Addiction最新文献

{"title":"Heat exposure and drug overdose mortality in the USA.","authors":"Julia M Dennett, Daniel Carrión, David A Fiellin, Gregg S Gonsalves","doi":"10.1111/add.70191","DOIUrl":"https://doi.org/10.1111/add.70191","url":null,"abstract":"<p><strong>Background and aims: </strong>Understanding the relationship between heat and drug overdose mortality is critical given the ongoing overdose crisis and rising global temperatures driven by climate change. Evidence from local jurisdictions in the United States (US) and Canada indicates that exposure to heat is associated with increased drug overdose fatalities, but the widespread impact of heat on national drug overdose deaths is undetermined. We aimed to determine the effect of heat exposure on drug overdose mortality in the US.</p><p><strong>Design: </strong>An observational study using monthly, county-level data from 1999 to 2020 and a fixed effect model estimated with linear regression. The model accounts for time-invariant county-month factors and state-level time-specific shocks.</p><p><strong>Setting: </strong>All counties in the continental US during the months of June to September from 1999 to 2020.</p><p><strong>Participants: </strong>Decedents in the National Center for Health Statistics restricted Vital Statistics mortality data with a cause of death of a drug overdose, aggregated to county-level mortality rates.</p><p><strong>Measurements: </strong>All drug overdose mortality rate per 100 000 population. The monthly average maximum heat index (measured in degrees Celsius) was collected from the Centers for Disease Control and Prevention National Environmental Public Health Tracking Network.</p><p><strong>Findings: </strong>A one-degree Celsius increase in the heat index was associated with an increase in all drug overdose mortality by 0.0098 deaths per 100 000 population [95% confidence interval (CI) = 0.0057-0.014, P < 0.001], with significant effects for deaths related to opioids (0.0060 deaths, 95% CI = 0.0026-0.0095, P < 0.001), cocaine (0.0028 deaths, 95% CI = 0.0012-0.0045, P < 0.001) and psychostimulants (0.0028 deaths, 95% CI = 0.0015-0.0041, P < 0.001). In further analyses, larger impacts were observed after 2013, in counties with greater levels of social vulnerability and in suburban and urban counties. Estimates suggest that approximately 150 excess drug overdose deaths occurred per year during the hottest periods due to heat exposure.</p><p><strong>Conclusions: </strong>Exposure to heat appears to be associated with increases in drug overdose deaths in the United States in recent decades.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OK Boomer: A longitudinal analysis unravelling generational cohort differences in alcohol consumption among Australians.","authors":"Gianluca Di Censo, Kirrilly Thompson, Murthy Mittinty, Jacqueline Bowden","doi":"10.1111/add.70201","DOIUrl":"https://doi.org/10.1111/add.70201","url":null,"abstract":"<p><strong>Background and aims: </strong>Alcohol consumption is a key preventable cause of disease and injury worldwide. Recent evidence suggests that younger generations may be consuming less alcohol. However, it is still uncertain whether this trend is temporary or indicative of an enduring generational shift. This study sought to determine whether there are generational differences in alcohol consumption in Australia, while accounting for age and other sociodemographic factors.</p><p><strong>Design and setting: </strong>The analysis used data from the Household Income and Labour Dynamics in Australia (HILDA) Survey.</p><p><strong>Participants: </strong>The analysis included 23 368 participants (51.9% female) across 23 waves of data. Participants were classified into different generational cohorts according to Pew Research Centre definitions: Silent Generation (1928-1945), Baby Boomers (1946-1964), Generation X (1965-1980), Millennials (1981-1996) and Generation Z (1997-2012).</p><p><strong>Measurements: </strong>The study included three outcome measures: 1) abstention; 2) typical alcohol consumption per drinking occasion; and 3) typical weekly alcohol consumption.</p><p><strong>Findings: </strong>Although the likelihood of abstaining from alcohol consumption increased with age, Generation Z [odds ratio (OR) = 17.74, 95% confidence interval (CI) = 13.22-23.80, P < 0.001], Millennials (OR = 9.67, 95% CI = 7.98-11.71, P < 0.001) and Generation X (OR = 3.29, 95% CI = 2.75-3.92, P < 0.001) exhibited increased odds of abstention when compared with Baby Boomers, while the Silent Generation demonstrated decreased odds (OR = 0.33, 95% CI = 0.27-0.41, P < 0.001). Among drinkers, the quantity of per-occasion alcohol consumption reached its peak in early adulthood. Millennials (β = 0.52, 95% CI = 0.44-0.60, P < 0.001) and Generation X (β = 0.40, 95% CI = 0.32-0.47, P < 0.001) self-reported a significantly higher quantity of per-occasion alcohol consumption compared with Baby Boomers, while Generation Z did not significantly differ (β = 0.10, 95% CI = -0.02 to 0.23, P = 0.106) and the Silent Generation consumed significantly less (β = -0.21, 95% CI = -0.30 to -0.11, P < 0.001). Weekly quantity of alcohol consumption among drinkers peaked in early adulthood and midlife, with the Silent Generation [exp(β) = 1.16, 95% CI = 1.09-1.23, P < 0.001] exhibiting the highest levels of consumption, while Generation Z [exp(β) = 0.57, 95% CI = 0.53-0.62, P < 0.001] and Millennials [exp(β) = 0.77, 95% CI = [0.73-0.81, P < 0.001] demonstrated the lowest (compared to Baby Boomers).</p><p><strong>Conclusions: </strong>In Australia, there appear to be generational differences in alcohol consumption, including an increase in abstention and an overall reduction in alcohol consumption among Generation Z compared with previous generations.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cigarette smoking across life from 1946 to 2018: Harmonisation of four British birth cohort studies.","authors":"Liam Wright, Loren Kock, Harry Tattan-Birch, David Bann","doi":"10.1111/add.70204","DOIUrl":"https://doi.org/10.1111/add.70204","url":null,"abstract":"<p><strong>Background and aims: </strong>Tobacco smoking has declined dramatically in many high-income countries over the past seventy years. Studies that have mapped this trend have relied on repeat cross-sectional or retrospectively measured smoking data, which have limitations regarding accurate measurement, inclusion of early smokers, and capturing of within-person change over time. Here, we introduce a new resource detailing harmonisable smoking data in four British birth cohort studies spanning 1946-2018 and use these data to document age and cohort changes in smoking.</p><p><strong>Design: </strong>Longitudinal data from four nationally representative British Birth Cohort Studies, born 1946, 1958, 1970 and 2000/02, respectively.</p><p><strong>Setting: </strong>Great Britain.</p><p><strong>Participants: </strong>50 942 participants were eligible for inclusion in this study (5362 in the 1946c, 16 178 in the 1958c, 16 036 in the 1970c, and 13 366 in the 2001c). Data collection spanned the years 1946-2018.</p><p><strong>Measurements: </strong>Prevalence of daily smoking and cigarettes smoked per day were measured prospectively at various points across the life course via self-report.</p><p><strong>Findings: </strong>The prevalence of smoking and the average number of cigarettes smoked by daily smokers declined between each successive cohort. At age 42/43y, prevalence of daily smoking was 33.6% (95% confidence interval [CI] = 31.8%, 35.5%) in the 1946c, 27.3% (95% CI = 26.5%, 28.2%) in the 1958c, and 22.1% (95% CI = 21.3%, 22.8%) in the 1970c. Males smoked more and with greater intensity than females, on average, though sex differences were smaller in latter cohorts. Within a cohort, the prevalence and intensity of smoking peaked in early adulthood (< age 30y) and declined thereafter; participants who continued to smoke daily smoked fewer cigarettes as they grew older.</p><p><strong>Conclusions: </strong>In Great Britain, smoking prevalence and cigarette consumption appear to have declined substantially between cohorts born across the latter half of the twentieth and early twenty-first centuries. The British Birth Cohorts represent a unique and largely underutilized resource for investigating trends in smoking across life (prenatal to old age) and by year of birth (1946-2001), including changes in the determinants, correlates, and consequences of smoking. We provide syntax and information on items on smoking in these cohorts to catalyse future research, also available at: https://cls-data.github.io/smoking-in-the-cohorts/.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deaths of despair: A reply to Darke et al.","authors":"James P Higham","doi":"10.1111/add.70203","DOIUrl":"https://doi.org/10.1111/add.70203","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-processed food addiction in a nationally representative sample of older adults in the USA.","authors":"Lucy K Loch, Matthias Kirch, Dianne C Singer, Erica Solway, J Scott Roberts, Jeffrey T Kullgren, Ashley N Gearhardt","doi":"10.1111/add.70186","DOIUrl":"https://doi.org/10.1111/add.70186","url":null,"abstract":"<p><strong>Aims: </strong>Ultra-processed foods (UPFs; industrially produced foods typically containing unnaturally elevated levels of refined carbohydrates and/or added fats) became more widely introduced into the United States (US) food environment in the 1980s and have proliferated since. UPFs have been shown to trigger an addictive-like response. This study examines the prevalence of ultra-processed food addiction (UPFA) in older US adults and its association with various health domains.</p><p><strong>Design: </strong>In July 2022, a cross-sectional online and telephone survey was conducted using the University of Michigan National Poll on Healthy Aging (NPHA). Gender-stratified analyses examined the association between UPFA and perceptions of physical and mental health, and social isolation. Prevalence ratios were calculated, unadjusted and adjusted for age, race/ethnicity, education, and income.</p><p><strong>Setting: </strong>Nationally representative sample of older adults (aged 50-80 years) in the United States.</p><p><strong>Participants: </strong>The sample included 2038 older adults (49.4% aged 50-64 years and 50.6% aged 65-80 years, 51.2% women, M age = 63.6, standard deviation = 8.1).</p><p><strong>Measurements: </strong>The modified Yale Food Addiction Scale 2.0 (validated measure that applies the diagnostic criteria for substance use disorder to the overconsumption of UPFs) was used to assess diagnostic criteria for UPFA. Various self-reported items were used to assess health-related domains (i.e., physical and mental health, social isolation).</p><p><strong>Findings: </strong>The overall prevalence of UPFA was 12.4%, higher among women (16.9%) than men (7.5%), with the highest rate in women aged 50-64 (21%). Men reporting being overweight were 19.14 (95% confidence interval [CI] [5.26-69.66]) times more likely to meet the criteria for UPFA. Women reporting being overweight were 11.44 (95% CI [4.56-28.71]) times more likely to meet UFPA criteria. Women and men reporting worse physical health were 1.93 (95% CI [1.26-2.98]) times and 2.99 (95% CI [1.70-5.26]) times more likely to meet the criteria for UPFA, respectively. Similarly, women reporting worse mental health were 2.78 (95% CI [1.79-4.32]) times more likely to meet the criteria for UPFA, with men 4.02 (95% CI [2.19-7.38]) times more likely. Lastly, women and men reporting feelings of social isolation were 3.40 (95% CI [2.16-5.34]) times and 3.35 (95% CI [1.83-6.14]) times more likely to meet UFPA criteria.</p><p><strong>Conclusion: </strong>Ultra-processed food addiction appears to be prevalent among older adults in the United States, particularly among women who were in adolescence and early adulthood when the nutrient quality of the US food supply worsened. Addictive patterns of UPF intake appear to be associated with poorer physical health, mental health, and social well-being.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of rapid onset heroin overdose cases from a supervised injecting facility in Melbourne, Australia.","authors":"Nathan C Stam, Monika Shrestha, Basak Tas, John Furler, Yvonne Bonomo, John Strang","doi":"10.1111/add.70199","DOIUrl":"https://doi.org/10.1111/add.70199","url":null,"abstract":"<p><strong>Aims: </strong>To characterise the clinical condition of rapid onset heroin overdose cases, and to determine the incidence and characteristics of such cases.</p><p><strong>Design: </strong>A retrospective cohort study of witnessed heroin overdose cases over a 12-month period (1 July 2023 to 30 June 2024).</p><p><strong>Setting: </strong>The Medically Supervised Injecting Room in Melbourne, Australia.</p><p><strong>Cases: </strong>Individuals who experienced a rapid onset overdose. A control group of standard onset cases amongst those same individuals was used for comparison.</p><p><strong>Measurements: </strong>The severity of acute opioid toxicity for rapid versus standard onset heroin overdose cases, using a clinical severity scale regularly used at the Medically Supervised Injecting Room.</p><p><strong>Findings: </strong>From a total of 1727 heroin overdoses, 202 were identified as rapid onset cases that occurred amongst a cohort of 98 individuals. There were 997 standard overdoses from 75 individuals from this same cohort used as a control. Rapid onset overdoses presented with greater severity of respiratory depression. Forty-one percent (n = 82) of cases required positive pressure ventilation, including 19% (n = 38) classified as Grade 2 severity and 22% (n = 44) classified as Grade 3a severity. The standardised rate of rapid overdoses was approximately doubled on High overdose risk days (0.151/overdose) compared with that on Low overdose risk days (0.077/overdose).</p><p><strong>Conclusion: </strong>Rapid onset heroin overdoses typically present as medical emergencies involving severe respiratory depression shortly after heroin administration. Some people appear more likely to experience a rapid onset overdose than others, but factors for this are unclear. Rapid onset heroin overdoses also more commonly occur on some days compared with others, which may indicate an interrelationship between personal risk and the unregulated drug market. Rapid onset overdose cases may play a substantial role in hypoxic-related morbidity and mortality associated with heroin overdoses.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Red Box, Green Box: Psychometric evaluation of a self-report behavioral frequency measurement approach for behavioral addictions research.","authors":"Matthew W R Stevens, Marcela Radünz, Christina Galanis, Blake Quinney, Ian Zajac, Joël Billieux, Paul H Delfabbro, Daniel L King","doi":"10.1111/add.70192","DOIUrl":"https://doi.org/10.1111/add.70192","url":null,"abstract":"<p><strong>Aims: </strong>The behavioral addictions field lacks clinically useful behavior frequency measures. This study evaluated the psychometric performance of the new 'Red Box, Green Box' method for measuring gaming behavior with a focus on its utility for gaming disorder (GD) screening.</p><p><strong>Design, setting and participants: </strong>A prospective, cross-sectional survey study was conducted using an online crowdsourcing platform. Participants were 1149 male gamers aged 18-35 years from Australia, Canada, United States, United Kingdom and Asia, reporting ≥12 hours of weekly gaming.</p><p><strong>Measurements: </strong>Gaming time was measured using a conventional weekly hours item, Red Box hours (gaming instead of fulfilling responsibilities) and Green Box hours (gaming during free or leisure time). GD was assessed by the Internet Gaming Disorder Test (IGDT-10), with International Classification of Diseases, 11th Revision (ICD-11) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) scoring approaches. Psychological distress [Depression, Anxiety and Stress Scale - 21 Items (DASS-21)] and impulsivity [Barratt Impulsiveness Scale-short form (BIS-15)] were measured.</p><p><strong>Findings: </strong>Gamers with GD reported higher Red Box hours [mean (M) = 21.1, standard deviation (SD) = 11.3] than those without (M = 8.7, SD = 8.4; P < 0.001), and greater Red Box proportion (41.9% vs. 26.8%; P < 0.001). Red Box hours demonstrated superior diagnostic accuracy for GD [area under the curve (AUC) = 0.86, sensitivity = 0.94, specificity = 0.63] and Internet gaming disorder (IGD) (AUC = 0.76, sensitivity = 0.88, specificity = 0.56), outperforming comparative measures. A Red Box response of ≥ 9.5 hours had a 94% likelihood of indicating ICD-11 GD.</p><p><strong>Conclusions: </strong>The 'Red Box, Green Box' method appears to effectively identify International Classification of Diseases, 11th Revision, gaming disorder risk among males. Red Box hours demonstrated greater classification validity than the conventional weekly hours approach. This method provides a simple tool for epidemiological research, routine screening (e.g. outpatient consultation) and clinical assessment and treatment planning. Further validation in clinical populations and longitudinal studies is needed.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric evaluation of a trans-addiction craving questionnaire: The Craving Assessment Scale for Behavioral Addictions and Substance-use Disorders (CASBAS).","authors":"Stephanie Antons, Annika Brandtner, Andreas Oelker, Patrick Trotzke, Elisa Wegmann, Matthias Brand, Silke M Müller","doi":"10.1111/add.70197","DOIUrl":"https://doi.org/10.1111/add.70197","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Craving is a central construct across different kinds of addictive disorders, but craving assessments are highly heterogeneous. Our aim was to develop a valid, standardized and short scale for assessing subjective feelings of acute craving for different substances and addictive behaviors using the same set of items. We aimed to test the resulting scale, the Craving Assessment Scale for Behavioral Addictions and Substance-use Disorders (CASBAS) for factor structure (proposing three factors: reward craving, relief craving, urgency) and validity (study 1) and sensitivity to changes in state craving perception (study 2).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;We conducted two independent studies. Study 1 followed a correlative design to test for internal consistency, convergent and divergent validity. Study 2 used an experimental within-subjects design with two conditions including a craving induction and three repeated craving measures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Study 1 was conducted online. Study 2 took place in a German laboratory in individual sessions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Participants were assigned to a survey (study 1) or condition (study 2) for one specific (potentially) addictive behavior (i.e. gaming, gambling, buying-shopping, pornography use, social network use, alcohol use, cannabis use and nicotine use) of those behaviors that they indicated that they felt they had used 'too much' in the past twelve months. Study 1: n = 1659 (58.5% female). Study 2: n = 287 (56.8% female). Samples were similarly distributed across the different behaviors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;We used the CASBAS specified for the respective behavior plus convergent and divergent measures (study 1). In study 2, participants underwent an imagery-based neutral (i.e. brushing teeth) and behavior-specific (e.g. gaming/alcohol use) desire thinking task with CASBAS assessments before and after each task.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;In study 1, the assumed three-factorial structure of the CASBAS was confirmed: the second-order model with a general craving factor fitted best, overall and per behavior (comparative fit indices and Tucker-Lewis indices &gt; 0.95; standardized root mean square residuals &lt; 0.04). The CASBAS proved to be valid by correlating highly with other craving measures (rs &gt; 0.58) and lowly with divergent measures (rs &lt; 0.10). Study 2 revealed significant differences in CASBAS ratings between measurements (i.e. craving decrease after neutral 'teeth brushing' condition and increase after addictive-behavior-specific condition), which indicates the CASBAS' sensitivity towards state changes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A newly developed short scale for measuring subjective feelings of acute craving [the Craving Assessment Scale for Behavioral Addictions and Substance-use Disorders (CASBAS)] appears to be a reliable and valid instrument, able to detect increases in craving when people ar","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nicotine pouches and clinical outcomes related to smoking cessation: A systematic review of randomized trials.","authors":"Javad Heshmati, Spencer Shahen, Emma Lynn Bates, Sarah Visintini, Evyanne Quirouette, Kerri-Anne Mullen, Hassan Mir","doi":"10.1111/add.70193","DOIUrl":"https://doi.org/10.1111/add.70193","url":null,"abstract":"<p><strong>Background and aims: </strong>Tobacco-free nicotine pouches (NPs) are oral nicotine products promoted by manufacturers and some researchers as tools that may reduce nicotine cravings and support smoking reduction or cessation. However, evidence regarding their actual clinical impact remains limited. This review aimed to evaluate the potential clinical effects of NPs in the context of smoking cessation, specifically focusing on user satisfaction, smoking urges and cigarette reduction compared with other nicotine and tobacco products.</p><p><strong>Design: </strong>Systematic review of randomized trials conducted in adult smokers or nicotine users, reported according to PRISMA 2020 guidelines and registered in PROSPERO.</p><p><strong>Setting: </strong>Studies conducted in high-income countries across Europe and North America were included, with data collected up to March 2024.</p><p><strong>Participants/cases: </strong>Seven trials involving a total of 269 adult participants (≥18 years), including current smokers and users of other nicotine products. The review focused on tobacco-free NPs containing varying nicotine strengths and flavors. NPs were compared individually to multiple specific comparators across trials, including cigarettes, snus, nicotine gum and placebo, rather than being combined into a single comparator group.</p><p><strong>Measurements: </strong>The primary outcomes were user satisfaction, urges to smoke and changes in cigarette consumption, considered the most important outcomes for assessing the potential of NPs in smoking cessation.</p><p><strong>Findings: </strong>NPs were rated more favorably for satisfaction and product liking than gum or placebo, but consistently less than cigarettes (e.g. intent to reuse 14-46% for NPs vs. 57% for cigarettes). In one pilot randomized controlled trial, daily cigarette use decreased from 15.0 to 8.3 cigarettes/day over 8 weeks with 4 mg NPs (P = 0.01), with dependence scores also reduced (3.1 to 2.4, P = 0.02). Across studies (n = 7, sample sizes 24-63), none demonstrated a statistically significant increase in smoking cessation compared with control, snus or gum. Adverse events were mostly mild (e.g. cough, throat irritation, headache) and more frequent at higher NP doses, but no serious adverse events were reported. Meta-analysis was not performed due to heterogeneity in study designs and outcomes.</p><p><strong>Conclusions: </strong>Tobacco-free nicotine pouches appear to be well tolerated and may reduce cigarette consumption compared with control, with effects similar to those seen with snus or nicotine gum. However, there is currently no statistically significant evidence that NPs increase rates of smoking cessation compared with other products or control.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professionalism, professional identity and community pharmacy culture: The context of substance dependency through the lens of student and early career pharmacists.","authors":"Natalie Weir, Emma Dunlop, Adrian MacKenzie, Thomas Byrne, Katie Johnston, Alice O'Hagan, Zohaib Rehman, Holly Richardson, Aalia Shah, Gemma Wilson, Andrew Radley","doi":"10.1111/add.70180","DOIUrl":"https://doi.org/10.1111/add.70180","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to explore the reflections of student and newly qualified pharmacists (NQPs) surrounding community pharmacy culture around substance dependency. This study explored professionalism and professional identity formation, and the possibility that a fragmented professional identity may impact behaviours and the provision of compassionate care.</p><p><strong>Design: </strong>Qualitative study: semi-structured interviews were conducted with student and exploring stigma within community pharmacy environments in relation to people with substance dependency, the community pharmacy culture and their own ideas of professionalism and their professional identity formation. Interviews were undertaken by six pharmacy student researchers, under the supervision of two experienced researchers.</p><p><strong>Setting: </strong>Community pharmacies across Scotland.</p><p><strong>Participants: </strong>Twenty-eight participants were recruited, including undergraduates based at Scottish Schools of Pharmacy (n = 20); Foundation Year Pharmacy students (n = 2) and NQPs (n = 6). Recruitment utilised university networks and social media platforms.</p><p><strong>Measurements: </strong>Interviews were conducted between September and November 2023 on Microsoft Teams®, each lasting 17-60 minutes. Data underwent inductive thematic analysis via NVivo® through data familiarisation, initial coding, theme searching, reviewing and defining and reporting.</p><p><strong>Findings: </strong>Stigmatisation of people with substance dependency attending a pharmacy was a prominent observation. This included negative stereotyping, adverse treatment because of judgements made about substance use and structural stigma relating to barriers to accessing care. Positive care provision in pharmacies was evident. Pharmacy staff who were empathetic, respectful, professional and who formed long-term relationships with people with substance dependency were valuable role models for students and influenced their professional identify formation. Students appreciated the exposure to practice and the opportunity to make judgements that would mould the type of pharmacist they aspired to become. A number of participants reported that their university course poorly prepared them for the reality of supporting people with substance dependency.</p><p><strong>Conclusions: </strong>Pharmacy practice in Scotland appears to be characterised by stigma and lack of professionalism towards people with substance dependency, although there are examples of compassionate care. Observing staff in practice allowed participants of this study to develop their own professional identity and attitudes, yet there is a need to better prepare students in undergraduate curricula.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}