Repeated Cross-sectional Data Research Articles

Prices and Purchase Sources for Dried Cannabis Flower in the United States, 2019-2020.

Introduction: The price of cannabis has major implications for public health, public safety, social equity, and government revenues. This article examines prices and sources of purchased dried cannabis flower among consumers facing different state laws in the United States. Methods: Repeat cross-sectional survey data were collected from the International Cannabis Policy Study in 2019 and 2020. U.S. respondents were recruited through online commercial panels, ages 16-65, and purchased dried flower in the past year (n=9766). Weighted binary logistic regression models examined legal purchasing in states that had legalized recreational cannabis. Results: Compared with respondents in states with recreational stores, respondents living in "illegal," "medical," and "recreational" states without stores were associated with paying a higher unit price of dried flower (+20.5%, +23.6%, +27.4%, respectively; all p<0.05). The majority of respondents in states with recreational stores last purchased from stores/dispensaries (2019: 66.6%; 2020: 62.0%) and the odds of purchasing legally was greater with each additional year after stores opened (adjusted odds ratio=1.48, 95% confidence interval: 1.37, 1.60). Conclusions: Cannabis prices and purchase behaviors are strongly influenced by its legal status and presence of stores. After states legalize for recreational purposes, it takes multiple years for the legal market to become established as the number of retail stores increase and prices decrease. The findings demonstrate that consumers use sources that they are legally allowed to access, suggesting an increased number of physical retail stores and online delivery services could expand uptake of legal sources in states with recreational cannabis laws.

Social Norms and Gender Disparities with a Focus on Female Labor Force Participation in South Asia

Abstract Despite decades of economic growth, gender disparities in South Asia remain remarkably high. Although not the only one, social norms are a crucial driver of various gender outcomes, including differential economic participation. Using repeated cross-sectional data from nationally representative surveys, this study explores long-term trends across gender outcomes and social norms (contrasting attitudes and social normative expectations towards gender roles) in South Asia. The results corroborate the evidence that there has been almost no progress in gender disparities in South Asia over the past half-century. There has been little progress in female labor force participation, age at first birth, agency, and intimate partner violence, while (basic) education is an important exception. The lack of progress is apparent among all layers of society, including women who live in urban areas, are educated, and have higher incomes. Gender attitudes also remain unchanged, while for some issues, they have become more conservative and have a negative relationship with gender outcomes. This negative relationship is even stronger when social normative expectations are considered. More data on social norms and a better understanding of their constraining role may be critical for achieving gender equality in the region.

Long COVID and Significant Activity Limitation Among Adults, by Age - United States, June 1-13, 2022, to June 7-19, 2023.

Long COVID is a condition encompassing a wide range of health problems that emerge, persist, or return following COVID-19. CDC analyzed national repeat cross-sectional Household Pulse Survey data to estimate the prevalence of long COVID and significant related activity limitation among U.S. adults aged ≥18 years by age group. Data from surveys completed between June 1-13, 2022, and June 7-19, 2023, indicated that long COVID prevalence decreased from 7.5% (95% CI=7.1-7.9) to 6.0% (95% CI=5.7-6.3) among the overall U.S. adult population, irrespective of history of previous COVID-19, and from 18.9% (95% CI=17.9-19.8) to 11.0% (95% CI=10.4-11.6) among U.S. adults reporting previous COVID-19. Among both groups, prevalence decreased from June 1-13, 2022, through January 4-16, 2023, before stabilizing. When stratified by age, only adults aged <60 years experienced significant rates of decline (p<0.01). Among adults reporting previous COVID-19, prevalence decreased among those aged 30-79 years through fall or winter and then stabilized. During June 7-19, 2023, 26.4% (95% CI=24.0-28.9) of adults with long COVID reported significant activity limitation, the prevalence of which did not change over time. These findings help guide the ongoing COVID-19 prevention efforts and planning for long COVID symptom management and future health care service needs.

Birth cohort changes in fertility ideals: evidence from repeated cross-sectional surveys in Finland

Abstract Fertility has declined in developed countries but whether there is a similar pattern in the number of children individuals wish to have (henceforth an ideal number of children) remains unclear. Using repeated cross-sectional survey data from the Finnish Family Barometers, we examine birth cohort changes in the ideal number of children among men and women from five birth cohorts (1970–1974, 1975–1979, 1980–1984, 1985–1989, and 1990–1994). We also investigate whether associations between socioeconomic factors and the ideal number of children differ across birth cohorts, and whether there are any gender differences in these associations. We find that the ideal number of children is lower among more recent than earlier birth cohorts and that this shift is driven by substantially higher child-free ideals among recent cohorts. While the ideal number of children among men and women is associated with socioeconomic factors, birth cohort differences remain significant after controlling for these characteristics. These findings suggest that large birth cohort differences in child-free ideals are not due to the individual socioeconomic circumstances of more recent birth cohorts. Rather, it appears that the childbearing attitudes of Finns have changed and may have contributed to the recent fertility decline.

Evaluating the effects of minimum unit pricing in Scotland on the prevalence of harmful drinking: a controlled interrupted time series analysis

ObjectivesIn May 2018, the Scottish Government introduced a minimum unit price (MUP) for alcohol of £0.50 (1 UK unit = 8 g ethanol) to reduce alcohol consumption, particularly among people drinking at harmful levels. This study aimed to evaluate MUP's impact on the prevalence of harmful drinking among adults in Scotland. Study designThis was a controlled interrupted monthly time series analysis of repeat cross-sectional data collected via 1-week drinking diaries from adult drinkers in Scotland (N = 38,674) and Northern England (N = 71,687) between January 2009 and February 2020. MethodsThe primary outcome was the proportion of drinkers consuming at harmful levels (>50 [men] or >35 [women] units in diary week). The secondary outcomes included the proportion of drinkers consuming at hazardous (≥14–50 [men] or ≥14–35 [women] units) and moderate (<14 units) levels and measures of beverage preferences and drinking patterns. Analyses also examined the prevalence of harmful drinking in key subgroups. ResultsThere was no significant change in the proportion of drinkers consuming at harmful levels (β = +0.6 percentage points; 95% confidence interval [CI] = −1.1, +2.3) or moderate levels (β = +1.4 percentage points; 95% confidence interval = −1.1, +3.8) after the introduction of MUP. The proportion consuming at hazardous levels fell significantly by 3.5 percentage points (95% CI = −5.4, −1.7). There were no significant changes in other secondary outcomes or in the subgroup analyses after correction for multiple testing. ConclusionsIntroducing MUP in Scotland was not associated with reductions in the proportion of drinkers consuming at harmful levels but did reduce the prevalence of hazardous drinking. This adds to previous evidence that MUP reduced overall alcohol consumption in Scotland and consumption among those drinking above moderate levels.

Temporal stability of shipment size decisions related to choice of truck type

The choice of shipment size is a vital decision in logistics and has a strong indirect influence on freight transport demand, via the choice of mode and truck type choice. Through time, shipment sizes can change as a result of new decisions in the logistics process or due to conditions external to the supply chain. This study investigates the temporal stability of shipment size choices, relating these to the choice of truck types. It uses repeated cross-sectional data for the years 2015, 2017, and 2019 collected from cordon and business establishment surveys in Addis Ababa city, Ethiopia. The integrated choice and latent variables (ICLV) and latent growth (LG) models were used to assess the time-dependent patterns of choosing shipment sizes, both at the level of the entire freight system as well as the specific truck types. The model results reveal that shipment size decisions are temporally unstable where, in our case, shipment sizes exhibited a declining trend.

Patterns of problematic cannabis use in Canada pre- and post-legalisation: Differences by neighbourhood deprivation, individual socioeconomic factors and race/ethnicity.

The legalisation of cannabis in Canada in 2018, and subsequent increase in prevalence of use, has generated interest in understanding potential changes in problematic patterns of use, including by socio-demographic factors such as race/ethnicity and neighbourhood deprivation level. This study used repeat cross-sectional data from three waves of the International Cannabis Policy Study web-based survey. Data were collected from respondents aged 16-65 prior to cannabis legalisation in 2018 (n = 8704), and post-legalisation in 2019 (n = 12,236) and 2020 (n = 12,815). Respondents' postal codes were linked to the INSPQ neighbourhood deprivation index. Multinomial regression models examined differences in problematic use by socio-demographic and socio-economic factors and over time. No evidence of a change in the proportion of those aged 16-65 in Canada whose cannabis use would be classified as 'high risk' was noted from before cannabis legalisation (2018 = 1.5%) to 12 or 24 months after legalisation (2019 = 1.5%, 2020 = 1.6%; F = 0.17, p = 0.96). Problematic use differed by socio-demographic factors. For example, consumers from the most materially deprived neighbourhoods were more likely to experience 'moderate' vs 'low risk' compared to those living outside deprived neighbourhoods (p < 0.01 for all). Results were mixed for race/ethnicity and comparisons for high risk were limited by small sample sizes for some groups. Differences across subgroups were consistent from 2018 to 2020. The risk of problematic cannabis use does not appear to have increased in the 2 years following cannabis legalisation in Canada. Disparities in problematic use persisted, with some racial minority and marginalised groups experiencing higher risk.

Minimum legal age laws and perceived access to cigarettes, e-cigarettes, and other substances among youth in Canada, England, and the United States: 2017-2021.

Minimum legal age (MLA) restrictions are a core policy to reduce youth use of tobacco, e-cigarettes, and other substances. We examined trends in perceived ease of access to tobacco and other substances across three countries with differing MLA policies, including the United States (US), which increased the federal MLA for tobacco products from 18 to 21 in 2019. Repeat cross-sectional data were analyzed from seven waves of the International Tobacco Control (ITC) Youth Tobacco and Vaping Survey conducted between 2017 and 2021. Online surveys were conducted with non-probability samples of 91,647 youth aged 16-19 in Canada, England, and the US. Regression models were used to examine differences in perceived ease of accessing each of 7 substances (analyzed as "very easy" or "fairly easy" versus else), and differences between countries and over time (including before and after any MLA changes) for cigarettes, e-cigarettes, cannabis, and alcohol; additional models examined sub-national variation in MLA. Perceived access varied by substance and across countries: in August/September 2021, perceived ease of accessing cigarettes and e-cigarettes was greater in Canada where MLA was 18-19 (61.7% cigarettes, 66.4% e-cigarettes) and England where MLA was 18 (66.9%, 69.6%), compared to the US where MLA was 21 (48.0%, 60.9%; p<0.001 for all). Perceived ease of accessing cannabis was greatest in Canada (53.3%), followed by the US (44.1%) and England (34.0%; p<0.001 for all). Following the federal MLA increase for tobacco products in the US, perceived ease of access decreased significantly for cigarettes (65.1% in 2019Aug to 59.7% in 2020Feb; aOR=0.80 (95%CI=0.71-0.89)) and e-cigarettes (72.4% in 2019Aug to 69.4% in 2020Feb; aOR=0.87 (95%CI=0.77-0.98)). Higher MLA was strongly associated with fewer youth perceiving easy access to substances: perceived access varied between countries with differing MLA, as well as within-country before and after changes to MLA.

Early-onset smoking and vaping of cannabis: Prevalence, correlates and trends in New Zealand 14-15-year-olds.

Initiating cannabis use at an early age elevates risk of harm. Cannabis vaping is an emerging issue, and it is unknown whether the patterning and correlates of early-onset cannabis vaping differ from those of cannabis smoking. We used repeat cross-sectional data from a nationally representative biennial survey (2012-2018) of students aged 14-15 years in New Zealand (N=11,405), response rate 65% (2012), 64% (2014-2016) and 59% (2018). Between 2012 and 2018 lifetime cannabis use decreased, but regular use (past month, weekly, daily) was stable. Prevalence of past month, weekly and daily use in 2016-2018 (pooled) was 8.6%, 3.4% and 1.5%, respectively. Cannabis vaping was reported by 24% of past month cannabis users. The demographic profile of early-onset cannabis smokers and vapers was similar, with elevated use of both modes among Māori (Indigenous), same- or both-sex attracted students and those in low decile (high-deprivation) schools. Correlates were similar for both modes. Cannabis use was strongly associated with tobacco and alcohol use. The next strongest associations (after adjustment) were exposure to second-hand smoke at home, student income >$50/week and low parental monitoring of whereabouts. Past week social media use, psychological distress and low parental monitoring of spending were also associated with both modes. Early-onset cannabis use is much higher in structurally disadvantaged groups, and among those who use tobacco and alcohol. Comprehensive multisubstance approaches to prevention are indicated in this age group. Efforts to reduce socio-economic inequity and exposure to other risk factors may reduce cannabis-related harm.

Pseudo Panel Analysis of Waste Disposal and Household Health Expenditure in Ghana: The Role of Institutions

This study analyzed the effect of waste disposal on household health expenditure in Ghana by using Pseudo Panel technique to inform policy. It further analyzed the role institutions play in dealing with waste disposal and household health expenditure in Ghana. Numerous empirical studies have been carried out on waste disposal. However, these empirical studies did not focus on examining the effect of waste disposal on household health expenditure in Ghana. The study employs pseudo panel constructed from repeated cross sectional data from Ghana Living Standard Surveys (5, 6 &amp;7) to achieve this objective. The System Generalized Method of Moments (GMM) is employed to estimate the model. Results from the study indicates that, improper solid waste disposal leads to the spread of diseases like malaria, cholera, diarrhoea, dengue and others. This leads to the increase in the health expenditure of these households. However, when solid waste disposal is interacted with institutions (Faith Based Organizations), it reduces household health expenditure. The study recommends that, government institutions should complement the efforts of these Faith Based Organizations (FBOs) to help achieve higher positive outcome. Keywords: Solid waste disposal, liquid waste disposal, household health expenditure, pseudo panel, institutions DOI: 10.7176/JRDM/89-04 Publication date: November 30 th 2022

Home cannabis cultivation in the United States and differences by state-level policy, 2019-2020

ABSTRACT Background: As of 2022, all but two U.S. states with adult-use cannabis laws also allow home cultivation. Home cultivation has the potential to support or oppose public health measures, and research in U.S. states is nascent. Objectives: 1) estimate the percentage of respondents who reported growing cannabis plants; 2) estimate the average number of plants grown; 3) examine the association between home cultivation, jurisdiction, and individual-level factors; and 4) examine the association between home cultivation and state-level policies in adult-use states. Methods: Repeat cross-sectional survey data come from U.S. respondents aged 21–65 in 2019 and 2020. Respondents were recruited through online commercial panels. Home cultivation rates were estimated among all U.S. respondents (n = 51,503; 46–52% male). Additional analyses were conducted on a sub-sample of respondents in states that allowed adult-use home cultivation (n = 29,100; 50% male). Results: A total of 6.8% and 7.3% of U.S. respondents reported home cultivation in 2019 and 2020, respectively. Respondents in states that allowed adult-use home cultivation had higher odds of reporting home cultivation than respondents in states without medical or adult-use cannabis laws (AOR = 1.48, 95% 1.26, 1.75). Among respondents in states that allowed adult-use home cultivation, the median number of plants that respondents reported growing was below state cultivation limits. Conclusion: Home cultivation rates in the U.S. were higher in states that allowed adult-use home cultivation; however, other evidence suggests these same states had higher rates predating adult-use legalization. Further work is needed to examine how home cultivation relates to public health measures in adult-use states.

When does morbidity start? An analysis of changes in morbidity between 2013 and 2019 in Italy

Morbidity is one of the key aspects for assessing populations’ well-being. In particular, chronic diseases negatively affect the quality of life in the old age and the risk that more years added to lives are years of disability and illness. Novel analysis, interventions and policies are required to understand and potentially mitigate this issue. In this article, we focus on investigating whether in Italy the compression of morbidity is in act in the recent years, parallely to an increase of life expectancy. Our analysis rely on large repeated cross-sectional data from the national surveillance system passi, providing deep insights on the evolution of morbidity together with other socio-demographical variables. In addition, we investigate differences in morbidity across subgroups, focusing on disparities by gender, level of education and economic difficulties, and assessing the evolution of these differences across the period 2013–2019.

The risk of eviction and the mental health outcomes among the US adults

Although past studies establish a link between residential instability and poor mental health, studies investigating the association between perceived risk of eviction and mental health with nationally representative data are largely lacking. This study examines the association between self-reported risk of eviction and anxiety, depression, and prescription medication use for mental or emotional health reasons. This is a retrospective observational study using the repeated-cross sectional data (n = 14548; unweighted) using the US Census Bureau’s Household Pulse Survey from July 2021 to March 2022. Survey respondents aged 18 years and above who lived in rented residences and were not caught up with the rent payments at the time of the survey were included in the analysis. The descriptive summary shows a higher prevalence of depression (59.33 % vs 37.01 %), anxiety (67.01 % vs 43.28 %), and prescription medication use (26.57 % vs 23.68 %) among the respondents who are likely to face eviction in the next two months compared to the reference group not at the risk of eviction. When adjusted for demographic characteristics, family context, and socioeconomic setting, the odds of depression, anxiety, and prescription medication use in the at-risk eviction group were significantly higher than in the reference group. Specifically, odds ratios (ORs) [95 % CI] for depression, anxiety, and prescription medication use are 2.366 [2.364, 2.369], 2.650 [2.648, 2.653], and 1.172 [1.171, 1.174], respectively. These results suggest that the perceived risk of eviction is associated with elevated mental health problems. Addressing the housing crisis may help decrease the mental health burden among rented households.

Readiness for transition to adult health care among US adolescents, 2016-2020.

Adolescence is a critical period of transition from paediatric to adult health care, but readiness for this transition has been described as low in the general adolescent population. We aimed to investigate whether transition readiness improved over time among US adolescents and to examine associations between demographic and clinical characteristics and transition readiness over time. Deidentified caregiver-reported repeated cross-sectional data from the 2016-2020 National Survey of Children's Health were analysed for caregiver-reported measures of transition readiness among adolescents age 12-17 years. Logistic regression was used to identify trends in transition readiness and change over time in factors associated with this outcome. Among 55 022 adolescents represented in the five survey years, the proportion meeting a composite definition of transition readiness increased from 15% (95% confidence interval [CI]: 14%, 16%) in 2016 to 19% (95% CI: 17%, 20%) in 2020. After multivariable adjustment, each additional year was associated with 12% greater odds of caregiver-reported transition readiness (95% CI: +8%, +15%; P< 0.001), and transition readiness was more likely for girls, older adolescents and adolescents with special health care needs. Associations between adolescent characteristics and transition readiness did not change over the study period. Population-level caregiver-reported transition readiness among US adolescents has increased but remains low. Factors previously associated with transition readiness (age, sex, race and ethnicity, family income and presence of special health care needs) have persisted over recent years.

Secular changes in personality: An age-period-cohort analysis

There has been a surge in media interest regarding the generational effects on the distribution and structure of personality traits. This article examines time and generational effects on the Five Factor personality traits. Hierarchical Age-Period- Cohort Modeling (HAPC) was deployed on a sample of 30,722 participants assembled from pooled repeated cross-sectional data collected between 2006 and 2018. After controlling for both age and period effects no generation-related effects in personality traits (both aggregate and facet levels) were detected. Our findings imply that broad societal changes delineating various “generations” exert a minor influence over the distribution of personality traits in the general population.

Austerity, Short-term Economic Recovery and Public Perception of Immigration in Ireland

The economic crisis of 2007/2008 did not affect all members of the European Union (EU) to the same extent. In the Irish case, the economic crisis and subsequent period of austerity paralleled an erosion in public support for immigration. However, little is known about how public perception changed during a period of short-term economic recovery, like that experienced in Ireland from 2014 to 2018. Using repeated cross-sectional survey data unique to Ireland, this work captures change in attitudes towards immigrants during the pre-crisis and late-austerity periods. Moreover, this research evaluates the importance placed on two immigrant attributes intimately linked to the labour market — education and skills. We provide evidence of an emergence of more moderate views of immigration during the recovery period, but only in the perceived importance of educational qualifications. Perception of skills remains notably unchanged. Of note, both attributes remain more important in the public eye relative to before the economic crisis. In other words, short-term economic recovery does not automatically translate into a more welcoming reception. We confirm that crises and periods of austerity erode public perception of newcomers, particularly when immigration is framed in terms of skill-based economic contribution. However, this work reveals some of the scars of a rapid and deep economic downturn alter the context of reception in a durable way, which remains notably resistant to short-term recovery.

Association between Increasing Social Capital and Decreasing Prevalence of Smoking at the Municipality Level: Repeated Cross-Sectional Study from the JAGES.

As smoking cessation is crucial for both individual and public health, this study aimed to elucidate the association between changes in social capital and in terms of smoking at the level of municipal units in Japan. Using repeated cross-sectional data from the Japan Gerontological Evaluation Study, we analyzed data from adults aged 65 years or older from 69 municipal units that participated in two survey waves. We received valid responses from 91,529 and 86,403 older people in 2013 and 2019, respectively, and aggregated all variables by municipal units. For the dependent variable, we used the units’ prevalence of smoking for both years. The independent variables were the percentages of social capital indicators, such as social participation, social cohesion, and reciprocity for each of the 69 municipal units. The mean prevalence of smoking increased from 9.7% in 2013 to 10.2% in 2019. Multiple regression analysis revealed that increases in the percentages of sports group participation, receiving emotional and instrumental social support, and reciprocity were significantly associated with decreased prevalence of smoking, after we adjusted for confounding variables. This study indicates that building social capital might be useful in promoting smoking cessation and that its indicators could be useful in monitoring efforts.

Perceived access to cannabis and ease of purchasing cannabis in retail stores in Canada immediately before and one year after legalization

ABSTRACT Background: Canada legalized non-medical cannabis in October 2018. Little research has examined the change in perceived access to cannabis after legalization in Canada, including the perceived ease of purchasing cannabis in a legal market. Objectives: To: 1) describe changes in perceived ease of access to cannabis before and one year after legalization; 2) examine associations between perceived ease of cannabis access and cannabis use; and 3) examine associations between perceived ease of purchasing from cannabis stores and cannabis use. Methods: Repeat cross-sectional data come from Canadian respondents aged 16–65 (50% male) in August-October 2018 (n = 10,057) and September-October 2019 (n = 15,256). Respondents were recruited through commercial online panels. Multivariable logistic regression models examined correlates of perceived proximity to retail stores, ease of access, and ease of purchasing from retail stores. Results: Canadians who do not consume cannabis were more likely to report “easy” access to cannabis in 2019 than in 2018 (55% vs. 42%; AOR = 1.80:1.66,1.96). All cannabis consumer groups were more likely to report living 15 minutes or less from a retail store in 2019 than 2018, but the association was strongest among non-consumers in 2019 vs 2018 (AOR = 2.01:183,2.21 vs. AOR = 1.33:1.03,1.73 for daily consumers). Non-daily and daily cannabis consumers were more likely to report it was easy to purchase from an illegal (AOR ranged 1.58–2.22) or legal (AOR ranged 1.31–1.39) store than non-consumers in 2019. Conclusion: Most cannabis consumers and non-consumers perceived access to cannabis as ‘easy’ before legalization and the percentage increased one year after legalization.

The impact of changes in COVID-19 lockdown restrictions on alcohol consumption and drinking occasion characteristics in Scotland and England in 2020: an interrupted time-series analysis.

Background and AimsEarly evidence suggests that COVID‐19 lockdown restrictions affect alcohol consumption. However, existing studies lack data on how drinking practices changed as restrictions disrupted people’s work, family life and socializing routines. We examined changes in consumption and drinking occasion characteristics during three periods of changing restrictions in Scotland/England.DesignInterrupted time‐series analysis of repeat cross‐sectional market research data (assessing step‐level changes).SettingScotland/England, January 2009–December 2020.ParticipantsScotland: 41 507 adult drinkers; England: 253 148 adult drinkers.MeasurementsThree intervention points: March 2020 lockdown, July 2020 easing of restrictions and October 2020 re‐introduction of some restrictions. Primary outcome: mean units consumed per week (total/off‐trade/on‐trade; 1 unit = 8 g ethanol). Secondary outcomes: drinking > 14 units per week, heavy drinking, drinking days per week, solitary drinking, drinking with family/partners, drinking with friends/colleagues, own‐home drinking, drinking in someone else’s home and drinking start times.FindingsIn Scotland, March 2020’s lockdown was associated with a 2.32 [95% confidence interval (CI) = 0.61, 4.02] increase in off‐trade (i.e. shop‐bought) units per week, a −2.84 (95% CI = −3.63, −2.06) decrease in on‐trade (i.e. licensed venues) units per week, but no statistically significant change in total units per week. July 2020’s easing of restrictions was associated with a 1.33 (95% CI = 0.05, 2.62) increase in on‐trade units per week, but no statistically significant total/off‐trade consumption changes. October 2020’s re‐introduction of some restrictions was not associated with statistically significant consumption changes. Results for England were broadly similar. Lockdown restrictions were also associated with later drinking start times, fewer occasions in someone else’s home and with friends/colleagues, more own‐home drinking and (in Scotland only) more solitary drinking.ConclusionsReductions in on‐trade alcohol consumption following COVID‐19 lockdown restrictions in Scotland/England in 2020 were mainly offset by increased own‐home drinking. This largely persisted in periods of greater/lesser restrictions. The shift towards off‐trade drinking involved significant changes in the characteristics of drinking occasions.

Food insecurity and substance use in people with HIV infection and substance use disorder

Background Food insecurity and substance use are common among people living with HIV (PLWH). Substance use may help people cope with hunger and thus be associated with food insecurity, but the association is uncertain. This study assessed whether, in PLWH and substance dependence, if there was an association between food insecurity and substance use. Methods: We studied adults with HIV and current substance dependence or ever injection drug use interviewed at 12 and 24 months after enrollment in a prospective cohort study. The presence of food insecurity (insufficient food quantity or quality, or anxiety about its availability) was assessed using the Household Food Insecurity Assessment Scale questionnaire (HFIAS). Unhealthy alcohol use was assessed with the Alcohol Use Disorder Identification Test – Consumption (AUDIT-C) and past 30-day other drug use with the Addiction Severity Index. Associations using repeat cross-sectional data from each of two time-points, 12 months apart, from the same participants were tested using generalized estimating equations logistic regressions. Results: The 233 participants had a mean age of 50 years and 65% were male. At the first interview, 44% reported food insecurity, 40% unhealthy alcohol use, 25% past 30-day cocaine use, and 17% past 30-day illicit opioid use. In analyses adjusted for demographics, social factors, physical and mental health function, and substance use related variables, there was no significant association between food insecurity and unhealthy alcohol use (adjusted odds ratio (aOR) = 1.06 (95% CI: 0.59, 1.87)). Those with food insecurity had higher odds of illicit opioid use (aOR = 2.5 (95% CI: 1.12, 5.58)) and cocaine use (aOR = 1.95 (CI 95%: 1.00, 3.81)). Conclusion: Food insecurity was not associated with unhealthy alcohol use but was associated with cocaine and illicit opioid use. Given the prevalence and impact substance use has on PLWH, food insecurity should be identified and addressed.