood's effects on externalizing expressions of distress, like substance use, among sexual minorities. Our study is the first to address this issue using a large national sample of LGB individuals living in the United States. Using the 2010 Aging with Pride: National Health, Aging, and Sexuality/Gender Study ( n = 2,258), we ran logistic regression models predicting current smoking, past 30-day binge drinking, and past year drug use. Widowhood predicted higher odds of drug use. These results were found for currently partnered individuals, suggesting that widowhood's effects are not completely offset by current partnership. In contrast, widowhood did not predict smoking or binge drinking. All results held for women and men. Results suggest that LGB widowhood's effects on substance use vary by current partner status and substance type. These findings contrast with those of studies examining widowhood's effects on internalized expressions of distress, which consistently find detrimental effects.

The Heterogeneous Effects of College Education on Outcomes Related to Deaths of Despair.

College education features prominently in research on determinants of deaths from substance use disorders and self-harm-outcomes collectively referred to as "deaths of despair" (DoD). Limited attention has been given to whether the protective effects of college education on indicators of despair vary by individuals' likelihood of college completion. We use data from the National Longitudinal Study of Adolescent to Adult Health for 6,145 individuals to test whether the protective effects of college completion on precursors to DoD vary according to individuals' propensity to attain a college degree. Understanding whether the benefits of college education differ depending on the propensity to complete it is important for designing effective educational policies. Using the heterogeneous treatment effects approach, we find that individuals with a relatively low propensity for graduating from college but who complete it have a lower likelihood of depressive symptoms, binge drinking, prescription drug abuse, and hard drug use.

Reward deprivation is associated with elevated alcohol demand in emerging adults.

Policies vary substantially in terms of providing sources of psychosocial enrichment. Behavioral economic models of substance use and addiction emphasize that deficits in access to substance-free sources of reward increase substance reinforcing value and risk for addiction. The current study used an alcohol demand curve approach to test the hypothesis that various indices of reward deprivation would be associated with elevated alcohol reinforcing efficacy. We examined associations between alcohol demand indices and several facets of reward deprivation in a sample of young adults (N = 1,331; ages 19-25 years) recruited from the United States and Canada who reported recent binge drinking. Additionally, we created an index of cumulative reward deprivation that integrated the various reward facets and examined its association with alcohol demand intensity and maximum expenditure on alcohol. Our findings indicate that reward deprivation is associated with elevated alcohol demand and provide support for alcohol prevention and intervention approaches that emphasize environmental enrichment.

Cancer Information Seekers' Comprehension Level and the Association With Preventable Cancer Risk Factors: A Cross-Sectional Analysis From a Nationally Representative U.S. Adult Survey.

To examine the association between U.S. adult cancer information seekers' comprehension level and preventable cancer risk factors. Cross-sectional analysis. Health Information National Trends Survey-6, 2022. 2,453 cancer information seekers. Four cancer risk factors were dichotomized: cigarette smoking (have smoked ≥100 cigarettes and currently smoke every day/some days); experiencing sunburn (≥1 times/past 12 months); being overweight/obese (≥25 body mass index [kg/m2]); and binge drinking (≥5 [male] or ≥4 [female] alcoholic drinks on one occasion/past 30 days). Individuals who reported that cancer information was hard to understand were considered having comprehension difficulties. Binomial and multinomial logistic regression analyses were conducted to examine the association of cancer information comprehension level with individual and cumulative cancer risk factors, adjusting for sex, race/ethnicity, age, annual household income, education level, metropolitan status, depressed mood, and cancer diagnosis history. Cancer information seekers with comprehension difficulties had higher odds of binge drinking (aOR: 1.66, 95% CI: 1.12, 2.46), being overweight/obese (aOR: 1.46, 95% CI: 1.09, 1.96), and experiencing sunburn (aOR: 1.61, 95% CI: 1.23, 2.11), as well as having ≥3 (aOR: 3.38, 95% CI: 1.87, 6.09) cancer risk factors concurrently than cancer information seekers without comprehension difficulties. Dissemination of easy-to-understand cancer information would help better prevent cancer risk factors for cancer information seekers with comprehension difficulties.

Feature Selection and Machine Learning Approaches in Prediction of Current E-Cigarette Use Among U.S. Adults in 2022

Feature selection is essentially the process of picking informative and relevant features from a larger collection of features. Few studies have focused on predictors for current e-cigarette use among U.S. adults using feature selection and machine learning (ML) approaches. This study aimed to perform feature selection and develop ML approaches in prediction of current e-cigarette use using the 2022 Health Information National Trends Survey (HINTS 6). The Boruta algorithm and the least absolute shrinkage and selection operator (LASSO) were used to perform feature selection of 71 variables. The random oversampling example (ROSE) method was utilized to deal with imbalance data. Five ML tools including support vector machines (SVMs), logistic regression (LR), random forest (RF), gradient boosting machine (GBM), and extreme gradient boosting (XGBoost) were applied to develop ML models. The overall prevalence of current e-cigarette use was 4.3%. Using the overlapped 15 variables selected by Boruta and LASSO, the RF algorithm provided the best classifier with an accuracy of 0.992, sensitivity of 0.985, F1 score of 0.991, and AUC of 0.999. Weighted logistic regression further confirmed that age, education level, smoking status, belief in the harm of e-cigarette use, binge drinking, belief in alcohol increasing cancer, and the Patient Health Questionnaire-4 (PHQ4) score were associated with e-cigarette use. This study confirmed the strength of ML techniques in survey data, and the findings will guide inquiry into behaviors and mentalities of substance users.

Binge drinking in American Indian Alaskan Native college attending students

ABSTRACT Objectives American Indian and Alaskan Native (AIAN) populations have the highest rate of alcohol use disorder (AUD). Binge drinking is a known predecessor of AUD and is prevalent in college-attending populations. However, little is known about the prevalence and risk factors related to AIAN college student binge drinking. The current study examines prevalence of binge drinking and association with socio-demographic features, other substance use, exposure to discrimination and feelings of belonging within collegiate institutions. Design Data were collected by the Healthy Minds Study. Present analyses were restricted to 2- and 4-year college attending students in the 2021–2022 academic year who identified as AIAN (n = 1383). We used descriptive, bivariate and multivariate Poisson weighted models to evaluate distributions and associations of binge drinking, age, gender, socioeconomic status, degree program, military experience, substance use, sexual assault, discrimination, and feelings of belonging within the institution. Results In the prior 2 weeks, 26.3% of AIAN students reported binge drinking. Binge drinking commonly overlapped with other substance use. AIAN students aged 21–34 reported the highest rates of binge drinking, as did students pursuing bachelor’s degrees. AIAN students who identified as trans or queer gender were less likely to report binge drinking, while across gender identities those reporting sexual assault or racial discrimination were more likely to report binge drinking in multivariate analyses. Conclusion There are multiple factors associated with binge drinking, representing individual and contextual influences on AIAN students. Developing prevention and intervention activities to address overlap in substance use and high concurrence of sexual assault and binge drinking are critical. Additionally, colleges must make concerted efforts to reduce racial discrimination and be more inclusive of AIAN students to reduce institutional-based features that exacerbate risk.

Perceptions of Overall Health Differences Among Veterans Across Marital Statuses.

We examined the relationship between substance use, marital status, and perceived overall health using national data from a sample of 1,506 retired active-duty veterans. We found that binge drinking and heavy alcohol use among widowed veterans have a negative effect on overall health compared to married veterans who did not use alcohol in the past month. We found that non-binge and binge drinking have a positive effect on perceptions of overall health among divorced or separated veterans compared to those who are married and did not use alcohol in the past month. We discuss these findings and address clinical implications.

Substance Use in Adolescent and Young Adult Cancer Survivors: An Integrative Review.

The adolescent and young adult (AYA) ages are a time when individuals are susceptible to risky behaviors, including binge drinking, tobacco, marijuana, and illicit drug use. AYAs are at an increased risk for developing chronic health problems compared with their healthy peers, and substance use can pose additional risks. The purpose of this review is to compare substance use in AYAs with their healthy peers and identify contributing factors. A literature search was conducted of PubMed, Scopus, and OVID databases using keywords substance*, adolescent*, adolescence*, teens*, teenager*, young adult*, pediatric*, childhood*, cancer*, and oncology*. The initial search yielded 148 articles. Inclusion criteria specified English language and articles from January 1, 2013, to December 31, 2023. Studies were excluded if they did not include participants aged <18 years and without a noncancer comparison group. Five relevant articles were included after review and appraisal. Substance use was examined by substance use type and contributing factors, including caregiver-AYA relations, age, and depression/coping. Findings were mixed for substance use, including tobacco and alcohol use. Findings indicate no consistent pattern-substance use was both more and less common in AYAs than in their noncancer peers, or substance use did not differ between AYAs and their noncancer peers. With mixed results, each study identified some level of substance use in AYAs. Given this knowledge, when treating AYAs, providers should be diligent about screening for substance use during each visit. AYAs should be educated about the risk of substance use, especially as a vulnerable, at-risk population.

The impact of alcohol consumption and binge drinking on the risk of dental trauma in South Korean adolescents

Objectives: This study aimed to investigate the impact of alcohol consumption and binge drinking on the occurrence of dental trauma in South Korean adolescents. Methods: Data were analyzed from the South Korean Youth Risk Behavior Survey, which used a complex sampling design to ensure representativeness. A total of 52,875 adolescent were included in this study. Logistic regression analysis was conducted to assess the association between alcohol consumption and tooth fractures. Confounders such as gender, education, city, academic performance, economic status, etc. were adjusted. Results: Logistic regression analysis revealed that alcohol consumption was significantly associated with tooth fractures in adolescents. After adjusting for all factors in Model 3 of binge drinking, the odds ratio remained statistically significant at 1.331 (95% CI: 1.064-1.664). Conclusions: Alcohol consumption and binge drinking increase the risk of tooth fractures in adolescents. Preventive measures targeting alcohol-related behaviors in this population are crucial for improving oral health outcomes.

Prevalent Adverse Childhood Experiences Among Young Adults Returning Home From Jail: The Need for Trauma-Informed Reentry Services.

Prevalence of adverse childhood experiences (ACEs) and the extent to which they relate to health among young adults (ages 18-25) returning home from jail is underexamined. To build on the growing literature examining associations between ACE exposure among young people involved with carceral systems and health, we (1) measured ACE prevalence and (2) explored associations between ACEs and health/well-being indicators among young adults experiencing reentry. Using a telephone survey on reentry experiences, participants completed an ACE screening, single-item responses on health and social indicators, and five-item responses on substance misuse. Fisher's exact tests and t tests compared sociodemographic and health-related factors by the levels of ACEs. Among the 85 participants, 66 (78%) reported four or more ACEs and 48 (56%) reported six or more ACEs, including divorced parents (n = 69, 81%), witnessing violence (n = 63, 74%), and household member incarceration (n = 60, 71%). Higher exposure to ACEs was associated with mental health diagnoses, psychiatric medication prescriptions, psychiatric hospitalizations, drug dependence, binge drinking, and cannabis misuse. High ACE exposure among young adults experiencing reentry portends worse mental health and high rates of substance use. Findings signify an opportunity to apply a trauma-focused developmental framework to support emerging adults during the crucial reentry period.

Interest in the Use of Herbal Supplements to Close the Treatment Gap for Hazardous Alcohol Use Among Men Who Have Sex With Men: Secondary Analysis of a Cross-Sectional Study.

Hazardous alcohol consumption is highly prevalent for men who have sex with men (MSM). The 4 treatments currently approved by the Food and Drug Administration for alcohol use are reaching an alarmingly low percentage of people who would benefit from a reduction in their alcohol use. There is increasing interest in alternative methods of treatment, such as herbal supplements, to address hazardous drinking. However, research on the acceptability of alternative pharmacotherapies among MSM remains limited. We examined the prevalence and correlates of expressing interest in using herbal supplements for alcohol treatment among MSM with hazardous alcohol consumption. We conducted a secondary data analysis from a cross-sectional study of MSM who use alcohol, conducted from March 2015 to July 2017 in San Francisco, California, to assess the overall prevalence of interest in using herbal supplements to help reduce alcohol consumption. Associations between expressing interest in herbal supplements and demographic, social, and clinical characteristics were examined using bivariate and multivariable logistic regression models. One-third (66/200, 33%) of the participants expressed interest in an herbal supplement for reducing alcohol consumption. In the multivariable analyses, weekly binge drinking (adjusted odds ratio [aOR] 2.85, 95% CI 1.17-6.93), interest in abstaining from alcohol use (aOR 5.04, 95% CI 1.46-17.40), higher severity of alcohol dependence score (aOR 1.22, 95% CI 1.04-1.41), and interest in naltrexone (aOR 3.22, 95% CI 2.12-4.91) were independently associated with higher odds of being interested in using an herbal supplement to reduce alcohol consumption, adjusting for age, race or ethnicity, and education. We found that MSM who have hazardous drinking habits, more severe alcohol dependence, and interest in pharmacotherapy were more likely to express interest in using an herbal supplement for reducing alcohol consumption. To our knowledge, this is the first study that has evaluated correlates of interest in herbal supplements for alcohol use among MSM. As researchers implement novel alcohol treatment studies, they should focus on recruitment efforts among MSM with a motivation to reduce their alcohol use patterns.

Exploring the Relationship Between Health Literacy and Alcohol Consumption Patterns in Tuscany

Abstract Introduction Alcohol consumption is a prevalent aspect of social and cultural life worldwide. However, high and binge consumption has become a significant public health concern. Inadequate health literacy (HL) may contribute to poor awareness and/or knowledge regarding the risks of alcohol-related behaviors. However, to date, only a few studies have examined the relationship between HL and different types of alcohol consumption. This study aimed to investigate the relationship between HL, other sociodemographic determinants, and their influence on high and binge consumption among the general population aged 18-69 in Tuscany. Methods The study analyzed data from 2017 to 2022 from a Tuscan population subsample in the Italian Behavioral Risk Factor Surveillance System PASSI. HL was assessed using the Italian version of the six-item European Health Literacy Survey Questionnaire (HLS-EU-Q6). Results Among the 12,953 interviewees, binge drinking was reported by 8.3%, while high consumption by 3.6% of the entire sample. In the multivariate logistic regression, participants aged between 50 and 69 years with problematic or inadequate HL levels had an increased adjusted odds ratio for high alcohol consumption. Instead, females, individuals older than 34 years, and those of foreign nationality had a reduced odds ratio for binge drinking. Low HL was a predictor of high alcohol consumption but not of binge drinking. Discussion As expected, young males are more likely to engage in binge drinking, while older individuals are more likely to have high consumption. In a challenging period for healthcare system sustainability, it is mandatory to use economic resources efficiently and target the right population with tailored interventions: given that HL impacts on high consumption, research and policy should focus HL interventions specifically on high alcohol consumers. Conversely, educational campaigns aimed at increasing HL in binge drinkers risk to have a lesser impact. Key messages • Health literacy does not influence binge drinking. • Inadequate levels of health literacy predict high alcohol consumption.

Income inequality and risky health behaviors of affluent adolescents in the post-Communist Europe

Abstract Background We aim to study the “golden youth” hypothesis and examine the risky behaviors of adolescents with high socioeconomic position (SEP) in post-Communist countries of Europe (PCCE) in relation to income inequality. Methods Adolescents aged 11-15 years from 14 PCCE participating in the Health Behavior in School-aged Children survey 2017/18 were included. A K-means cluster analysis was conducted to group adolescents based on tobacco smoking, alcohol use, binge drinking, and bullying perpetration. Generalized linear mixed models were fitted. Results Four clusters of adolescents were identified. The percentage of high-SEP adolescents in Cluster 1 (low risky behaviors) was slightly less compared to middle and low-SEP groups (70.9% vs 73.1% vs 73.9%, respectively). High-SEP adolescents were more likely to be in Cluster 2, characterized by frequent alcohol consumption but moderate binge drinking (14.3% vs 12.6% vs 10.7%). The prevalence of risky behaviors was similar between high and low-SEP adolescents in Cluster 3 (high smoking, frequent alcohol use, binge drinking, and moderate bullying) (8.0% vs 7.7% vs 8.2%) and Cluster 4 (high levels of bullying perpetration) (6.7% vs 6.5% vs 7.2%). Countries with higher Gini index were at a greater risk of reporting risky behaviors. High-SEP adolescents were more likely to engage in risky behaviors in countries with high income inequality. The odds ratios comparing high- vs. low-SEP adolescents ranged from 0.89 in the least unequal to 1.67 in the most unequal countries for multiple risky behaviors (Cluster 3: P-interaction = 0.042) and from 0.61 to 1.19 for bullying perpetration (Cluster 4: P-interaction = 0.030). Conclusions High-SEP adolescents in PCCE might be at an increased risk for unhealthy and vicious behaviors, especially in countries with high income inequality. This study highlights the need for policies that address income inequality to ensure the well-being of adolescents across socioeconomic strata in PCCE. Key messages • High-SEP adolescents might be at an increased risk for unhealthy behavior in PCCE. • Wide income inequality might contribute to risky behaviors among high-SEP adolescents.

Impact of the transition to retirement on alcohol consumption: a longitudinal analysis within SHARE

Abstract In an ageing society, the impact of retirement on behavioural risk factors and health status needs to be carefully assessed. Evidence on the short-term and long-term effects of retirement on alcohol consumption are contrasting and inconsistent. A longitudinal study was conducted based on data from the Survey on Health, Ageing and Retirement (SHARE) collected between 2004 and 2020 in 27 European countries and Israel. A repeated measure generalised estimating equation (GEE) model was fitted to estimate the relative risks (RR) and corresponding 95% confidence intervals (CI) of alcohol consumption (frequency, quantity, and binge drinking) at different time periods before and after retirement. We selected a cohort of 8,998 individuals who were employed at baseline and retired during follow-up (median follow-up: 9 years; maximum: 16 years). Compared to the year of retirement, the RR for habitual daily or near-daily drinking was 0.88 (95%CI 0.76-1.02) 10 years before retirement and 0.92 (95%CI 0.83-1.02). This pattern reversed post-retirement with a RR of 1.12 (95%CI 1.01-1.23) 3-4 years after retirement and 1.28 (95%CI 1.11-1.48) 10 years or more after retirement. No significant changes in the consumption of high volumes (more than 8 units of alcohol) were observed: while the frequency of regular drinking might increase post-retirement, the instances of heavy episodic drinking do not necessarily rise. Additionally, a reduction in occasional heavy drinking episodes was noted both before (RR 0.86; 95%CI 0.77-0.95, 5-9 years prior) and after retirement (RR 0.78; 95%CI 0.66-0.93, more than 10 years after). These findings underscore the complexity of alcohol use behaviours in the context of retirement. The increase in regular drinking post-retirement might be attributed to changes in daily structure, social interactions, or coping mechanisms for life transitions. The decline in binge drinking suggests a shift towards more moderated consumption patterns as individuals age. Speakers/Panelists Licia Iacoviello University of Insubria, Varese, Italy João Vasco Santos University of Porto, CINTESIS, ARS Norte, Porto, Portugal

Exploring the dynamics of alcohol use, poverty and the role of social context in Athens, Greece

Abstract Background A body of research conducted across diverse national context, including the United Kingdom, Russia, Denmark and Norway, shows a robust link between poverty and increased alcohol related harm, even after accounting for different drinking patterns. This paper examines the unexplored relationship between poverty and alcohol use in Athens, Greece, focusing on alcohol’s impact related to the familial and social life of individuals and whether this system is affected by poverty. Methods This is a 2021 cross-sectional study, with 300 adult participants of mean age 45.8. We administered four questionnaires. The participants were equally distributed above and below the poverty threshold, sampled randomly. The latter were beneficiaries of social services. The data analysis established two scoring variables: the level of dysfunction from alcohol use and the level of strength of family ties. We computed their correlation and multiple linear regressions to assess their relationships. Results Individuals not residing in poverty exhibit a higher frequency of alcohol use (81.9%) than their counterparts (57.1%), however, those living in poverty tend to consume greater quantities of alcohol per occasion (p &amp;lt; 0.001) and reported elevated levels of dysfunction within familial and social interactions. Conclusions This study indicates that different consumption patterns are tied to diverse socioeconomic strata, with binge drinking behaviours specifically linked to financial hardship. Also, alcohol related dysfunction and family and social dynamics are affected by poverty. Our findings show that as dysfunction attributed to alcohol use increases, participants socialize less and report lower levels of well-being. In contrast those with balanced family ties and social encounters exhibit the opposite trend. This study warrants further exploration in cities in Southern Europe. Key messages • To mitigate alcohol use, policies empowering social and familial connections are of high importance. • Uncovering poverty as a factor for binge drinking can inform prevention strategies.

Risk factors for the gambling, smoking and alcohol consumption triad in Portuguese adolescents

Abstract Background Addiction to gambling, tobacco, and alcohol poses significant risks to mental, social, and physical health, particularly during adolescence, a critical period for habit formation. This study investigates risk factors linked to these habits among Portuguese adolescents. Methods This cross-sectional study used the 2019 ESPAD questionnaire, targeting 16-year-old adolescents. The sample comprised 4,365 responses. Descriptive analysis determined the prevalence of gambling, smoking, and alcohol use, as well as social, economic, and behavioral factors. Bivariate associations were assessed using the Exact Fisher test, and multiple logistic regression identified key predictors for the outcome of interest (cumulative presence of gambling, smoking and alcohol consumption). Statistical analysis was conducted with SPSS version 29.0, with a significance level of p &amp;lt; 0.05. Results Among adolescents, 6.2% presented probable problematic gambling according to the Lie/Bet test, with 3.7% spending at least 30 minutes a day gambling. In the past 30 days, 14.3% smoked, 42.7% drank alcohol, and 10.5% engaged in binge drinking. The behavioral triad was observed in 56 individuals. Male gender (OR = 2.024; 95% CI: 1.097-3.734; p = 0.024), problematic online gaming behavior (OR = 2.041; 95% CI: 1.005-4.144; p = 0.048) and going out at night at least once a week (OR = 1.439; 95% CI: 1.242-1.669; p &amp;lt; 0.001) significantly increased the risk of the behavioral triad. In contrast, parental control (parents knowing where the adolescent is on Saturday night) had a significant protective effect (OR = 0.162; 95% CI: 0.086-0.303; p &amp;lt; 0.001). Conclusions The study underscores the importance of parental supervision to curb risky behaviors in adolescents. It suggests implementing public health programs in schools, leveraging gaming for early screening, and tightening online gambling regulations to mitigate future health risks associated with gambling, smoking, and alcohol use. Key messages • Absence of parental supervision, male gender, problematic online gaming and frequently going out at night are risk factors for this behavioral triad. • Public health strategies are needed to prevent gambling addiction, emphasizing parental awareness, identification of at-risk students, and comprehensive school-based approaches.

Differences and similarities in adolescents accessing emergency care for acute alcohol intoxication in three urban regions in Italy, Belgium, and The Netherlands

Abstract Background Excessive drinking among adolescents in Western Europe is prevalent, posing significant health risks and societal costs. Early initiation of alcohol use and binge drinking are associated with adult alcohol use disorders. Collecting comprehensive data on adolescent drinking patterns is crucial for developing effective prevention strategies. Methods To gain insight into the demographic and clinical characteristics of acute alcohol intoxication (AAI), we analysed emergency department access data of adolescents aged 14-17 years presenting with AAI symptoms from 2015-2023. Three urban regions were included: the Reinier de Graaf Gasthuis in Delft (The Netherlands), eight combined hospitals in Antwerp (Belgium) and the IRCCS San Martino Hospital in Genoa (Italy). Results A total of 1841 patients with symptoms of AAI were included. The mean age of patients in the Netherlands was statistically significant younger than in Italy and Belgium (15.7 compared to 15.9 and 16.0 years old, respectively). Moreover, the blood alcohol concentration was higher in the Netherlands and Belgium compared to Italy (2.0‰ compared to 1.95‰ and 1.8‰ respectively). The distribution of sex was nearly equal in the Netherlands, while statistically significant differences were observed with a higher proportion of males in Italy (54.8%) and Belgium (56.8%). Combined drug use was lower in Belgium with 10.0%, compared to 13.4% in The Netherlands and 14.7% in Italy. The most common reason for admission was ‘reduced consciousness’ in the total population (45.2%). Conclusions This is one of the first international studies which combines data on AAI in minors. In the future, efforts should be made to establish a common European database where records of AAI can be stored and analysed more efficiently for prevention purposes.

Prevalence and Correlates of Cannabis Use among Cancer Survivors

Abstract Background Delaware has legalized marijuana use for both medical and recreational use. This study identified factors associated with cannabis use among adults with chronic relative to individuals without a history of cancer in the First State. Methods Combined data (2020, 2021 and 2022) from the Behavioral Risk Factor Surveillance System (BRFSS) were analyzed for Delaware. Multivariable logistic regression examined individual-level demographic, socio-economic, clinical, and behavioral predictors associated with marijuana use stratified by history of cancer. Results Cannabis use was lower among cancer survivors compared to individuals with no history of cancer (6.76% vs. 13.43%). However, a higher proportion of cancer survivors reported use for medical purposes (75.13% vs. 64.28%). Marijuana use prevalence decreased with age among cancer survivors. After adjusting for sex, age, educational attainment, self-reported race/ethnicity, mental health status and physical health status, current smoking (odds ratio [OR], 4.24 vs. 2.74) and binge drinking (OR, 2.45 vs. 1.75) were associated with cannabis use in both groups. Conclusions Adults with cancer were more likely to use marijuana. Marijuana use prevalence decreased with age. Public perceptions of marijuana is becoming more acceptable. Risk of medical conditions such as cancer increase with age. As such, older adults might also become consumers of marijuana. Clinicians should screen for marijuana use among patients and initiate open discussions with patients about the benefits and risks associated with marijuana. Key messages • Need for ongoing cannabis research to better understand and inform its use for medical purposes. • Development of high-quality standardized education materials and clinical practice guidelines for marijuana use.

Depressive symptoms among medical students

Abstract Background Adolescence is a period of psychological development which is associated with an increased risk of developing mental health disorders. Medical students have a higher prevalence of depression compared to the general population, but they are given low priority in the healthcare system. The aim of this study was to examine the prevalence of clinically significant scores on the Patient Health Questionnaire 9 (PHQ-9), and factors associated with clinically significant scores. Methods The research was conducted through a cross-sectional study among fifth-year medical students, using a 95-item questionnaire anonymously filled out. The questionnaire examined: socio-demographic and socio-economic characteristics of the students; students’ lifestyles (including alcohol consumption, binge drinking, smoking cigarettes, electronic cigarettes, use any of other tobacco products); Patient Health Questionnaire (PHQ-9); International Physical Activity Questionnaire (IPAQ); Zung’s Anxiety Scale; and Problematic Internet Use Scale. Based on the score on PHQ-9, the participants were classified in two groups: with clinically significant scores (score ≥10) and without clinically significant scores (score &amp;lt;10). Results The study included 461 medical students who completed the PHQ-9. Average score on PHQ-9 scale was 5.25±4.53 and total of 66 students (14.3%) had the PHQ-9 indicative of clinically significant depressive symptoms (PHQ-9 ≥10). The clinically significant depression was associated with smoking of any tobacco product (OR:3.02, 95% CI: 1.37-6.63), score on social support scale (0.94, 95% CI: 0.90-0.98), age (OR: 1.42, 95% CI: 1.06-1.90) and score on Zung anxiety scale (OR: 1.15, 95% CI: 1.16-1.34). Conclusions Considering that medical students, are at higher risk of developing clinically significant symptoms of depression, it is crucial to form psychological and social support programs. Key messages • Monitoring the mental health of young individuals holds significant importance. • It is crucial to detect risk factors in time and develop prevention programs.

Associations between bedtime media use and sleep outcomes in an adult population-based cohort

Abstract Background We aimed to extend existing research on associations between bedtime media use and sleep in adults by taking relevant covariates into account and testing hypothesised mediating and moderating pathways. Methods Frequency of bedtime media use and sleep outcomes were examined by questionnaire in 4188 adults (59% women, aged 19-94 years) from the Specchio cohort in Geneva, Switzerland. We tested: 1) associations between bedtime media use and sleep (bedtimes, sleep latency, sleep duration, sleep quality, insomnia symptoms, and daytime sleepiness), adjusting for prior sleep, mental health, and health behaviours (physical activity, binge drinking, smoking, total leisure screen time), 2) whether bedtime media use mediates associations between individual susceptibility factors (age, chronotype, and mental health) and sleep, and 3) whether individual susceptibility factors moderate associations between bedtime media use and sleep. Results Often using a screen in the 30 minutes before going to sleep at night was associated with a late bedtime (≥midnight; OR [95% CI]=1.90 [1.44, 2.51], p &amp;lt; 0.001), short sleep duration (&amp;lt;7 hours; 1.21 [1.01, 1.46], p &amp;lt; 0.05), and excessive daytime sleepiness (Epworth score &amp;gt;9; 1.47 [1.25, 1.74], p &amp;lt; 0.001) after adjustment for all covariates. Bedtime media use partly mediated the association between younger age and an evening chronotype and these sleep outcomes. Mental health moderated the association between bedtime media use and sleep quality/insomnia, such that the former was associated with poorer sleep quality/insomnia among individuals with better mental health, but not among those with poorer mental health. Conclusions Frequent bedtime media use was associated with various sleep outcomes, independently of relevant covariates. Limiting the use of screens at bedtime is important to promote sleep among adults. Individuals with poorer mental health likely require additional support to improve their sleep quality. Key messages • Frequent bedtime media use is associated with a late bedtime, short sleep duration, and more daytime sleepiness in adults, and these associations hold after adjustment for relevant covariates. • Frequent bedtime media use mediates the association between individual susceptibility factors and sleep outcomes. Mental health moderates the association between bedtime media use and sleep quality.