Addiction最新文献

{"title":"Quitting trajectories of Hong Kong Chinese smokers receiving behavioral smoking cessation interventions: A post hoc analysis of eight randomized controlled trials.","authors":"Yingpei Zeng, Yongda Socrates Wu, Tzu Tsun Luk, Sheng Zhi Zhao, Ziqiu Guo, Yajie Li, Henry Sau Chai Tong, Vienna Wai Yin Lai, Yee Tak Derek Cheung, Tai Hing Lam, Man Ping Wang","doi":"10.1111/add.70328","DOIUrl":"10.1111/add.70328","url":null,"abstract":"<p><strong>Background and aims: </strong>Characterizing distinct quitting trajectories may inform tailored behavioral smoking cessation interventions. We identified the quitting trajectories and associated characteristics in Hong Kong Chinese smokers.</p><p><strong>Methods: </strong>Data were from eight randomized controlled trials nested within the annual Smoking-free Community Campaign ('Quit-to-Win' Contest) from 2014 to 2021. The trials were two- or three-arm evaluating the effectiveness of behavioral smoking cessation interventions in 8300 adult daily smokers who were proactively recruited from communities across Hong Kong and followed-up at 1, 2, 3 and 6 months. Daily cigarette consumption was collected at baseline and follow-ups for identifying quitting trajectories by group-based trajectory modeling based on relative changes in cigarette consumption (vs. baseline) over four follow-up assessment points. Multinomial logistic regressions were used to yield relative risk ratios (RRRs) for the trajectories by baseline smoking-related characteristics, adjusting for sex, age, economic status and education attainment.</p><p><strong>Results: </strong>Four quitting trajectories were identified, including quitters (4.6%), relapsers (6.8%), reducers (54.8%) and persistent smokers (33.8%). Compared with persistent smokers, smokers in the other 3 trajectories were associated with having previous quit attempts, higher intention to quit and perceived higher importance and confidence in quitting (all P < 0.05). Quitters [adjusted RRR (aRRR) = 0.59, 95% confidence interval (CI) = 0.62-1.00] and relapsers (aRRR = 0.75, 95% CI = 0.61-0.91) reported lower nicotine dependence vs. persistent smokers, whereas reducers showed higher nicotine dependence (aRRR = 1.39, 95% CI = 1.25-1.55) at baseline. Relapsers and reducers perceived higher difficulty of quitting (all P < 0.05). When compared with quitters, relapsers had higher intention to quit within 7 days (aRRR = 2.32, 95% CI = 1.64-3.28) and perceived higher importance (aRRR = 1.17, 95% CI = 1.09-1.25) and confidence (aRRR = 1.10, 95% CI = 1.04-1.17) in quitting, while reducers showed lower intention to quit within 7 days (aRRR = 0.59, 95% CI = 0.45-0.77) and perceived lower confidence in quitting (aRRR = 0.91, 95% CI = 0.86-0.95). Subgroup analysis of different interventions showed similar trajectory shapes and group probabilities.</p><p><strong>Conclusions: </strong>Chinese smokers who joined behavioral smoking cessation trials in Hong Kong appear to have four quitting trajectories, each with associated characteristics, which may help predict the potential quitting trajectories and inform future interventions.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"1568-1579"},"PeriodicalIF":5.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145987500","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":"Understanding the interplay between alcohol use, cannabis use and mental health across the lifespan: A network analysis.","authors":"Inês Macedo, Emese Kroon, Karis Colyer-Patel, René Freichel, Christophe Romein, Rita Pasion, Fernando Barbosa, Janna Cousijn","doi":"10.1111/add.70324","DOIUrl":"10.1111/add.70324","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;This study aimed to understand the interplay between alcohol use, cannabis use and mental health across the lifespan by addressing the following questions: (1) Do the structure and overall connectivity of mental health symptom networks differ between individuals who use alcohol and those who co-use alcohol and cannabis?; (2) Within co-users, what is the strength of the associations between characteristics of alcohol and cannabis use (quantity/frequency, severity of use-related problems and age of onset) and mental health symptoms?; and (3) Does age moderate these associations among co-users?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting and participants: &lt;/strong&gt;Cross-sectional observational study including 740 participants aged 16-81 years, of which 446 used alcohol (57.6% female) and 294 co-used alcohol and cannabis (50.7% female). Data were collected online from English- and Dutch-speaking participants across multiple countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;Main outcome measures included self-reported severity of mental health symptoms (DSM-Level 1-Cross-Cutting Symptom Measure), quantity/frequency and problematic use of cannabis (Cannabis Use Disorder Identification Test - Revised) and alcohol (Alcohol Use Disorder Identification Test). Using a network approach, interactions between mental health symptoms (12 nodes) were compared between alcohol users and alcohol and cannabis co-users. In co-users, we incorporated detailed measures of alcohol and cannabis use (6 nodes) in the network and assessed the moderating role of age.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The alcohol and cannabis co-use group was characterized by higher quantity/frequency of use, problematic use and severity for all mental health symptoms compared with the alcohol group (Ps ≤ 0.001). Still, the alcohol use and alcohol-cannabis co-use networks did not statistically significantly differ (network invariance test: maximum difference in edge weights = 0.167, P = 0.611, global strength invariance test: global strength difference statistic = 0.265, P = 0.470), with both showing strong connections between anxiety, personality functioning and depression. However, the centrality invariance test revealed a statistically significantly (P = 0.018) higher strength of somatic symptoms in co-use (strength = 1.31) compared with alcohol use (strength = 0.17). When substance use outcomes were included in the co-use network, distinct associations emerged: alcohol-related problems were uniquely linked to anxiety, impaired personality functioning and suicidal ideation (partial cor. = 0.03, 0.01 and 0.01, respectively), while cannabis-related problems were associated with mania and dissociation (partial cor. = 0.05 and 0.02). Age did not moderate these relationships.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Alcohol use and alcohol-cannabis co-use appear to be associated with a range of mental health symptoms, including overlapping and distinct symptom patterns that are similar regard","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"1421-1433"},"PeriodicalIF":5.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996809","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 systematic review and meta-analysis of self-reported exposure to cannabis advertising and its association with cannabis use and intentions.","authors":"Caitlin McClure-Thomas, Tesfa Yimer, Caroline Strong, Tianze Sun, Wayne D Hall, Gary Chung Kai Chan, Jason P Connor, Janni Leung","doi":"10.1111/add.70310","DOIUrl":"10.1111/add.70310","url":null,"abstract":"<p><strong>Background and aims: </strong>Global changes in cannabis legislation have raised concerns about the potential impact of cannabis advertising on cannabis use and intentions to use. This systematic review and meta-analysis evaluated the relationship between self-reported exposure to cannabis advertising across various media platforms and self-reported cannabis use and use intentions.</p><p><strong>Design: </strong>Systematic review and meta-analysis of eligible quantitative studies using random-effects models.</p><p><strong>Setting: </strong>All included studies were conducted in the United States or Canada.</p><p><strong>Participants: </strong>Participants ranged in age from 11 to 65 + years across 21 included studies.</p><p><strong>Measurements: </strong>Studies measured self-reported exposure to cannabis-related advertising and either cannabis use or intentions to use cannabis. Three types of exposure were examined: [1] general cannabis advertising (a composite measure including billboards, storefront/sidewalk, magazines, social media, and other types of advertising avenues), [2] internet/social media advertising, and [3] storefront/sidewalk advertising.</p><p><strong>Findings: </strong>A total of 2588 records were identified through database searches (PubMed, Scopus, and PsycINFO; January 2024). After title and abstract screening, 45 underwent full text review; of these, 21 studies met inclusion criteria. Most were cross-sectional (86%, n = 18), and three were longitudinal. Ten cross-sectional studies were eligible for meta-analysis, which found a statistically significant association between cannabis advertising exposure and cannabis use (adjusted odds ratio [aOR] = 1.77, 95% confidence interval [CI] [1.32, 2.30]). Statistically significant heterogeneity was found (Q [11] = 22.73, P < 0.05, I² = 42.3%) and therefore, based on methodological comparability, three additional meta-analyses were conducted by exposure type. General cannabis advertising (3 studies) exposure was statistically significantly associated with cannabis use (aOR = 1.67, 95% CI [1.27, 2.21]); internet/social media advertising (5 studies) also showed a statistically significant association (aOR = 3.38, 95% CI [1.07, 10.66]); exposure to storefront/sidewalk advertising (3 studies) was not statistically significantly associated with cannabis use (aOR = 1.25, 95% CI [0.95, 1.66]). Across studies, methodological quality was mostly good (48%) or satisfactory (43%), with 10% rated as unsatisfactory.</p><p><strong>Conclusion: </strong>There appears to be a generally positive association between exposure to cannabis advertising and cannabis use, with a consistent positive relationship observed between advertising exposure and intentions to use.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"1343-1361"},"PeriodicalIF":5.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218072","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":"Adolescent cannabis use and psychological distress from 2013 to 2023: A population-based study in Ontario, Canada.","authors":"André J McDonald, Amanda Doggett, Susan J Bondy, Ian Colman, Steven Cook, Hayley A Hamilton, Paul Kurdyak, Scott T Leatherdale, Daniel T Myran, Jürgen Rehm, Christine M Wickens, James MacKillop, Jillian Halladay","doi":"10.1111/add.70333","DOIUrl":"10.1111/add.70333","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Epidemiologic research suggests that adolescent cannabis use is associated with psychological distress (i.e. depression and anxiety symptoms); however, most studies have relied on 20th-century data, when cannabis was significantly less potent than today. This study aimed to estimate the association between adolescent cannabis use and psychological distress using contemporary population-based data and examine the roles of time [as a proxy for increasing Δ9-tetrahydrocannabinol (THC) potency], sex and age of initiation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Representative cross-sectional survey conducted biennially from 2013 to 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Ontario, Canada.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;35 007 adolescents in grades 7 to 12.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;Past-year cannabis use was categorized as Never, 1-2 times, 3-9 times, 10-39 times or 40+ times. Psychological distress was measured with the Kessler-6 scale using a cut-off score of 13+ indicating anxiety/depression symptoms. Multivariable modified Poisson and least-squares models were used to estimate the association between past-year cannabis use and psychological distress. Survey year and sex were tested as effect modifiers on the multiplicative and additive scales. The association between school grade of cannabis use initiation and psychological distress was also estimated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;From 2013 to 2023, the prevalence of psychological distress increased from 10.7% to 27.4%, whereas cannabis use decreased from 23.1% to 17.6%. Survey year and sex were statistically significant effect modifiers for the association between cannabis use and psychological distress with associations consistent with a super-additive effect but not multiplicative synergy (additive interactions: P &lt; 0.05; multiplicative interactions: P &gt; 0.05). The association between cannabis use and psychological distress strengthened over time, particularly for those using 40+ times compared with abstinence (from 0% [95% confidence interval (CI) = -6% to 6%] adjusted prevalence difference in 2013 to 18% (95% CI = 11%-25%] adjusted prevalence difference in 2023). Independent of time, there was evidence of dose-response among females, but not males. A 5% (95% CI = 1%-10%) lower prevalence of psychological distress was observed per later school grade of cannabis use initiation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Psychological distress increased markedly among adolescents in Ontario, Canada, from 2013 to 2023. In that setting, adolescent cannabis use was statistically significantly associated with psychological distress, especially among females, and this association increased in magnitude over time, especially for those using most frequently. It is possible that adolescents are increasingly self-medicating psychological distress with cannabis and/or that rising cannabis potency is increasingly contributing to psychological distress. While caus","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"1495-1507"},"PeriodicalIF":5.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146058331","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":"Decline of phosphatidylethanol (B-PEth) during abstinence in patients with alcohol use disorder undergoing withdrawal treatment, and the correlation of B-PEth with self-reported alcohol intake.","authors":"Andrea de Bejczy, Lisa Walther, Cecilia Nilsson-Wallmark, Barbro Askerup, Anders Isaksson","doi":"10.1111/add.70359","DOIUrl":"10.1111/add.70359","url":null,"abstract":"<p><strong>Background and aim: </strong>Accurately estimating alcohol consumption is crucial for clinical decision-making and monitoring treatment outcomes. Phosphatidylethanol in blood (B-PEth), a direct alcohol biomarker, is currently the most reliable indicator of alcohol intake, with a detection window of several weeks; however, the factors influencing the decline of B-PEth levels remain largely unknown. This study aimed to investigate the decline of B-PEth levels during abstinence in patients with alcohol use disorder (AUD) undergoing withdrawal treatment.</p><p><strong>Method: </strong>A total of 100 patients were recruited in withdrawal treatment and followed during three to four weeks of abstinence. Blood samples were collected at baseline and weekly during abstinence to measure B-PEth levels of two homologues (16:0/18:1 and 16:0/18:2). Self-reported alcohol consumption was documented using the Timeline Followback (TLFB) method for 30 days before abstinence and throughout the study period.</p><p><strong>Results: </strong>B-PEth elimination followed first-order kinetics. The mean half-life was 7.24 days [95% confidence interval (CI) = 6.98-7.53] for 16:0/18:1 and 4.55 days (95% CI = 4.44-4.67) for 16:0/18:2. The rate of decline varied by week, with a longer half-life observed in week three compared with week one. No statistically significant sex differences were detected. The strongest correlation between B-PEth levels and self-reported alcohol consumption was found for data from two weeks prior to abstinence.</p><p><strong>Conclusion: </strong>Elimination of phosphatidylethanol in blood (B-Peth) follows first-order kinetics, with homologue 16:0/18:1 exhibiting a longer half-life than 16:0/18:2. The rate of decline is influenced by the week of alcohol abstinence and B-PEth levels are detectable even in the fourth week of abstinence. The strongest correlation between B-PEth and self-reported alcohol consumption is at two weeks prior to abstinence.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":"1474-1482"},"PeriodicalIF":5.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218145","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":"Self-harm in individuals with substance use disorders: Predictive factors and risk model.","authors":"Rongqin Yu, Derek K Tracy, Julia Sinclair, Isabell Brikell, Paul Lichtenstein, Henrik Larsson, Seena Fazel","doi":"10.1111/add.70465","DOIUrl":"https://doi.org/10.1111/add.70465","url":null,"abstract":"<p><strong>Background and aims: </strong>Substance use disorders are associated with an elevated risk of self-harm. Currently, clinical and structured assessment of self-harm risk typically relies on evidence from the general population samples. The aim of this study was to develop a risk model for self-harm that incorporates predictors specific to individuals with substance use disorders.</p><p><strong>Methods: </strong>Using national registers, we identified a population-based cohort of 449 720 individuals with substance use disorders in Sweden between 2006 and 2020. We tested independence and strength of a range of socio-demographic and clinical factors, obtained through linkage of population-based registers, with a Cox proportional hazards model, and estimated the risk of self-harm. For the risk model, 361 120 individuals were allocated to the development sample and 88 600 to external validation based on different geographical regions. We assessed self-harm risk over five predetermined follow-up periods-within 7 days, 1 month, 3 months, 6 months and 12 months-following a healthcare contact for substance use disorders.</p><p><strong>Results: </strong>In the development sample, self-harm rates ranged from 0.6% to 3.5%, and in the validation sample from 0.5% to 3.6%. Ten risk factors were retained in the final risk model. Strongest associations with subsequent self-harm were for clinical factors: previous self-harm [hazard ratio (HR) = 3.17, 95% confidence interval (CI) = 3.08-3.26] and comorbidity of mental disorders (HR = 2.63, 95% CI = 2.50-2.72). Recent psychotropic medication use, including antidepressant (HR = 1.29, 95% CI = 1.23-1.38) and antipsychotic treatments (HR = 1.34, 95% CI = 1.24-1.44), was associated with increased risk, even after adjusting for psychiatric comorbidity, likely reflecting greater clinical severity and complexity. Across follow-up periods, performance was good in terms of discrimination, with area under the curve (AUCs) ranging from 0.73 (95% CI = 0.71-0.76) to 0.79 (95% CI = 0.78-0.80). In relation to calibration, expected-to-observed risk ratios were 1.00 to 1.04 and Brier scores 0.01 to 0.04 across follow-up periods. We used the model to generate a simple web-based risk calculator [Oxford Self-hArM after substance use disorders (OxSAMS)].</p><p><strong>Conclusions: </strong>Modifiable clinical factors appear to have the strongest associations with increased risk of self-harm in people with substance use disorders. Structured tools, taking account of the different strengths of those factors, could inform clinical decision-making and provide a baseline assessment for training and research.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147830862","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":"Cost-effectiveness of in-hospital motivational smoking cessation counselling and proactive referral to community-based follow-up.","authors":"Karin Pleym, Ingrid Engebretsen, Elise Sverre, Toril Dammen, Einar Huseby, Mohpal Singh Kahlon, Marie Stugaard, Henrik Støvring, Ivar Sønbø Kristiansen, John Munkhaugen","doi":"10.1111/add.70460","DOIUrl":"https://doi.org/10.1111/add.70460","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aim: &lt;/strong&gt;In a randomised open-label trial among hospitalised patients with atherosclerotic vascular disease, motivational smoking cessation counselling with proactive referral to community-based follow-up was more effective than brief cessation advice and written information, with 6-month continuous abstinence rates of 49.5% vs. 24.5%. This study aimed to estimate the cost-effectiveness of this intervention compared with brief cessation advice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Economic evaluation alongside a multicentre, randomised open-label, blinded-endpoint trial with 1:1 randomisation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Three secondary care hospitals in Norway. Recruitment took place from November 2021 to October 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Hospitalised patients aged 18 years or older with established atherosclerotic vascular disease who reported smoking at least one cigarette daily before admission were eligible for participation, regardless of whether admission was planned or unplanned. A total of 221 patients were randomised. One participant withdrew informed consent and was excluded from all analyses, leaving 220 participants in the economic evaluation. The cohort comprised 40% women and the mean age was 65.2 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;Intervention costs included staff training, materials and personnel time. Hospital costs during the 16-month follow-up were estimated using Diagnosis-Related Group cost weights. Survival beyond follow-up was extrapolated using national mortality data adjusted for age, sex and atherosclerotic vascular disease. Lifetime costs were estimated using mean costs from the final six months of follow-up. The primary economic outcome was net monetary benefit (NMB), calculated at a willingness-to-pay threshold of €38 346 per life-year gained. The incremental cost-effectiveness ratio was also estimated. Future costs and life-years were discounted at 4%. Uncertainty estimates (UE) were obtained using bootstrapping.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;During the 16-month follow-up, five patients (4.6%) died in the intervention group and nine (8.1%) in the control group. Discounted life expectancy from baseline was 13.54 years in the intervention group and 12.47 years in the control group, corresponding to an incremental gain of 1.06 life-years (95% UE = -0.72 to 3.31). The incremental discounted lifetime cost was €3280 per patient (95% UE = -€19 457 to €26 436), resulting in an incremental cost-effectiveness ratio of €3094 per life-year gained. At a willingness-to-pay threshold of €38 346 per life-year gained, the NMB was €37 475 (95% UE = -€15 868 to €107 797) and the probability of the intervention being cost-effective was 90.5%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Motivational smoking cessation counselling delivered during hospitalisation with proactive referral to community-based follow-up had a high probability of being cost-effective from a hospital perspective f","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147830925","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":"Academic detailing is effective at altering clinician practice and patient outcomes for opioid use disorder.","authors":"Jonathan Zhang, Jodie Trafton, Mark Bounthavong, Melissa Christopher","doi":"10.1111/add.70468","DOIUrl":"https://doi.org/10.1111/add.70468","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147830842","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":"Preventing lower-level gambling harms: Shifting from individual- to system-frame approaches.","authors":"Robert M Heirene","doi":"10.1111/add.70467","DOIUrl":"https://doi.org/10.1111/add.70467","url":null,"abstract":"<p><strong>Background: </strong>Gambling-related harm is not concentrated solely among individuals meeting criteria for problematic or disordered gambling. Tackling harm at a population level is essential to reducing the total burden of harm and preventing escalation to more severe harms. The public health approach to gambling recognises this and the need to address both individual and systemic factors that shape people's risk of harm. Despite this, research and policy in the field remain largely focused on interventions that target individual responsibility, such as educational messages, warnings, and voluntary tools.</p><p><strong>Argument: </strong>Chater and Loewenstein's i-frame (individual-frame) and s-frame (system-frame) distinction provides a compelling basis for reorienting gambling harm prevention efforts. I-frame interventions target individual decision-making and self-regulation, while s-frame interventions seek systemic changes through restrictions and structural reforms. This paper argues that s-frame approaches are better suited to preventing gambling harms, particularly lower-level harms at the population level, because they [1] do not rely on individuals to recognise and effectively navigate the complex mathematical properties and potentially misleading features inherent in many gambling products, [2] apply universally without requiring individual engagement, and [3] can counter commercial interests without depending on consumer self-restraint. Reframing gambling harm prevention through the i-/s-frame lens offers conceptual clarity, highlights the opportunity costs of an overreliance on individual-focused interventions, and exposes incentives that perpetuate the status quo. This paper explains why i-frame approaches have dominated to date and how we can make the shift towards the s-frame.</p><p><strong>Conclusions: </strong>Rather than abandoning i-frame approaches, research priorities should be rebalanced toward understanding, implementing, and evaluating systemic solutions. While i-frame interventions remain valuable for individuals seeking help, preventing population-level harms requires proportionate investment in structural solutions that make gambling products safer by design.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147830939","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":"Are people who use methamphetamine at increased risk of physical violence? Results from a nationally representative sample.","authors":"Christel Macdonald, Rebecca McKetin, Sergey Alexeev, Don Weatherburn","doi":"10.1111/add.70455","DOIUrl":"https://doi.org/10.1111/add.70455","url":null,"abstract":"<p><strong>Background and aims: </strong>The association between methamphetamine use and violent behaviour has received much attention in the research. The risk of violent victimisation among people who use methamphetamine is comparatively underexplored. People who use methamphetamine appear to be at a high risk of violent victimisation, but no studies have examined this association in a population-based representative survey. The aim of the current study was to examine the association between methamphetamine use and violent victimisation using a nationally representative sample of Australians.</p><p><strong>Design: </strong>Observational study.</p><p><strong>Setting: </strong>Australia.</p><p><strong>Participants: </strong>18 805 individuals aged 15 years or over.</p><p><strong>Measurements: </strong>Outcome variable: whether a respondent reported having been a victim of violence in the past 12 months. Exposure variable: frequency of methamphetamine use in the past 12 months (no use, every few months, monthly or more often). Co-variates: age, gender, financial stress, personal stress, long-term health condition, social isolation, cocaine use, drinking consumption, remoteness of area and survey year. Analyses were exploratory.</p><p><strong>Findings: </strong>1.27% of the sample reported violence victimisation in the past 12 months, and 1.33% reported methamphetamine use (0.71% every few months; 0.62% monthly or more often). After adjusting for covariates, the odds of being a victim of violence in the preceding 12 months were higher for those who used methamphetamine every few months [adjusted odds ratio (aOR) = 5.94; 95% confidence interval (CI) = 1.95-18.06], and once a month or more often (aOR = 9.04; 95% CI = 3.48-23.45) than for those who had not used methamphetamine in the past year. Predicted probabilities indicated an estimated 11 709 (95% CI = 9473-13 953) excess violent victimisations attributable to methamphetamine use.</p><p><strong>Conclusions: </strong>Methamphetamine use appears to be associated with an elevated risk of being a victim of violence. The population-level effects of methamphetamine use on violence may be small but are likely to have substantial public health implications in communities experiencing high levels of methamphetamine use.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147830935","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}