Addiction最新文献

{"title":"Examining the role of freebase nicotine in the harm reduction potential of oral nicotine pouches versus moist snuff: A randomized crossover trial.","authors":"Brittney Keller-Hamilton, Hayley Curran, Leanne Atkinson, Sriya Suraapaneni, Alice Hinton, Kirsten Chrzan, Darren Mays, Ahmad El-Hellani, Clark W Wilson, Marielle C Brinkman, Theodore L Wagener","doi":"10.1111/add.70114","DOIUrl":"10.1111/add.70114","url":null,"abstract":"<p><strong>Background and aims: </strong>Oral nicotine pouches (ONPs) contain varying proportions of freebase nicotine (FBN), with higher FBN expected to increase nicotine delivery across the oral mucosa. Because ONPs contain fewer toxicants than moist snuff and may serve as a reduced harm alternative for smokeless tobacco, we compared how the FBN in ONPs affects both nicotine pharmacokinetics and craving relief relative to moist snuff.</p><p><strong>Design: </strong>Three-visit (90-minute sessions; ≥48-hour washout), single-blind, randomized crossover study. Participants were asked to complete all visits within 1 month.</p><p><strong>Setting: </strong>Clinical facility in Columbus, Ohio, USA.</p><p><strong>Participants: </strong>N = 62 moist snuff users (M_age = 41 years, 96.8% male, 91.9% white, 33.9% had tried ONPs before), recruited through social media advertisements and participants' word-of-mouth from rural and Appalachian Ohio.</p><p><strong>Intervention: </strong>Following ≥12 hours of nicotine abstinence, participants used either a (1) low FBN peppermint ONP (27.4% FBN; 5.1 mg nicotine/pouch; Rogue brand), (2) high FBN peppermint ONP (70.2% FBN; 5.0 mg nicotine/pouch; Zyn brand) or (3) 2 g of usual brand moist snuff for 30 minutes. Participants completed the three study visits in one of six randomized orders.</p><p><strong>Measurements: </strong>Plasma nicotine and self-reported craving were assessed at t = baseline, 5, 15, 30, 60 and 90 minutes. Plasma nicotine and craving relief at t = 30 minutes were primary and secondary outcomes, respectively.</p><p><strong>Findings: </strong>At t = 30 minutes, mean [standard deviation (SD)] plasma nicotine concentrations were 7.1 (2.8) ng/mL for low FBN ONP, 14.8 (6.4) ng/mL for high FBN ONP and 12.3 (8.4) ng/mL for moist snuff (all comparison Ps ≤ 0.001). Craving was lower for moist snuff (mean = 0.8) than either ONP (means = 1.4), with the low FBN ONP providing statistically significantly less craving relief than moist snuff (P < 0.001).</p><p><strong>Conclusions: </strong>The proportion of freebase nicotine in oral nicotine pouches appears to statistically significantly influence their nicotine delivery, with higher freebase nicotine oral nicotine pouches delivering more nicotine than usual brand moist snuff. However, craving appears to be higher when using oral nicotine pouches than usual brand moist snuff.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12291100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537512","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":"An age–period–cohort–interaction analysis of meth/amphetamine-related deaths in Australia, 2001–2020","authors":"Oisin Stronach,&nbsp;Paul Dietze,&nbsp;Michael Livingston,&nbsp;Amanda Roxburgh","doi":"10.1111/add.70100","DOIUrl":"10.1111/add.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>The number of meth/amphetamine related deaths in Australia has quadrupled in the last 20 years, primarily due to drug toxicity and suicide among individuals in their 30s and 40s. Previous analysis of Australian meth/amphetamine-related deaths covered limited timeframes and causes, and there has been no exploration of the effects of changing cohorts on meth/amphetamine mortality. This paper provides comprehensive insights across 20 years into the evolving cohort trends in meth/amphetamine-related deaths in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An age–period–cohort–interaction (APC-I) analysis of Australian meth/amphetamine-related deaths (2001–2020) by cause extracted from the National Coronial Information System, a database of all deaths reported to the coroner in Australia and New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>APC-I analyses revealed that unintentional drug toxicity deaths peaked at ages 35–38 [Coefficient (Coef) = 0.92; 95% confidence interval (CI) = 1.0–0.8], intentional self-harm deaths peaked at ages 31–34 (Coef = 1.2; 95% CI = 1.4–1.0), unintentional injury deaths peaked at ages 23–26 (Coef = 1.02; 95% CI = 1.2–0.8) and natural cause deaths at 39–42 (Coef = 1.15; 95% CI = 1.4–0.9). Period effects were consistent across all causes, with a mean 29.3% increase in estimated mortality rate from 2001 to 2012, followed by a mean 103.3% increase in estimated mortality rate to 2016, at which time period effects stabilised. Cohort effects revealed that individuals born between 1962 and 1982 (mainly Generation X) faced a higher-than-average mortality risk across all four causes, with risk decreasing in later generations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite different age profiles across the various causes of death, cohort effects suggest a single generation (Generation X: people born between 1962 and 1982) is predominantly experiencing the increase in meth/amphetamine-related mortality observed in Australia over the past 20 years. As Generation X ages, the risk of meth/amphetamine-related natural deaths, especially from cardiovascular disease, is likely to increase.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 10","pages":"2032-2043"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537511","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":"Understanding medical cannabis use internationally: Why definitions and context matter","authors":"Myfanwy Graham,&nbsp;Rosalie Liccardo Pacula,&nbsp;Seema Choksy Pessar,&nbsp;Yimin Ge,&nbsp;Alexandra F. Kritikos,&nbsp;Wayne Hall,&nbsp;David Hammond","doi":"10.1111/add.70117","DOIUrl":"10.1111/add.70117","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To identify variation in identification of medical consumers using alternative self-reported measures and assess whether differences in these rates exist across jurisdictions with different medical policy approaches using evidence from an international study on cannabis use.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Secondary analysis of wave 4 (2021) of the International Cannabis Policy Study (ICPS) cross-sectional survey.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;United States, Canada and Australia.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;16 951 (USA 10 472; CAN 5935; AUS 544) respondents who completed the survey and reported past year cannabis use across the three jurisdictions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Measurements&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Four different medical cannabis use measures were available, and rates of each were estimated using logistic regression methods that adjusted for age, gender, education and ethnicity. Medical cannabis use measures included potentially authorized use (i.e. involving a licensed health professional recommendation, authorization or prescription), pharmaceutical use (i.e. involving a pharmaceutical-grade product), therapeutic use (i.e. to manage physical or mental health conditions) and self-identified medical cannabis use. Country-specific differences were compared and discussed in light of measure and differing cannabis policies.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Findings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In wave 4 of the ICPS, 34.0% reported any past year cannabis use, but rates of medical use differed significantly according to the specific question. Far more individuals reported therapeutic use in the past year across all countries [77.3%; 95% confidence interval (CI) = 76.4%–78.2%] than any other measure of medical use. While just over one quarter (28.2%; 95% CI = 27.3%–29.2%) self-identified as a medical user, fewer reported being potentially authorized (22.8%; 95% CI = 22.0%–23.7%) or having a pharmaceutical prescription from a medical professional (12.3%; 95% CI = 11.6%–13.0%). Australians (27.2%; 95% CI = 23.0%–31.4%) and Americans (25.9%; 95% CI = 24.6%–27.2%) were more likely to report potentially authorized use than Canadians (17.3%; 95% CI = 16.1%–18.4%), but only Australians (27.4%; 95% CI = 23.6%–31.2%) reported high levels of prior use of a pharmaceutical-grade cannabinoid.&lt;/p&gt;\u0000 ","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 10","pages":"2141-2146"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537515","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":"Offering e-cigarettes for smoking cessation and reduction in people with mental illness (ESCAPE): Protocol for a randomized controlled trial","authors":"Dimitra Kale,&nbsp;Emma Beard,&nbsp;Yan Ding,&nbsp;Jodi Pervin,&nbsp;Qi Wu,&nbsp;Catherine Arundel,&nbsp;Steve Parrott,&nbsp;Paul Galdas,&nbsp;Michelle Horspool,&nbsp;Simon Hough,&nbsp;Gregor Russell,&nbsp;Suzy Ker,&nbsp;Elena Ratschen,&nbsp;Lion Shahab","doi":"10.1111/add.70115","DOIUrl":"10.1111/add.70115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aims</h3>\u0000 \u0000 <p>Despite a steady decline in smoking rates across the United Kingdom (UK) over the past decades, substantial tobacco-related inequalities persist, particularly among individuals with mental illness. Smoking prevalence in this group has remained largely unchanged, highlighting a major public health concern. This protocol outlines a trial aimed at addressing this issue by evaluating the effectiveness of offering an electronic cigarette (e-cigarette) starter kit for smoking cessation and harm reduction as an adjunct to usual care to adults who smoke with mental illness treated in the community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Two-arm parallel randomized controlled superiority trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>A minimum of eleven UK National Health Service mental health Trusts or general practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Adults who smoke with a diagnosis of mental illness treated in the community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Intervention and comparator</h3>\u0000 \u0000 <p>Participants will be randomly allocated (1 : 1) to receive: (i) an e-cigarette starter kit, a brief demonstration and both verbal and written information on e-cigarette use as an adjunct to usual care; or (ii) usual care alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>The primary outcome is 7-day point prevalence carbon monoxide-validated abstinence, assessed six months after study enrolment or target quit date. Secondary outcomes include: 6-month continuous abstinence defined by Russell Standard, self-reported smoking abstinence at 1 month, ≥50% smoking reduction (cigarettes/day) at 1 and 6 months, mental health symptoms and general mood and physical symptoms at 1 and 6 months, cost-effectiveness of the intervention and adherence to and satisfaction with the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Comments</h3>\u0000 \u0000 <p>This will be the first large-scale study in the UK to assess the effectiveness and cost-effectiveness of providing an e-cigarette starter kit for smoking cessation and harm reduction in people with mental illness. Results will inform policy and practice related to supporting smoking cessation for this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 11","pages":"2335-2347"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537513","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":"Rare but relevant: Cannabis use and myocardial infarction.","authors":"Prianka Padmanathan, Emmert Roberts","doi":"10.1111/add.70128","DOIUrl":"https://doi.org/10.1111/add.70128","url":null,"abstract":"<p><p>Pre-clinical research and case reports have linked cannabis use to myocardial infarction (MI) since the 1970s. The association with MI may be specific to certain types and patterns of cannabis use as well as certain consumer characteristics; however, due to limited data availability, meta-analyses examining the association between cannabis use and MI typically report only broad binary categorisations of use vs. no use. Robust prospective studies that capture the complexities of consumption patterns are required to inform causal inferences. In the meantime, clinicians should be aware of the potential increased risk of myocardial infarction in young healthy patients presenting with chest pain and a recent history of cannabis use. Accurate assessment and documentation of recent cannabis use is also essential to improve future research and identify and monitor interactions with cardiovascular medications.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537514","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":"Synthetic cannabinoids in e-cigarettes seized from English schools","authors":"Gyles E. Cozier,&nbsp;Matthew Gardner,&nbsp;Sam Craft,&nbsp;Martine Skumlien,&nbsp;Jack Spicer,&nbsp;Rachael Andrews,&nbsp;Alexander Power,&nbsp;Tom Haines,&nbsp;Richard Bowman,&nbsp;Amy E. Manley,&nbsp;Peter Sunderland,&nbsp;Oliver B. Sutcliffe,&nbsp;Stephen M. Husbands,&nbsp;Lindsey Hines,&nbsp;Gillian Taylor,&nbsp;Tom P. Freeman,&nbsp;Jennifer Scott,&nbsp;Christopher R. Pudney","doi":"10.1111/add.70110","DOIUrl":"10.1111/add.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aims</h3>\u0000 \u0000 <p>People who use synthetic cannabinoids (SCs) report debilitating side effects and withdrawal symptoms, coupled with dependence. In the UK, SC use was believed to be largely restricted to prison, where they are the most common drug and associated with nearly half of non-natural deaths, or poly-drug users in the community who are also likely to be homeless. However, national media reporting has increasingly identified cases of children collapsing in schools, which are claimed to be associated with vaping and putatively involving a drug such as delta-9-tetrahydrocannabinol (THC) or SCs. We therefore conducted the first study to identify and quantify SCs in e-cigarettes routinely collected from schools in England.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>E-cigarette and e-liquid samples seized by teachers in schools were identified through engagement with police forces and city councils in England. We sought agreements across broad geographical areas and based on acquiring the relevant approvals at a local level. Sample bias is considered in the analysis and reporting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting and cases</h3>\u0000 \u0000 <p>Samples were submitted from 27 secondary (age 11–18) schools from geographically distinct regions of England, representing a broad range of social metrics (free school meals, persistent absenteeism and special educational needs). All submitted samples were anonymised and no identifying information was collected. Analysis of samples was conducted both in a laboratory setting and in-field at local police stations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Qualitative gas chromatography–mass spectrometry and liquid chromatography–mass spectrometry were used to identify SCs and THC in e-cigarettes/liquid, with concentration measured by quantitative nuclear magnetic resonance spectroscopy. A subset of samples was screened for SCs and THC using a portable detector based on combined fluorescence and photochemical discrimination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>E-cigarettes containing SC were identified in 77.8% of all participating schools and were detected in 17.4% of all samples seized. These were almost entirely in refillable devices and liquid bottles, with very few in single use products. The percentage of SC e-cigarettes in schools positively correlated with the fraction of pupils eligible for free school meals, a social deprivation metric (Pearson's correlat","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 10","pages":"1995-2004"},"PeriodicalIF":5.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504267","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":"What should we do with the drunken sailor? Research gaps on alcohol-related drowning","authors":"Emmanuel Kuntsche,&nbsp;Amy Peden,&nbsp;Hannah Calverley,&nbsp;Jasmin Lawes,&nbsp;Maree Patsouras,&nbsp;William Koon,&nbsp;Geoff Dickson","doi":"10.1111/add.70111","DOIUrl":"10.1111/add.70111","url":null,"abstract":"&lt;p&gt;The effects of alcohol on physical performance and driving ability are well-established [&lt;span&gt;1, 2&lt;/span&gt;] and in many countries drink-driving has become both socially and legally unacceptable and irresponsible. Research, education and policy emphasises the dangers of drink driving, with campaigns and law enforcement throughout high-income countries intended to reduce alcohol-related deaths on the roads [&lt;span&gt;3&lt;/span&gt;]. There is an ongoing challenge to view the consumption of alcohol while in, on and around the water in the same way [&lt;span&gt;4&lt;/span&gt;]. Regrettably, the drunken sailor (or swimmer) remains a common scenario, often with a tragic outcome.&lt;/p&gt;&lt;p&gt;Blood alcohol restrictions for boating vary from country to country and are often linked to vessel size. However, evidence suggests that many boaters, regardless of their familiarity with the laws, often consume alcohol before or while operating vessels, with many believing that alcohol enhances their enjoyment of boating activities [&lt;span&gt;5&lt;/span&gt;]. Worryingly, surveyed river users reported they felt it was more acceptable to drink and operate a vessel than it is to drink and drive on the road [&lt;span&gt;6&lt;/span&gt;]. Part of the problem is that random breath testing, recommended by the World Health Organization (WHO) [&lt;span&gt;7&lt;/span&gt;] to be one of the most effective measures against drink driving, is much more difficult to implement in aquatic environments. This is likely because of dynamic environmental conditions and a lack of structured networks (i.e. roads) that enable targeted monitoring opportunities, as such is the case in roadside random breath testing.&lt;/p&gt;&lt;p&gt;This is a concerning issue because alcohol is a leading risk factor not only for aquatic incidents such as boating collisions and capsizing—but also for drowning [&lt;span&gt;5&lt;/span&gt;] posing risks not just to those who consume alcohol, but also to those around them. For example, inebriated vessel operators may put their passengers at risk while inebriated caregivers may neglect their supervision duties toward children around water.&lt;/p&gt;&lt;p&gt;The WHO considers drowning to be a major cause of preventable injury-related mortality and morbidity and an under-recognised threat to global public health [&lt;span&gt;8&lt;/span&gt;]. More than 820 people die from drowning every day worldwide, the majority occurring in low- and middle-income countries [&lt;span&gt;9&lt;/span&gt;]. Because alcohol consumption is a significant factor in many drowning deaths worldwide, WHO recommends public awareness programmes that focus on better communication of the dangers of consuming alcohol around water and of inadequate supervision of children near water [&lt;span&gt;9&lt;/span&gt;]. Unfortunately, almost two-thirds of the included countries globally indicated having no (42%) or no substantial (far-reaching: 23%) alcohol-focused drowning prevention or water safety campaigns. Most of the existing campaigns were delivered in the Americas, Europe and Western Pacific; a distribution reflecting the preval","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 9","pages":"1706-1708"},"PeriodicalIF":5.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482633","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":"Changing patterns of nicotine product use and nicotine dependence among United States high-school students: The National Youth Tobacco Survey, 2014–2023","authors":"Sarah E. Jackson,&nbsp;Jamie Brown,&nbsp;Harry Tattan-Birch,&nbsp;Martin J. Jarvis","doi":"10.1111/add.70120","DOIUrl":"10.1111/add.70120","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background and aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Concerns have been raised that e-cigarettes have created a new generation of people addicted to nicotine. This study aimed to measure changes in the proportion of US high-school students reporting symptoms of nicotine dependence over the past decade, in the context of changing patterns of nicotine product use.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Repeat cross-sectional analyses of the 2014–2023 National Youth Tobacco Surveys.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;United States of America.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;107 968 high-school students (14–18y).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Measurements&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Nicotine product use was categorised based on self-reported past-30-day use of cigarettes, other combustible tobacco, smokeless/non-combustible products and e-cigarettes. Nicotine dependence was operationalised as (a) strong past-30-day cravings to use tobacco and (b) wanting to use nicotine products within 30 minutes of waking.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Findings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Past-30-day use of any nicotine product decreased from 24.5% (95% confidence interval = 22.5%–26.6%) to 19.6% (16.8%–22.4%) between 2014 and 2017, increased sharply, reaching 31.4% (29.0%–33.7%) in 2019 (driven by an increase in e-cigarette use), then fell to the lowest level at 12.5% (10.9%–14.1%) by 2023. The proportion who reported symptoms of nicotine dependence was substantially lower, but followed a similar pattern of changes over time. For example, the proportion reporting strong cravings decreased from 7.8% (6.6%–9.0%) to 5.5% (4.3%–6.7%) between 2014 and 2017, increased to 7.9% (6.8%–9.0%) between 2017 and 2018 and remained stable up to 2020, then fell to the lowest level at 2.5% (1.9%–3.1%) by 2023. While dependence symptoms were consistently highest among cigarette users, they were increasingly prevalent among those using only e-cigarettes after 2017.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The sharp rise in the prevalence of nicotine product use (in particular, e-cigarettes) among US high-school students in the late 2010s was short-lived and was not accompanied by a sustained increase in the overall population burden of nicotine dependence. By 2023, both nicotine product","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 11","pages":"2215-2222"},"PeriodicalIF":5.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482631","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":"Responding to medicinal and non-medicinal ketamine use","authors":"Owen Bowden-Jones,&nbsp;Arun Sahai,&nbsp;Paul Dargan","doi":"10.1111/add.70075","DOIUrl":"10.1111/add.70075","url":null,"abstract":"&lt;p&gt;Ketamine challenges our consideration of drug benefit and harm and how these two opposing concepts should be balanced by clinicians, policy makers and the public. At a time when ketamine and other related arylcyclohexamines are being investigated as novel treatments for a range of mental health problems, the non-medical use of ketamine is increasing along with associated, often severe, harms. Untangling this apparent contradiction requires sound research, careful monitoring of emerging evidence and a co-ordinated response from health providers.&lt;/p&gt;&lt;p&gt;Derived from phencyclidine and first synthesized in 1962, ketamine has a complex neurochemical profile producing effects including sedation, dissociation, anaesthesia, analgesia and amnesia [&lt;span&gt;1&lt;/span&gt;]. Primarily acting as a non-competitive &lt;i&gt;N&lt;/i&gt;-methyl-&lt;span&gt;d&lt;/span&gt;-aspartate (NMDA) receptor agonist, ketamine is also a weak dopamine D2, 5-HT&lt;sub&gt;2A&lt;/sub&gt; and μ-opioid agonist and has weak affinity for the serotonin and norepinephrine transporters.&lt;/p&gt;&lt;p&gt;Listed as an essential medicine by the World Health Organization, ketamine is well established in paediatric, emergency and pre-hospital medicine, and also used in veterinary medicine [&lt;span&gt;2, 3&lt;/span&gt;]. More recently, ketamine's antidepressant effects have been studied in those with treatment-resistant and major depressive disorders. Intravenous ketamine shows powerful, rapidly acting, but short-lived antidepressant effects [&lt;span&gt;4, 5&lt;/span&gt;]. More recently an enantiomer of ketamine, esketamine, has been developed as a nasal preparation and licensed for the management of treatment-resistant depression [&lt;span&gt;6&lt;/span&gt;]. A range of other indications are being explored including for the treatment of substance use disorders and post-traumatic stress and there are currently over 1500 clinical trials registered on clinictrials.gov investigating ketamine and related arylcylohexamines [&lt;span&gt;7&lt;/span&gt;]. There is genuine excitement among researchers about the potential for ketamine and related compounds working through similar mechanisms to deliver new treatment options for patients. However, as the evidence continues to develop, ‘ketamine clinics’ have been opening in some countries providing off-label ketamine prescriptions for a wide-range of mental-health and ‘lifestyle’ indications for which there is little or no supporting research. It is estimated the United States (US) ketamine clinic market was worth US$3.4 billion in 2023 [&lt;span&gt;8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Non-medical use of ketamine was first reported in the United States in 1971 and has since spread worldwide with the United Nations Office on Drugs and Crime reporting non-medical ketamine use in 64 countries [&lt;span&gt;9&lt;/span&gt;]. Rather than being diverted from legitimate hospital, pharmacy or veterinary supplies, most ketamine used non-medically is produced in clandestine laboratories as a fine crystalline powder that is generally used by nasal insufflation. People using ketamine report desirable e","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 8","pages":"1494-1496"},"PeriodicalIF":5.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482632","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":"Commentary on Jackson et al.: The role of regional tobacco control in centralised nations","authors":"Nathan Davies,&nbsp;Tessa Langley","doi":"10.1111/add.70112","DOIUrl":"10.1111/add.70112","url":null,"abstract":"<p>In nations with federal or decentralised governance structures, the role of subnational tobacco control is clear. Local and regional areas not only provide smoking cessation services, but implement significant tobacco control policies. For example, in the United States, local and state authorities enacted the first Tobacco 21 statutes [<span>1</span>]; in China, municipal governments introduced smoke-free laws [<span>2</span>]; and in South America, smoke-free legislation originated at the provincial tier in Argentina [<span>3</span>].</p><p>The same is not true of England, United Kingdom. Despite the introduction of elected regional mayors, England has undergone decades of funding cuts for local and regional tiers of government and has a highly centralised system of governance [<span>4, 5</span>]. It has also experienced sustained increases in regional economic inequality since the mid-2000s [<span>6</span>]. In relation to tobacco control, most legislative activity in England takes place at national government level. Local areas deliver smoking cessation services, enforcement of national policy and broader tobacco control measures that require no major new legislation. Regional programmes were previously funded by the national government to support local areas by providing expert advice, co-ordinating activity and enabling economies of scale [<span>7</span>]; however, this funding was withdrawn in the early 2010s, leaving regional programmes only where local areas banded together to pool resources [<span>8</span>].</p><p>This makes the results of Jackson <i>et al</i>.’s study on regional tobacco trends in England especially important [<span>9</span>]. Drawing on approximately 370 000 survey participants from 2006 to 2024, the authors modelled age-standardised smoking prevalence by region and social grade. When comparing areas with and without dedicated supra-local tobacco-control programmes, they found that prevalence fell in every region, but declined fastest in the North East, the only region that has maintained continuous regional tobacco control capacity, by 13.3 percentage points (95% CI = −15.3 to −11.3) against 9.3 percentage points (95% CI = −10.0 to −8.5) elsewhere.</p><p>The authors offer strong arguments that regional tobacco control played a role reducing smoking prevalence. During the same period, economic inequalities in England have widened [<span>6</span>], alcohol harms have increased in the North East [<span>10</span>], and yet smoking prevalence strongly bucked this trend.</p><p>How might regional tobacco control be reducing smoking prevalence? Prior research sheds some light on the possible mechanisms at play. Despite England's pronounced administrative centralisation, long-standing supra-local tobacco-control units have exercised a distinct role. Without independent legislative authority or substantial distributive budgets, these teams have spearheaded strategies against illicit trade [<span>11</span>], led mass-media ce","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 9","pages":"1802-1803"},"PeriodicalIF":5.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473399","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}