International Journal of Drug Policy最新文献

{"title":"Generative tension and social risk management surrounding sexualised drug use practice among men who have sex with men in highly stigmatised environments: A qualitative study from Jakarta, Indonesia","authors":"Laura Nevendorff ,&nbsp;Adam Bourne ,&nbsp;Mark Stoové ,&nbsp;Alisa Pedrana","doi":"10.1016/j.drugpo.2024.104683","DOIUrl":"10.1016/j.drugpo.2024.104683","url":null,"abstract":"<div><h3>Background</h3><div>Global policies emphasise the need for tailored interventions to reduce the harms of sexualised drug use (SDU) among men who have sex with men (MSM), including taking account of local risk environments and the influence of social norms, drug and sexual minority stigma, and cultural and political conditions. To help guide the production of local SDU harm reduction interventions, this study aimed to explore the social and structural conditions that shape the practice of, and response to, SDU by MSM in Jakarta, Indonesia.</div></div><div><h3>Methods</h3><div>Informed by an interactionism theoretical perspective and socioecological frameworks, a reflexive thematic approach was used to analyse in-depth qualitative interview data from 20 MSM who practised SDU in Jakarta. To recruit the participants, the study was promoted through local organisations providing HIV services for MSM, as well as snowball recruitment.</div></div><div><h3>Results</h3><div>To protect their SDU practice, MSM in Jakarta developed a set of social risk management strategies designed to reduce the generative tension between enabling and disabling forces caused by local social and structural environments. Enabling forces emerged primarily from within MSM networks, were extended through the interpersonal dynamics of sexual partner relationships to peer influence and reinforced by product branding and marketing on both offline and online platforms. The disabling forces, which were introduced primarily from outside the network, manifested in stigmatising social norms, politics and religious beliefs towards homosexuality and drug use, and forced MSM who practised SDU to relocate to virtual environments.</div></div><div><h3>Conclusion</h3><div>Programmatic responses seeking to mitigate the risks associated with SDU practice among sexual minority men should incorporate established mechanisms of peer networks and virtual spaces into their design to maximise reach and intervention acceptability and effectiveness.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"135 ","pages":"Article 104683"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“It always needs a higher level of care than what I can provide”: Practical, ethical, and administrative tensions arising from the integration of wound care services into syringe service programs in Maryland","authors":"Laura N. Sisson,&nbsp;Suzanne J. Block,&nbsp;Tricia Triece,&nbsp;Emily M. Martin,&nbsp;Jill Owczarzak,&nbsp;Susan G. Sherman,&nbsp;Kristin E. Schneider","doi":"10.1016/j.drugpo.2024.104685","DOIUrl":"10.1016/j.drugpo.2024.104685","url":null,"abstract":"<div><h3>Introduction</h3><div>The emergence of xylazine into the U.S. drug supply has increased demand for wound care services among people who inject drugs (PWID). Traditional health care settings have historically been ill-equipped to accommodate the complex needs of PWID and syringe service programs (SSPs) have created wound care services to fill the gap. In doing so, many SSPs are extending the scope of their services beyond health promotion into a quasi-medical space that is largely unregulated.</div></div><div><h3>Methods</h3><div>We conducted 10 qualitative interviews with staff employed by eight SSP programs across six counties in the state of Maryland to explore how they have navigated shifting demand for more intensive wound care services.</div></div><div><h3>Results</h3><div>Contested boundaries in training of non-medical staff, lack of clarity in SSP-based providers’ scope of practice, and conflicts in operational norms and standards between harm reduction and medical services are significant sources of tension that impact delivery of wound care services in SSP settings. In taking on responsibility to provide wound care services to PWID, SSPs take on significant administrative, practical, and ethical burden that increase vulnerability to medicolegal liability.</div></div><div><h3>Discussion</h3><div>There is a significant unmet need for increased resources, administrative support, and mentorship to guide the integration of medicalized wound care into SSP programs. Additionally, efforts to expand access to community-based wound care services for PWID should not replace efforts to promote timely access to services in more traditional healthcare settings.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"135 ","pages":"Article 104685"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol, affective atmospheres and structures of feeling in women at midlife","authors":"Kate Kersey ,&nbsp;Antonia C. Lyons","doi":"10.1016/j.drugpo.2024.104680","DOIUrl":"10.1016/j.drugpo.2024.104680","url":null,"abstract":"<div><h3>Introduction</h3><div>Women at midlife have increased rates of harmful drinking in many high-income countries. This cohort grew up within permissive alcohol environments that encouraged women's consumption, linking it to success, femininity, and empowerment. This research drew on notions of ‘structures of feeling’ and ‘affective atmospheres’ to explore how women at midlife describe and make sense of alcohol and drinking within their lives.</div></div><div><h3>Methods</h3><div>Eight friendship discussion groups and 17 individual interviews were conducted with 50 women (aged 35–59 years) in Aotearoa/New Zealand about alcohol and drinking. Transcripts were analysed using an affective-discursive approach.</div></div><div><h3>Findings</h3><div>Shaped by idealised femininities and alcohol's chemical affordances, particular affective atmospheres and feelings arose in women before, during, and after drinking, providing insights into women's experiences and sense-making around alcohol. Three areas of life were highly affectively charged in discussions, namely drinking that: 1) enabled bonding with partner, 2) facilitated time out from busy lives, and 3) was part of coping with life's difficulties.</div></div><div><h3>Discussion and conclusions</h3><div>Women at midlife experienced pressures to be economically and socially successful, to maintain slim bodies, and to have ‘appropriate’ feelings such as selflessness and gratitude. For women in this study, drinking alcohol was a way to achieve, and to cope with, expectations around idealised femininities and socially endorsed ways of living, being, and feeling. Repeated and routine affective experiences reinforced the role of alcohol in women's lives. Findings suggest the need for gender-transformative policies that address the structural environments of women's lives.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"135 ","pages":"Article 104680"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motivations for and perspectives of medication diversion among clients of a safer opioid supply program in Toronto, Canada","authors":"Lucas Martignetti ,&nbsp;Rod Knight ,&nbsp;Frishta Nafeh ,&nbsp;Kate Atkinson ,&nbsp;Gab Laurence ,&nbsp;Colin H Johnson ,&nbsp;Dan Werb ,&nbsp;Mohammad Karamouzian","doi":"10.1016/j.drugpo.2024.104665","DOIUrl":"10.1016/j.drugpo.2024.104665","url":null,"abstract":"<div><h3>Background</h3><div>Safer opioid supply programs in Canada have come under intense scrutiny related to the perceived risk of diversion of safer opioid supply medications. We sought to explore the experiences and perspectives of safer opioid supply medication diversion with clients of a safer opioid supply program in Toronto, Canada.</div></div><div><h3>Methods</h3><div>From December 2022 to August 2023, we conducted in-depth, semi-structured interviews with 25 adult clients of a safer opioid supply program in Toronto, Canada. We analyzed the data using deductive and inductive approaches via thematic analysis.</div></div><div><h3>Results</h3><div>Our analysis identified five themes regarding clients’ perceptions and experiences with safer opioid supply diversion: (i) Compassionate sharing with others to address withdrawal symptoms; (ii) Selling or sharing due to unmet medication or survival needs of program clients; (iii) High demand for safer alternatives to those that are available in unregulated drug markets; (iv) Price of safer opioid supply medications in the unregulated drug markets as a diversion deterrent; and (v) Coerced diversion through harassment or violence.</div></div><div><h3>Conclusions</h3><div>These findings document experiences of medication diversion and the multifaceted and complex interplay of various individual and contextual factors that motivate safer opioid supply clients to engage in it. Future policy and safer opioid supply practice should address root causes of diversion, particularly barriers to service access and the diverse medication needs of clients.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"135 ","pages":"Article 104665"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in e-cigarette exposures reported to an Australian poisons information centre between 2017 and 2023 with a reflection on legislative changes in 2021","authors":"Ruby K Dempsey ,&nbsp;Kamran Zia ,&nbsp;Rohan A Elliott ,&nbsp;Firouzeh Noghrehchi ,&nbsp;Anselm Wong","doi":"10.1016/j.drugpo.2024.104684","DOIUrl":"10.1016/j.drugpo.2024.104684","url":null,"abstract":"<div><h3>Background</h3><div>Australians’ use of e-cigarettes has increased dramatically in the last few years, following trends worldwide. The Australian Federal government introduced legislation on October 1st, 2021, which reclassified nicotine e-cigarettes as prescription only medicine in an attempt to curb their rapid uptake, especially amongst adolescents.</div></div><div><h3>Methods</h3><div>This is a retrospective analysis of e-cigarette exposure cases reported to the Victorian Poisons Information Centre between January 1st, 2017, and September 30th, 2023. The primary outcome was the trend in case number over the study period, analysed by breakpoint and interrupted time series analyses, as well as comparison of mean monthly calls in the 24 months before and after the introduction of the 2021 law. Secondary outcomes included shifts in route of exposure and severity pre- and post-legislation.</div></div><div><h3>Results</h3><div>There were 547 e-cigarette cases between January 2017 and September 2023. Most cases (n=454, 83%) were unintentional exposures, usually via inhalation (n = 271, 49.5%) or ingestion (n = 201, 36.8%). According to breakpoint analysis, the number of poisonings increased after March 2021 with rate ratio (RR) of 2.68 (95% CI 2.22, 3.68) and again increased after October 2021 (RR=1.66; 95% CI 1.43, 1.94). There were 103 e-cigarette exposure cases reported in the 24 months before the legislation was implemented in October 2021, and 358 in the following 24 months. The median monthly cases increased from 3 (IQR 2–4) to 15 (IQR 13–17), p &lt; 0.001. The largest increase was seen in toddlers (1 to 4 years age group) whose median monthly exposures increased from 1 (IQR 0–2) to 9 (IQR 8–11), p &lt; 0.001, but significant increases were also seen amongst infants, children and adults, p &lt; 0.001 for all. Ingestion as the route of exposure decreased proportionally from 53% (55 cases) to 23% (84 cases). Conversely, inhalation increased from 21% (22 cases) to 68% (245 cases). Severity was unchanged, except in adolescents who saw an increase from a poisoning severity score of “none” to “minor”.</div></div><div><h3>Conclusion</h3><div>The 2021 Australian federal legislation did not prevent increases in e-cigarette poisoning exposures in the context of their increased use, supporting the need for further regulation. Toddlers were identified as being particularly at-risk, suggesting educational campaigns for parents are warranted.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"135 ","pages":"Article 104684"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“When she's there, I no longer worry about her being arrested”—Family perspectives on compulsory drug rehabilitation in Vietnam and implications for community-based services","authors":"Nguyen Thu Trang ,&nbsp;Le Minh Giang ,&nbsp;Han Dinh Hoe ,&nbsp;Nguyen Huu Anh ,&nbsp;Dinh Thi Thanh Thuy ,&nbsp;Gavin Bart","doi":"10.1016/j.drugpo.2024.104681","DOIUrl":"10.1016/j.drugpo.2024.104681","url":null,"abstract":"<div><h3>Introduction</h3><div>Compulsory drug rehabilitation continues to be a major governmental response to illicit drug use in East and Southeast Asia despite repeated calls for its discontinuation. Extensive evidence from individuals with substance use disorders and advocacy groups highlights the adverse health, social and economic outcomes associated with compulsory drug rehabilitation. However, the perspective of families on this issue remains relatively unexplored.</div></div><div><h3>Method</h3><div>Between April 2020 and August 2022, we conducted in-depth interviews in three major cities in Vietnam with 20 family members of people who recently returned from or were about to leave compulsory drug rehabilitation centers. Interviews explored how compulsory rehabilitation met the needs of families, how effective families perceived compulsory rehabilitation was and what families’ needs or concerns that remained unmet.</div></div><div><h3>Results</h3><div>Compulsory drug rehabilitation centers, despite their recognized limitations, were perceived as the last resort for family members after multiple failed attempts to protect their loved ones from the consequences of drug use and to relieve themselves from constant drug-related stress. Family members considered the effectiveness of compulsory rehabilitation to be the short-term improvements in the health and mood that their loved ones exhibited while in the centers. However, families predominantly worried about the risk of relapse after release and employed three main strategies consisting of conditional support, employment and close monitoring to prevent it. The support available to families to support recovery at post-release was severely limited.</div></div><div><h3>Conclusion</h3><div>The study underscores the urgent need to alleviate the burden of drug use on families affected by substance use disorders. It is imperative to develop community-based and evidence-based rehabilitation options for PWUD and supportive services for their families.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"135 ","pages":"Article 104681"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wound-associated agents in the unregulated drug supply: Evidence from a statewide drug checking program","authors":"Emily M. Martin ,&nbsp;Kristin E. Schneider ,&nbsp;Edward Sisco ,&nbsp;Meghan G. Appley ,&nbsp;Margaret Rybak ,&nbsp;Rae Elkasabany ,&nbsp;Gregory M. Burnett ,&nbsp;Susan G. Sherman","doi":"10.1016/j.drugpo.2024.104677","DOIUrl":"10.1016/j.drugpo.2024.104677","url":null,"abstract":"<div><h3>Background</h3><div>While the unregulated drug market has seen dramatic increases in fentanyl adulteration in the past decade, other adulterants have impacted the recent volatility of the drug supply. There has been recent documentation related to the presence of wound-associated substances; however, there is a lack of data showing the prevalence of these substances across unregulated drug market samples over time. The aim of this paper is to examine known and potential wound-associated agents’ (xylazine, levamisole, medetomidine) prevalence in Maryland's unregulated drug supply.</div></div><div><h3>Methods</h3><div>Using data from Maryland's statewide drug checking program, Rapid Analysis of Drugs (RAD), this paper discusses samples that were voluntarily provided at participating syringe service programs and analyzed at the National Institute of Standards and Technology between October 2021 and October 2023 (N= 2,210). We calculated prevalence and chi-square significance to assess co-occurrence of wound-associated agents and other substances and evaluated xylazine's prevalence over time.</div></div><div><h3>Results</h3><div>Xylazine was detected in 33.4 % of samples and primarily co-occurred with fentanyl; heroin and related compounds; and other opioids, stimulants, and anesthetics. Xylazine's prevalence decreased over time and varied geographically. Levamisole and medetomidine occurred in 1.9 % and 0.7 % of samples respectively with no significant co-occurrence.</div></div><div><h3>Conclusion</h3><div>These findings emphasize the importance of statewide monitoring amid an evolving drug market, especially regarding wound-associated agents. Drug checking, safer supply, overdose prevention, and non-stigmatizing wound care services for people who use drugs are instrumental in mitigating the health consequences of the unregulated drug supply.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"135 ","pages":"Article 104677"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in young people accessing English alcohol treatment services: 2014 to 2023","authors":"Karen P. Hayhurst ,&nbsp;Sam Burnett ,&nbsp;Stefan Jahr ,&nbsp;Dylan Mangan ,&nbsp;Tim Millar ,&nbsp;Oliver Rigby ,&nbsp;Andrew Jones","doi":"10.1016/j.drugpo.2024.104663","DOIUrl":"10.1016/j.drugpo.2024.104663","url":null,"abstract":"<div><h3>Background</h3><div>Recent reports suggest that the prevalence of alcohol consumption has reduced among young people in England. We used whole population, English substance use treatment data to examine whether there has been a corresponding decrease in the number of young people accessing specialist alcohol treatment. We also examined the trend among young people with the highest levels of alcohol treatment need.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of all young people (&lt;18 years) entering specialist treatment for alcohol use in all publicly funded services in England between 1 April 2014 and 31 March 2023 (<em>N</em> = 40,119). Analysis of alcohol use severity used complete-case information on indicators of frequency and quantity of alcohol consumption (<em>n</em> = 37,801, 94 %). An examination of trends over time also used the cohort (<em>N</em> = 562,037) of adults (18+ years) entering alcohol treatment over the same period.</div></div><div><h3>Results</h3><div>There was a 42 % decline in the number of young people entering treatment for alcohol use in England (from 6522 to 3771 per annum). The proportion of the total alcohol treatment population accounted for by young people also decreased from 6.8 % to 4.1 % over the same period. A less steep decline of 24 % (from 508 to 388) was observed in the number of young people entering treatment with severe alcohol use.</div></div><div><h3>Conclusions</h3><div>Despite the overall reduction in the number of young people accessing alcohol treatment between 2014/15 and 2022/23, it will be necessary to monitor whether this decreasing trend continues, especially among those young people with the most severe alcohol treatment needs. Further research is required to determine to what extent this reduction in treatment numbers is due to reduced treatment capacity rather than changes in treatment need.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"135 ","pages":"Article 104663"},"PeriodicalIF":4.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective association of interventions for at-risk families with illicit drug use among young students in Taiwan","authors":"Yi-Nuo Lee ,&nbsp;Tan-Wen Hsieh ,&nbsp;An-Jou Chen ,&nbsp;Jen-Huoy Tsay ,&nbsp;Chuan-Yu Chen","doi":"10.1016/j.drugpo.2024.104653","DOIUrl":"10.1016/j.drugpo.2024.104653","url":null,"abstract":"<div><h3>Background</h3><div>Young people who use illicit drugs disproportionately experience multiple problems in individual, family, and school domains. With a focus on illicit drug-using middle schoolers, the present study aims to characterize intervention services for risk indicators and to examine the prospective associations with reinitiated use throughout adolescence.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 1605 adolescents was identified from the 2013 to 2016 national school-based indicated prevention program serving illicit drug-using students in Taiwan. Reinitiated use of illicit drugs was confirmed by the Drug Abuse Big Datasets comprising police arrest records. Information concerning the history of intervention services—attention deficit hyperactivity disorder (ADHD) treatment, intervention for at-risk families, and school dropout consultation—was ascertained from national administrative data. A cohort of young adolescents from the general population (<em>n</em> = 809,477) was sampled for comparison. The Cox proportional hazards model was used to evaluate the risk of drug use.</div></div><div><h3>Results</h3><div>Nearly 80 % of illicit drug-involved middle schoolers used ketamine only, and 17 % used amphetamine or methamphetamine. Over a four-year follow-up, 35 % of middle schoolers were re-reported for drug use, with police arrest being the major source. A history of ADHD treatment was not linked with illicit drug use, whereas dropping out in early schooling can elevate middle schoolers’ hazard by 46 %. Notably, receiving services targeting at-risk families in late childhood can lower the hazard by 43 %, with the reduction even greater when non-school-attending adolescents were included.</div></div><div><h3>Discussion</h3><div>To reduce progression into advanced drug involvement and substance use disorders, an integrated model of school-based interventions is urgently needed.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"135 ","pages":"Article 104653"},"PeriodicalIF":4.4,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of smokeless tobacco (SLT) excise taxes on SLT use among youth","authors":"Yanyun He ,&nbsp;Hojin Park ,&nbsp;Kai-Wen Cheng ,&nbsp;Qian Yang ,&nbsp;Zezhong Zhang ,&nbsp;Ce Shang","doi":"10.1016/j.drugpo.2024.104664","DOIUrl":"10.1016/j.drugpo.2024.104664","url":null,"abstract":"<div><h3>Background</h3><div>Smokeless Tobacco (SLT) use prevalence among youth in the United States (US) is comparable to youth prevalence of cigarette smoking. However, it is in general understudied compared to cigarettes and draws less attention nowadays compared to e-cigarettes (ECs).</div></div><div><h3>Aim</h3><div>We estimate the own- and cross-tax elasticities of SLT use among US youth and explicitly test how SLT use changes in response to taxes on SLT, cigarettes, ECs, and beer.</div></div><div><h3>Methods</h3><div>We standardized SLT taxes for chewing tobacco, moist snuff, dry snuff, and snus, and computed average SLT taxes. We implemented a logit regression model within the state- and year-fixed effects framework.</div></div><div><h3>Results</h3><div>A 10 % increase in SLT excise taxes reduced youth SLT use by 4 % (<em>p</em> &lt; 0.01). This result is primarily driven by males, Whites, multiple non-Hispanic races, other races, and individuals living in non-Appalachian states. In addition, a 10 % increase in cigarette taxes increases youth SLT use by 8 % (<em>p</em> &lt; 0.05), suggesting substitutional effects. A 10 % increase in EC and beer taxes reduce SLT use by 0.5 % and 2.4 % (<em>p</em> &lt; 0.01), respectively, suggesting complementary effects.</div></div><div><h3>Conclusion</h3><div>Raising excise taxes on SLT products can effectively curtail their usage among the youth population. Furthermore, increasing EC and beer taxes reduces youth SLT use. However, an increase in cigarette taxes leads to an unintended consequence of promoting SLT use among youth. In addition, increasing SLT taxes does not appear to significantly impact the disparities in youth SLT use by whether living in Appalachian states. Future research is needed to assess whether SLT taxes reduce disparities in use by rural/urban divisions.</div></div>","PeriodicalId":48364,"journal":{"name":"International Journal of Drug Policy","volume":"135 ","pages":"Article 104664"},"PeriodicalIF":4.4,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}