Addiction最新文献

{"title":"Impact of mental health disorders on problematic substance use and effectiveness of brief intervention among young people in foster care.","authors":"Courtney B Dunn, Austin Blake, Katie Fox, Mary V Greiner, Sarah J Beal","doi":"10.1111/add.70546","DOIUrl":"10.1111/add.70546","url":null,"abstract":"<p><strong>Background and aims: </strong>Brief interventions delivered in healthcare settings represent a promising substance use prevention and early intervention strategy for youth in foster care, among whom early life adversity and resulting psychological sequalae increase risk for problematic substance use. Limited research has examined the effectiveness of brief interventions in this subpopulation. This study aimed to examine whether psychological diagnoses were associated with screening positive for problematic substance use, and whether psychological diagnoses impacted effectiveness of a brief intervention for substance use.</p><p><strong>Design: </strong>Longitudinal observational study of adolescents (ages 10-20 years) seen for mandated health examinations in a foster care clinic. Youth who endorsed substance use and received a brief intervention were invited to complete baseline surveys and follow-ups at 30 days, 60 days and 6 months. Logistic regressions evaluated associations of mental health disorders with endorsing problematic substance use. Generalized linear mixed models examined associations of mental health disorders with trajectories of post-intervention change in substance use.</p><p><strong>Setting: </strong>Midwest, United States.</p><p><strong>Participants: </strong>Adolescents seen for mandated health examinations in a foster care clinic who completed a substance use screening measure [CRAFFT2.1 + N; n = 1656; mean age (SD) = 14.4 (2.6); 53.4% female; 58.4% Black, 31.6% white]. A second subsample included only those adolescents who received a brief intervention for substance use during their clinic visit [n = 287; mean age (SD) = 15.9 (2.1); 59.9% female; 53.7% Black, 35.5% white].</p><p><strong>Measurements: </strong>Mental health diagnoses and CRAFFT2.1 + N were extracted from the electronic health record. Youth-reported count of past 30-day use of alcohol, cannabis and nicotine/tobacco at each wave.</p><p><strong>Findings: </strong>A minority (12%) of youth in foster care endorsed problematic substance use. Youth with a mental health diagnosis had 58% to 161% higher odds of reporting problematic substance use [odds ratios (ORs) = 1.58-2.61; 95% confidence intervals (CIs) = (1.16-2.13) - (1.93-3.56)]. Following the intervention, youth who had been diagnosed with internalizing disorders (i.e. anxiety, depressive and trauma disorders), and those with co-occurring internalizing and externalizing disorders, reported smaller decreases or no decreases in their cannabis [ORs = 2.09, 7.03; 95% CIs = (1.17-3.71), (3.43-14.42)] and nicotine use [ORs = 1.95-7.68; 95% CIs = (1.08-3.53) - (4.12-14.32)]. Alcohol use did not vary as a function of mental health diagnoses [ORs = 0.31-13.10; 95% CIs = (0.00-19.37) - (0.19-915.80).</p><p><strong>Conclusion: </strong>Foster youth in the United States, particularly those with mental health concerns, appear to be at high risk for problematic substance use.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"3106-3120"},"PeriodicalIF":5.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617519","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":"Longitudinal association of switching to dual cigarette and e-cigarette use vs. continued exclusive cigarette smoking with tobacco-specific nitrosamine and nicotine intake.","authors":"Rui Chen, Elizabeth A Stuart, Miranda R Jones, Yuan Shao, Meghan F Davis, Ana M Rule","doi":"10.1111/add.70527","DOIUrl":"10.1111/add.70527","url":null,"abstract":"<p><strong>Background and aims: </strong>Dual use of cigarettes and e-cigarettes is often employed by smokers as a harm reduction strategy. This study evaluated the harm reduction potential of e-cigarettes by investigating changes in urinary biomarker of exposure (BOE) to tobacco-specific nitrosamines (TSNAs) and nicotine among smokers transitioning to dual use.</p><p><strong>Methods: </strong>Data from 8688 adult smokers in waves 1 to 5 of the Population Assessment of Tobacco and Health Study (United States) were analyzed. 'Transitioned dual users' were defined as those changing from exclusive cigarette smoking to dual use across two consecutive waves. BOE levels were assessed before and after this transition and compared with those who continued smoking cigarettes exclusively ('remained smokers') across the same time frame. Propensity score weighting was used to adjust for baseline confounders. Further analyses were stratified by baseline cigarette consumption, dichotomized at the cohort median into heavy and light smoking groups.</p><p><strong>Results: </strong>Observational analysis revealed that transitioned dual users experienced a statistically significant reduction in TSNAs without a statistically significant change in nicotine. The regression analysis comparing transitioned dual users with 'remained smokers' showed that transitioning to dual use was statistically significantly associated with a 13% decrease in 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) [95% confidence interval (CI) = -20% to -6%] and a 10% decrease in N'-nitrosonornicotine (NNNT) (95% CI = -15% to -4%). In contrast, dual use was statistically significantly associated with a 17% increase in total nicotine equivalents-2 (95% CI = 12%-23%) and 8% increase in total nicotine equivalents-6 (95% CI = 5%-12%). Stratified analysis further showed that the association between dual use and TSNAs reduction was attenuated among the baseline heavy smoking group (>13 cigarettes/day), with one-fourth of the effect estimates and no statistical significance.</p><p><strong>Conclusions: </strong>Smokers transitioning to dual use alongside e-cigarettes appear to show reductions in tobacco-specific nitrosamines exposure, particularly among lighter smokers, but do not appear to show reductions in nicotine exposure.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"3075-3083"},"PeriodicalIF":5.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374026","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":"A stable floor beneath the overdose decline?","authors":"Wayne Kepner","doi":"10.1111/add.70552","DOIUrl":"10.1111/add.70552","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"3140-3141"},"PeriodicalIF":5.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148467933","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":"From emergence to replacement: The evolution of 3-methylmethcathinone (3-MMC) and its substitutes in the Dutch drug market (2012-2024).","authors":"Nadia Robert Petronella Wilhelmina Hutten, Pieter Edmond Oomen, Frederiek Schutten, Margriet Walburga van Laar, Laura Alexandra Smit-Rigter","doi":"10.1111/add.70538","DOIUrl":"10.1111/add.70538","url":null,"abstract":"<p><strong>Background and aims: </strong>The market for new psychoactive substances (NPS) is highly dynamic, with hundreds of substances emerging on the European drug market in the last decade. 3-methylmethcathinone (3-MMC), a synthetic cathinone and isomer of mephedrone (4-MMC), gained popularity in the Netherlands due to its psychostimulant effects and initial legal status. The present study aimed to systematically examine developments in the Dutch 3-MMC market between 2012 and 2024, based on the Drugs Information and Monitoring System (DIMS) data, to describe trends in pricing, sources of purchase, chemical composition, user-reported effects and demographic and contextual use patterns.</p><p><strong>Design and setting: </strong>Observational study using drug checking data collected from 2012 to 2024 through DIMS, a national network of 33 drug checking services operating throughout the Netherlands.</p><p><strong>Cases: </strong>In total, 3437 samples sold as 3-MMC were submitted to DIMS for analysis and were included in the study. Of these, 2627 samples were chemically analysed.</p><p><strong>Measurements: </strong>Number of samples sold as 3-MMC submitted for drug checking, price, source of purchase, drug composition, self-reported effects in relation to drug composition, and setting of use.</p><p><strong>Findings: </strong>The number of samples sold as 3-MMC submitted to DIMS each year increased from n = 1 in 2012 to n = 1853 in 2024. Following the scheduling of 3-MMC in 2021, median prices doubled (from €10 during the period 2019-2021 to €20 in 2022) and the reported source of purchase shifted towards dealer (from approximately 50% of samples before scheduling to more than 90% after scheduling). Chemical composition of the analysed samples changed significantly (Cramér's V = 0.49, P < 0.01). Since 2022, samples sold as 3-MMC increasingly contained a variety of substances. By 2024, only 10% of samples still contained 3-MMC, compared with 85% in 2021, whereas substitutes such as 2-methylmethcathinone (2-MMC) and 3-chloromethcathinone (3-CMC), as well as more potent compounds including di(methyl)pentylone (DMP) and N-ethylnorpentedrone (NEP) became more prevalent. Self-reported effects (noted for 376 samples) were qualitatively similar for samples containing 2-MMC and 3-CMC compared with 3-MMC, whereas DMP and NEP were associated with more severe adverse reactions (e.g. anxiety, paranoia, cardiovascular disturbances, insomnia). Patterns of use shifted towards festivals and parties (around 50% and 25%, respectively), while home use (15%) remained notable in 2024.</p><p><strong>Conclusions: </strong>The Dutch 3-methylmethcathinone (3-MMC) market changed substantially following scheduling in 2021, with more samples sold as 3-MMC submitted for drug checking. By 2024, only 10% of submitted samples contained 3-MMC and structurally related substitutes with greater health risks were increasingly detected.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"3065-3074"},"PeriodicalIF":5.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443467","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":"Weighted prevalence of biochemically verified substance use in healthy adolescents across the USA.","authors":"Natasha E Wade, Yajuan Si, Susan F Tapert, Janosch Linkersdörfer, Krista M Lisdahl, Hailley R Moore, Laila Tally, Biplabendu Das, Marilyn A Huestis, Alexander L Wallace, Ryan M Sullivan, Veronica Szpak, Le Zhang, Laura Ziemer, Wesley K Thompson","doi":"10.1111/add.70548","DOIUrl":"10.1111/add.70548","url":null,"abstract":"<p><strong>Background and aims: </strong>Adolescent substance use is a significant public health concern, though the scope of the problem is difficult to ascertain given reliance on self-reported substance use information. Recent, large cohort studies in adolescents and young adults suggest underreporting of substance use. Analyses here aimed to determine concordance between self-reported substance use and biochemical verification through hair samples and to estimate prevalence of the three most reported substances used by adolescents.</p><p><strong>Design: </strong>Observational cohort longitudinal study design. Liquid chromatography and gas chromatography tandem mass spectrometry (LC or GC/MS-MS) were used to test hair samples for biochemically verified substance use, with results compared with self-reported substance use. Multi-step weighting methods estimated prevalence trends of cannabis, alcohol and nicotine use over time, adjusting for discrepancies in sample representation due to recruitment demography, missed visits and hair sample testing.</p><p><strong>Setting and participants: </strong>Data came from the United States nationwide Adolescent Brain Cognitive Development Study (n = 11 868; age 9-10 at baseline, age 15-16 at wave 6). Participants were followed annually, with data here from 2016 to 2024.</p><p><strong>Measurements: </strong>Hair samples objectively detected at least several days of substance use in a subsample of participants (n_samples = 11 865; n = 6133 unique participants). Participants self-reported past 3-month substance use. Sociodemographic, individual and environmental-level factors were included in inverse propensity weights to estimate prevalence rates of cannabis, alcohol and nicotine use in teens.</p><p><strong>Findings: </strong>Concordance between self-report and toxicological data improved with age (for cannabis, ages 11-12 = <1%; ages 15-16 = 45%). Weighted estimates of biochemically verified substance use indicated 7.1% [95% confidence interval (CI) = 6.0-8.3] of 15-16 year olds engaged in biochemically detected cannabis use, 0.2% (95% CI = 0.1-0.4) used alcohol and 4.7% (95% CI = 3.7-6.0) used nicotine.</p><p><strong>Conclusions: </strong>In United States youth, the concordance between self-reported substance use patterns and biochemical verification improves with age. Biochemical verification reflects substantive cannabis and nicotine use by United States youth aged 15-16, supporting combining toxicological and self-report data to improve identification of substance use in youth when possible.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"3129-3139"},"PeriodicalIF":5.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148467895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The silent consequence of overdose: The case for brain injury-informed opioid treatment.","authors":"Nathaniel Day, Kym Kaufmann, Mauricio Garcia-Barrera, Jitender Sareen, Daniel Vigo","doi":"10.1111/add.70577","DOIUrl":"10.1111/add.70577","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"3142-3144"},"PeriodicalIF":5.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811457","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":"Promoting smoking cessation and preventing relapse to tobacco use following a smokefree mental health in-patient stay: A multi-centre randomised controlled feasibility study.","authors":"Petal Petersen Williams, Lisa Huddlestone, Emily Shoesmith, Jennifer Sweetman, Heidi Stevens, Alex Mitchell, Fraser Wiggins, Lesley Sinclair, Victoria Exley, Catherine Hewitt, Judith Watson, Qi Wu, Jodi Pervin, Moira Leahy, Claire Paul, Lion Shahab, Michelle Horspool, Tim Coleman, Simon Hough, Elena Ratschen","doi":"10.1111/add.70519","DOIUrl":"10.1111/add.70519","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;This study assessed the feasibility and acceptability of a new theory- and evidence-based intervention designed to prevent return to pre-admission smoking behaviours after discharge from a smokefree mental health in-patient setting in the United Kingdom (UK).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A multi-centre individually randomised controlled feasibility trial with follow-up at 3 and 4-6 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Acute adult mental health wards of six National Health Service Mental Health Trusts in England.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Thirty-eight (17 intervention, 21 usual care) adults who smoked on or after admission to an acute adult mental health in-patient ward and wished to continue reducing or quitting smoking after discharge, enrolled between February and November 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;The intervention comprised usual care and a 12-week, theory- and evidence-informed support programme including a bespoke resource kit, personalised behavioural support including phone calls and text messages, and access to a digital smoking cessation app with 24/7 live support. It was delivered by trained mental health workers. The comparator group received usual care as per UK national guidance, typically involving brief behavioural support, offers of nicotine replacement therapy and sometimes electronic cigarettes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurement: &lt;/strong&gt;Primary outcomes included recruitment and retention, intervention acceptability and feasibility of collecting smoking, mental health and economic data. Success criteria for progression to trial were set a priori at a minimum of 60% of the n = 64 target for both recruitment and retention, i.e. at n = 38. Secondary outcomes included measures of smoking, quitting, reduction of cigarette consumption. Acceptability data were collected through exploratory interviews with participants, mental health staff and interventionists.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;We recruited n = 38 (60%) participants and retained n = 20 (52.6%) at 3 months, and n = 13 (34.2%) at second follow-up. As such, criteria agreed to determine progression to full trial were marginally met for recruitment and not met for retention. Two intervention participants reported maintaining abstinence. Motivation to quit remained higher in the intervention than the usual care group over time, and use of e-cigarettes was overall common (76.9% n = 10 across groups at 4-6 month follow up). Intervention group participants reported valuing the tailored and personalised behavioural support options but engaged little with tailored digital tools. Health economic data collection was feasible, though refinement is needed for future research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A new intervention delivering smoking cessation support to individuals discharged from smoke-free mental health settings was discontinued because key feasibility criteria were not met, highlighting the need for focused reconsid","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"3084-3105"},"PeriodicalIF":5.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663034","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":"The association between job loss and alcohol and tobacco use.","authors":"Don Weatherburn, Sergey Alexeev","doi":"10.1111/add.70547","DOIUrl":"10.1111/add.70547","url":null,"abstract":"<p><strong>Aims: </strong>This study used Australian longitudinal data to examine the effect of being fired or made redundant on alcohol and tobacco use.</p><p><strong>Design and setting: </strong>Fixed effect panel analyses of 19 waves of the Household Income and Labour Dynamics in Australia (HILDA) survey, a voluntary representative longitudinal survey of over 17 000 Australians.</p><p><strong>Participants: </strong>143 517 survey responses from 15 934 individuals, with the effective sample varying by analysis.</p><p><strong>Measurements: </strong>Outcome variables were drinking status (drinker/non-drinker), drinking frequency (days per week/month), drinking amount (number of standard drinks), smoking status (smoker/non-smoker), tobacco consumption (packets per week). Covariates included age, sex, Indigenous status, marital status, country of birth (Australia vs. other country), remoteness of residence, year 12 completion, mental health [measured using the mental health component of the 36-Item Short Form Health Survey (SF36)], poor health, low socio-economic status, whether separated/divorced in the last 12 months, whether experienced a sudden loss of income in the last 12 months and survey year.</p><p><strong>Findings: </strong>After adjusting for the effects of other factors, there is no statistically significant association between being fired and the risk that a non-drinker will initiate or return to drinking alcohol [odds ratio (OR) = 0.889, 95% confidence interval (CI) = 0.894-1.093]. Nor is there a statistically significant association between being fired and the frequency with which a drinker drinks [incidence rate ratio (IRR) = 1.008, 95% CI = 0.999-1.016)]. There is an association between being fired and the amount of alcohol consumed (IRR = 1.030, 95% CI = 1.018-1.093), but the association is weak. Being fired is associated with an increase in the likelihood of initiating or returning to tobacco use (OR = 1.276, 95% CI = 1.153-1.412) and with the quantity of tobacco smoked (IRR = 1.024, 95% CI = 1.003-1.046). In the latter case, however, the effect is small.</p><p><strong>Conclusion: </strong>There appears to be limited evidence that being fired or made redundant in the past year increases alcohol and/or tobacco consumption among Australians.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"3121-3128"},"PeriodicalIF":5.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434400","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":"Flavored e-cigarette use and its association with subsequent short-term e-cigarette abstinence among youth, young adults and adults: Findings from the United States longitudinal population assessment of tobacco use and health, 2016 to 2023.","authors":"Joanna M Streck, Andrew S Hyatt, Randi M Schuster, Jodi Gilman, Sharon Levy, Jonathan P Winickoff, A Eden Evins","doi":"10.1111/add.70674","DOIUrl":"https://doi.org/10.1111/add.70674","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;This study examined e-cigarette flavor use and its prospective association with short-term e-cigarette abstinence among youth (12-17 years old), young adults (18-24 years old) and adults (25+ years old) using United States (US)-representative data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Observational study using longitudinal data obtained from the Population Assessment of Tobacco and Health (PATH) study, waves 4-7 (2016-2023). A lagged design assessed three wave-pairings per participant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Household computer-assisted self-interviews of US youth and adults from 2016 to 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;A total of n = 8418 non-institutionalized youth and adults in the US.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;The primary exposure was past 30-day e-cigarette flavor use at the previous wave using the following mutually exclusive flavor groupings: exclusive tobacco flavor or flavorless e-cigarette use, exclusive menthol/mint flavor, exclusive sweet flavors (e.g. candy, fruit, chocolate, clove/spice) or use of multiple e-cigarette flavors (defined as individuals vaping multiple flavor combinations from: tobacco/flavorless, menthol/mint and sweet flavors); the primary outcome was past 30-day e-cigarette abstinence at the subsequent wave (yes/no). Generalized estimating equation (GEE) models examined prospective association between e-cigarette flavor type and covariates [e.g. demographics, e-cigarette dependence (time to first e-cigarette: ≤ 30 minutes of waking vs. &gt; 30 minutes), dual cigarette and e-cigarette use (yes/no)], on e-cigarette abstinence (primary outcome). We ran an overall GEE model adjusting for age group and three individual GEE models stratified by age group. All estimates were weighted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Exclusive sweet flavors were the most common e-cigarette flavor used among youth (46%), young adults (44%) and adults (41%). In the adjusted model, young adults [adjusted odds ratio (AOR) = 3.63, 95% confidence interval (CI) = 3.0-4.3, P &lt; 0.001] and adults (AOR = 4.58, 95% CI = 3.8-5.6, P &lt; 0.001) who vaped in the past 30 days had higher odds of subsequent e-cigarette abstinence compared with youth who vaped in the past 30 days. Across ages, among past 30-day vapers, exclusive tobacco/flavorless e-cigarette use was prospectively associated with increased e-cigarette abstinence (AOR = 2.2, 95% CI = 1.9-2.5, P &lt; 0.001), multiple-flavor-use was associated with decreased e-cigarette abstinence (AOR = 0.61, 95% CI = 0.53-0.71, P &lt; 0.001), compared with exclusive menthol or sweet-flavored e-cigarette use. Dual e-cigarette and cigarette use was prospectively associated with reduced e-cigarette abstinence in young adults (AOR = 0.60, 95% CI = 0.50-0.80, P &lt; 0.001), yet increased e-cigarette abstinence in adults (AOR = 1.4, 95% CI = 1.1-1.6, P &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary: &lt;/strong&gt;Among adults and youth in the United States, exclusive vaping of sweet, menthol or multiple","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149222853","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":"Expanding the boundaries of harm reduction: Why anabolic-androgenic steroid users require a paradigm shift","authors":"Willem de Ronde,&nbsp;Diederik L. Smit","doi":"10.1111/add.70564","DOIUrl":"10.1111/add.70564","url":null,"abstract":"&lt;p&gt;In their recent article, Piatkowski and colleagues [&lt;span&gt;1&lt;/span&gt;] elegantly deconstruct the mismatch between traditional harm reduction practices, born out of the crises of psychoactive drug epidemics, and the anabolic-androgenic steroid (AAS) user. We strongly agree with the authors that harm reduction in the context of AAS is fundamentally distinct from that of opioid or stimulant dependencies.&lt;/p&gt;&lt;p&gt;Fitness enthusiasts and strength athletes who use AAS do not identify as individuals with a substance use disorder [&lt;span&gt;2&lt;/span&gt;]. Their use is meticulously planned and deeply embedded in a contemporary lifestyle and body culture that commercializes and valorizes muscularity [&lt;span&gt;3&lt;/span&gt;]. Furthermore, the societal footprint of AAS use differs entirely from that of illicit psychoactive drugs. The community experience little public disruption, criminality or socio-economic burden directly attributable to the average gym-goer's steroid cycle.&lt;/p&gt;&lt;p&gt;Although AAS users are well aware that their lifestyle carries health risks, the medical community and public health authorities are often far more worried about the health risks of AAS use than the users themselves. The average AAS user has no interest in, nor will they respond to, top-down, paternalistic interventions aimed strictly at forcing them to stop. What they actually desire is objective health monitoring, specifically, access to regular blood analysis, cardiovascular screenings and medical expertise, from a physician who is willing to think along with them to minimize the downsides of their cycles [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Currently, the greatest hurdle to implementing this approach is the entrenched mentality of healthcare providers. When seeking help or presenting with complications, AAS users turn to general practitioners or medical specialists. Within these clinical circles, there is not only a deficit of practical knowledge regarding underground AAS regimens, but the concept of harm reduction in this context is treated as controversial.&lt;/p&gt;&lt;p&gt;Until recently, there were no controlled trials demonstrating that harm reduction interventions among AAS users could effectively change behavior or reduce risk. Additionally, clinicians may fear that providing medical supervision or health monitoring acts as an implicit endorsement of non-medical drug use, thereby lowering the threshold for entry and inadvertently increasing the number of users or the intensity of use.&lt;/p&gt;&lt;p&gt;The results of our recently published Harm Reduction in Anabolic Steroid Use (HARNAS) trial [&lt;span&gt;5&lt;/span&gt;] fundamentally dismantle these objections. This trial evaluated the efficacy of individualized, non-judgmental counseling and medical monitoring among male amateur athletes planning an AAS cycle. The intervention led to a highly significant reduction in total cumulative androgen dosage compared to the control group. Crucially, the study observed no enabling effect. Although the HARNAS trial proves that harm reduction","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 11","pages":"2874-2875"},"PeriodicalIF":5.9,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70564","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148628931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}