Substance use & addiction journal最新文献

{"title":"A Hospital-Based Intervention to Improve Access to Buprenorphine for Patients with Opioid Use Disorder.","authors":"Matthew Fine, Leeza Hirt Wilner, Cameron K Ormiston, Linda Wang, Trevor G Lee, Michael Herscher","doi":"10.1177/29767342241292416","DOIUrl":"https://doi.org/10.1177/29767342241292416","url":null,"abstract":"<p><strong>Background: </strong>Opioid use disorder (OUD) is often under-addressed in hospitalized patients. In the absence of formal addiction consult services, volunteer physician-led models can increase access to inpatient OUD treatment. This paper describes a novel, volunteer physician-led interprofessional approach to identifying patients with OUD, initiating buprenorphine, and linking to office-based opioid treatment.</p><p><strong>Methods: </strong>The intervention took place from April 2018 to August 2020 at a large, urban, tertiary care center and teaching hospital in New York, NY that does not have an addiction consult service. Hospitalized patients with OUD were identified by provider-driven referrals or an automated daily patient list generated by a bioinformatics search algorithm. Eligible patients with OUD were started on buprenorphine during their hospitalization and linked to primary care-based buprenorphine treatment. Patients were followed longitudinally via chart review to assess follow-up clinic rates at >30 days, >60 days, >90 days, >6 months, >12 months, and >24 months after discharge.</p><p><strong>Results: </strong>Over a 2-year period, 178 patients were evaluated, 88 were eligible for inpatient buprenorphine, and 47 were started on buprenorphine while hospitalized. Sixty-seven patients were referred to a post-discharge visit at a primary care practice, 29 (43%) of whom attended an appointment at least 30 days after discharge. Of these, 22 (76%) returned at >60 days and 20 (69%) at 6 months. At the 1-year time point, 16 of a possible 17 patients (94%) and 15 of a possible 16 patients (94%) were still engaged in care at 2 years.</p><p><strong>Conclusion: </strong>This intervention represents a proof of principle, adaptable model for identifying patients with OUD and engaging patients in primary care-based buprenorphine treatment. Limitations to consider include the sustainability of a volunteer-based initiative and that retention rates for 1 to 2 years post-discharge may be more indicative of the strengths of office-based opioid treatment itself as opposed to in-hospital engagement and the intervention.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice Changes 6 Months Following a Physical Therapist Training Program Regarding Opioid Use and Misuse Screening and Assessment: A Qualitative Study.","authors":"John Magel, Elizabeth Siantz, Priscilla Blosser, Julie M Fritz, Paul Hartman, Jason M Beneciuk, Adam J Gordon","doi":"10.1177/29767342241292259","DOIUrl":"https://doi.org/10.1177/29767342241292259","url":null,"abstract":"<p><strong>Background: </strong>The U.S. Preventive Services Task Force recommends that all healthcare providers be trained to screen for misuse and/or opioid use disorder. An opioid misuse training program for physical therapists was developed and implemented. The purposes of this research were to (1) understand whether the participants found the training useful, (2) understand if they instituted practice changes that resulted from the training, and (3) understand barriers to implementing the skills learned in the training.</p><p><strong>Methods: </strong>Four separate 30-minute virtual training sessions were provided (1 session every 2 weeks). The topics included an introduction to the opioid crisis, screening, assessing, and communicating with patients and with the healthcare team about opioid misuse. A final training manual was distributed after the final training session at which time participants were asked to implement what they learned in the training. Semi-structured interviews were conducted with all training program participants (n = 13) approximately 6 months after the final training session. Rapid content analysis was used to understand the perceptions of and barriers to implementing what the physical therapists learned in the training.</p><p><strong>Results: </strong>Generally, the participants found the training important and useful and strengthened their perceptions of physical therapists' role in screening for opioid misuse. Compared to the opioid misuse-related content of the training, most found it easier to implement general opioid-related content such as asking whether their patients were taking an opioid. Few participants screened any of their patients for opioid misuse. Barriers to implementation included concerns about how the patient might respond to being asked about their opioid use.</p><p><strong>Conclusion: </strong>These findings provide insight into physical therapists' perceptions of an opioid misuse training program and the challenges with implementing what they learned in the program. Future training could incorporate activities such as role-playing to improve participants' comfort with screening for opioid misuse.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One Third of Alcohol Use Disorder Diagnoses are Missed by ICD Coding.","authors":"Laura Mercurio, Augusto Garcia, Stephanie Ruest, Susan J Duffy, Carsten Eickhoff","doi":"10.1177/29767342241288112","DOIUrl":"https://doi.org/10.1177/29767342241288112","url":null,"abstract":"<p><strong>Background/significance: </strong>Alcohol use carries significant morbidity and mortality, yet accurate identification of alcohol use disorder (AUD) remains a multi-layered problem for both researchers and clinicians.</p><p><strong>Objective: </strong>To fine-tune a language model to AUD in the clinical narrative and to detect AUDs not accounted for by ICD-9 coding in the MIMIC-III database.</p><p><strong>Materials and methods: </strong>We applied clinicalBERT to unique patient discharge summaries. For classification, patients were divided into nonoverlapping groups stratified by the presence/absence of AUD ICD diagnosis for model training (80%), validation (10%), and testing (10%). For detection, the model was trained (80%) and validated (20%) on 1:1 positive/negative patients, then applied to remaining negative patient population. Physicians adjudicated 600 samples from the full model confidence spectrum to confirm AUD by Diagnostic and Statistical Manual of Mental Disorders-V criteria.</p><p><strong>Results: </strong>The model exhibited the following characteristics (mean, standard deviation): precision (0.9, 0.02), recall (0.65, 0.03), F-1 (0.75, 0.02), area under the receiver operating curve (0.97, 0.01), and area under the precision-recall curve (0.86, 0.01). Adjudication produced an estimated 4% under-documentation rate for the total study population. As model confidence increased, AUD under-documentation rate rose to 30% of the number of patients identified as positive by ICD-9 coding.</p><p><strong>Conclusion: </strong>Our model improves the identification of patients meeting AUD criteria, outperforming ICD codes in detecting cases of AUD. Detection discrepancy between ICD and free-text highlights clinician <i>under documentation</i>, not under recognition. Adjudication revealed model over-sensitivity to language around substance use, withdrawal, and chronic liver disease; future study requires application to a broader set of patient age and acuity. This model has the potential to improve rapid identification of patients with AUD and enhance treatment allocation.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Impact of Suspected Xylazine-Associated Skin Wounds Among People Using Fentanyl, Philadelphia, 2022 to 2023.","authors":"Patrick J A Kelly, Amy B Jessop, Madison Scialanca, Katie Singley, Caseem C Luck, Ariel Hoadley, Jessica Meisner, Sarah B Bass","doi":"10.1177/29767342241289797","DOIUrl":"https://doi.org/10.1177/29767342241289797","url":null,"abstract":"<p><strong>Background: </strong>The United States opioid crisis has been worsened by the emergence of fentanyl adulterated or associated with the veterinary sedative xylazine. Designated by the White House as an \"emerging threat to the US\" in 2023, xylazine use is associated with severe skin wounds.</p><p><strong>Methods: </strong>This research explored beliefs, concerns, and treatment behaviors for skin wounds among 93 participants recruited outside of a Philadelphia, Pennsylvania harm reduction agency who reported past-6-month history of a skin wound via a cross-sectional survey administered August-September 2022 (group 1; <i>n</i> = 33). Following a December 2022 Philadelphia Department of Public Health Report that indicated xylazine was becoming more prevalent in the Philadelphian drug supply, additional data was collected with new participants from February-March 2023 (group 2; <i>n</i> = 60) using the same survey. Participants were ≥18 years old, reported past-year fentanyl use, and spoke English. Our 17-item tool measured skin wound-related beliefs, concerns, treatment behaviors, and treatment sources. An open-response item explored why participants self-treat skin wounds.</p><p><strong>Results: </strong>Participants averaged 41 years old (SD = 9), slightly more than half were men (<i>n</i> = 54, 58%), 31% (<i>n</i> = 29) were non-White, and most (<i>n</i> = 66, 71%) were unhoused. Overall, 79% of participants self-treated skin wounds. Participants endorsed worry about limb loss (<i>n</i> = 77; 83%), wound shame (<i>n</i> = 76; 82%), and appearance changes (<i>n</i> = 80; 86%). Sixty participants (65%) reported waiting to see wound severity before seeking care. Forty-one participants (44%) delayed wound care because of withdrawal fears.</p><p><strong>Conclusions: </strong>People with probable xylazine-associated skin wounds have psychosocial concerns about and self-treat these wounds. Findings may be a harbinger of skin wound harm in other regions of the United States and internationally where xylazine is increasing.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Naloxone Distribution Models in the United States: A Scoping Review.","authors":"Nina Vadiei, David R Axon, Becka Eckert","doi":"10.1177/29767342241289008","DOIUrl":"https://doi.org/10.1177/29767342241289008","url":null,"abstract":"<p><strong>Background: </strong>Increasing naloxone distribution is a high priority means to mitigating opioid overdose rates in the United States. Since a variety of naloxone distribution models exist, with differences in infrastructure and funding between states and health-systems, it is important to review their differences and understand the strengths and barriers to widespread implementation of each model.</p><p><strong>Methods: </strong>The following 4 databases were searched for articles reporting on naloxone distribution models: (1) PubMed/Medline (National Library of Medicine), (2) Embase (Elsevier), (3) Scopus (Elsevier), and (4) the Cochrane library. Reports from all years written in English that discussed naloxone distribution models in the United States were included, as were all study designs.</p><p><strong>Results: </strong>Of 5825 articles initially identified, 173 were selected for full text review. Of these, 49 met full criteria and were included for data extraction and analysis. Most distribution models occurred in community-based opioid education and naloxone distribution programs and in community pharmacies via a standing order/statewide protocol. Most programs reported strengths related to feasibility, but frequently reported cost as a limitation. Fewer studies described distribution models in ambulatory care or hospital settings, though these studies also highlighted strengths related to feasibility, particularly with support from working partners, and when utilizing an interprofessional care approach. Few studies reported health/economic outcomes data associated with naloxone distribution, such as changes in the number of patient/layperson access, the number of opioid overdose reversals, or cost-savings.</p><p><strong>Conclusions: </strong>This review outlines the many ways in which naloxone is distributed in the United States and emphasizes a need for improved outcomes data collecting/reporting in the various settings where naloxone is distributed. This would allow for future studies to evaluate which distribution model factors are associated with improvements in health outcomes, such as increased layperson access, and lower opioid overdose/mortality rates.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lookout Project: A Student-Run Mail-Based Overdose Response Kit Distribution Program Through Social Media During COVID-19.","authors":"Shelby A Shaughnessy, Katherine C Hankes, Victoria Garrow, John A Hopper, Chin Hwa Dahlem","doi":"10.1177/29767342241288985","DOIUrl":"https://doi.org/10.1177/29767342241288985","url":null,"abstract":"<p><strong>Background: </strong>Naloxone distribution and overdose education are key preventive strategies to reduce opioid overdose deaths. This paper describes the development and evaluation of The Lookout Project (TLP), a 501(c)(3) organization led by college students and based in Ann Arbor, Michigan. This research aimed to examine the outreach of TLP with hopes of creating a reproducible mail-based kit distribution program for college student-run organizations to replicate.</p><p><strong>Methods: </strong>TLP used a targeted social media advertising campaign to ask participants 7 multiple-choice questions concerning their demographics, previous incarcerations, experiences with intranasal naloxone (IN), and if they had watched the optional informational video in the opioid overdose response kit (OORK) order form.</p><p><strong>Results: </strong>TLP's team distributed over 900 OORKs from August 3, 2020, to January 4, 2022, first by word of mouth and then through social media advertising that began on February 13, 2021. Of the 657 respondents who agreed to participate in research, the majority identified as white (76.0%, n = 400), did not identify with any specified ethnicity group (60.2%, n = 318), were female (60.8%, n = 356), were between the ages of 18 and 22 (35.4%, n = 209), had not been previously incarcerated (95.6%, n = 564), and did watch the hyperlinked video detailing how to respond to an overdose (74.7%, n = 438). Additionally, several kit recipients (2.8%, n = 19) responded to a follow-up survey. Of those, 7 people reported using the IN provided by TLP to reverse an overdose (36.8%, n = 7).</p><p><strong>Conclusion: </strong>TLP, a nonprofit organization founded by college students, shows potential for informing other student-run organizations about naloxone distribution programs using social media advertising.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redesigning a Stopped Clinical Trial as an Emulated Trial Using Real-World Data to Explore the Effectiveness of Slow-Release Oral Morphine as a Treatment for Opioid Use Disorder.","authors":"Rohan Anand, Stephanie Penta, Zishan Cui, Nadia Fairbairn, M Eugenia Socias","doi":"10.1177/29767342241279167","DOIUrl":"https://doi.org/10.1177/29767342241279167","url":null,"abstract":"<p><p>Canada is currently experiencing a problematic opioid crisis with increasing mortality rates. Traditional randomized controlled trials (RCTs) that examine the effectiveness of pharmacological treatment options for people with opioid use disorder (OUD) are challenging to conduct. An increasingly popular methodology is through the implementation of emulated clinical trials, a methodology in which key elements of a \"target\" RCT are replicated using previously collected healthcare-based data. They can possibly address some of the common challenges found in the conduct of RCTs, such as prolonged timelines, high cost, and poor participant recruitment. In effect, emulated trials accelerate knowledge generation by producing real-world evidence that can be akin to phase 3 effectiveness trials, without any need to recruit live participants or administer investigational products. During the COVID-19 pandemic, several trials were stopped due to increased pandemic-related research restrictions, leaving important questions about OUD treatment unanswered. In this commentary, we describe the transition of a traditional RCT to an emulated trial spurred by challenges posed by the COVID-19 pandemic. We describe our transition using a notable published framework with regards to the population sample, interventions, outcomes, and proposed analyses. This commentary aims to help other researchers and trialists apply emulated trials in substance use research and beyond, emphasizing the role of this methodology in clinical research and advancing scientific knowledge that could be otherwise lost or unattainable.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Racial Concordance for Black Patients in Addiction Treatment: A Scoping Review of the Literature.","authors":"Corinne A Beaugard, Natrina L Johnson, Daneiris Heredia-Perez, Sheila E Chapman, Avik Chatterjee, Christina S Lee, Craig McClay, Phillip Reason, Dana Thomas, Tayla Weeden, Amy M Yule, Kaku So-Armah, Miriam Komaromy","doi":"10.1177/29767342241276948","DOIUrl":"https://doi.org/10.1177/29767342241276948","url":null,"abstract":"<p><strong>Background: </strong>In the United States, Black people with substance use disorders (SUDs) have less access to treatment and worse treatment outcomes compared to White people. Though systemic racism is the root of these inequities, adapting treatment settings to serve this population may be a pragmatic way to improve access and outcomes. Shared racial identity between a patient and a provider, or <i>racial concordance</i>, is one feature of culturally tailored care that may improve treatment access, experiences, and outcomes for Black people. There is some evidence that racial concordance improves medical treatment for Black patients in non-addiction settings, but it is unknown whether racial concordance affects experiences or outcomes in addiction treatment.</p><p><strong>Methods: </strong>We conducted a scoping review guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-to understand the effect of racial concordance on Black patients in addiction treatment. Three reviewers read each title and abstract to identify eligible articles. The inclusion criteria were: (1) Black patients; (2) treatment access, experiences, or outcomes; and (3) patient-provider racial concordance in addiction treatment. One reviewer completed full-text reviews and data extraction.</p><p><strong>Results: </strong>We identified 259 nonduplicate articles and completed full-text reviews of 77 articles. Eleven articles, published between 1971 and 2016, met criteria. Racial concordance was not associated with treatment access or engagement, though it was associated with some positive outcomes including increased perceived provider empathy. Few studies met the review criteria and there were no randomized controlled trials.</p><p><strong>Conclusions: </strong>The studies identified in this review did not provide adequate evidence that racial concordance improved treatment access, experiences, or outcomes for Black patients. Future research should include a wider range of outcome measures, including relational measures (eg, medical trust, discrimination) and examine whether and under what circumstances racial concordance improves experiences and outcomes for Black patients in addiction treatment.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Community Corrections and Treatment Experience: A Qualitative Study Among People With Incarceration Histories Receiving Outpatient Methadone Treatment.","authors":"Marina Gaeta Gazzola, Lindsay M S Oberleitner, Kim Hoffman, Anthony Eller, Lynn M Madden, Ruthanne Marcus, David Oberleitner, Mark Beitel, Emma Thompson, Xiaoying Zheng, Declan T Barry","doi":"10.1177/29767342241238837","DOIUrl":"10.1177/29767342241238837","url":null,"abstract":"<p><strong>Background: </strong>Community correctional experiences among individuals receiving methadone treatment (MT) for opioid use disorder (OUD) are poorly understood. We qualitatively investigated perceptions of community corrections and treatment experiences among individuals with criminal-legal system experience currently receiving outpatient MT.</p><p><strong>Methods: </strong>From January to December 2017, we recruited 42 individuals with history of criminal-legal system involvement enrolled in outpatient MT at a low-barrier nonprofit organization operating multiple clinics in Connecticut. An experienced qualitative research team conducted one-to-one, in-person, semistructured interviews about incarceration and treatment experiences with individuals receiving MT. Participants completed a demographics survey. The interviews were audiorecorded, transcribed, de-identified, and independently coded using NVivo.</p><p><strong>Results: </strong>Participants described the community corrections system as restrictive and abstinence-focused. Most participants described positive perceptions of and experiences with community corrections officers (CCOs), yet described negative perceptions of and experiences with the community corrections system overall. Participants perceived CCOs to have limited knowledge of OUD and MT. Participants described a range of CCO judgment toward their OUD, with some appearing understanding and nonjudgmental while others were perceived to have stigma and prejudice. Few participants noted assistance from CCOs with seeking MT or community-based substance use disorder care. Some participants desired improved treatment facilitation, but viewed forced or coercive treatment negatively.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first qualitative study to examine community corrections experience among people receiving outpatient medication for OUD. While individuals receiving MT have negative experiences with the community corrections system, they perceive individual CCOs positively. Interventions addressing gaps in CCOs knowledge of OUD and MT are needed to optimize support for individuals on probation or parole with OUD. Provision of OUD treatment facilitation appears desirable to some individuals in community supervision.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and Determinants of Exclusive Smokeless Tobacco (Snus) Use, Exclusive Smoking and Dual Use in General Population During 20 Years.","authors":"Otto Ruokolainen, Hanna Ollila, Tommi Härkänen","doi":"10.1177/29767342241255816","DOIUrl":"10.1177/29767342241255816","url":null,"abstract":"<p><strong>Background: </strong>We investigate smokeless tobacco (snus) use and its correlates over 20 years in a country where selling snus is prohibited but a large import quota and illicit market exists.</p><p><strong>Methods: </strong>Repeated cross-sectional population-based surveys during 2000 to 2020 in Finland, including N = 57 111 adults aged 20 to 64 years. The outcome measures were current tobacco use (exclusive snus use, dual use, exclusive smoking, no tobacco use) and snus use (daily, occasional, no snus use). Study years, gender, age, education, marital status, self-rated health, body mass index, and binge drinking were used as explanatory variables.</p><p><strong>Results: </strong>Exclusive snus use and dual use increased 3.6% units and 2.6% units from 2000 to 2005 and from 2018 to 2020, respectively. Overall decrease of tobacco use was led by decreasing exclusive smoking from 30.1% to 18.2%. The shared risk factors for snus use and dual use were male gender, age group 20 to 34 years, and binge drinking. The increases in snus and dual use over time were also most prevalent among these groups. Among men, occasional smoking increased the likelihood of daily (relative risk ratio [RRR] 2.38, 95% confidence interval [CI] 1.42, 3.99) and occasional (RRR 3.11, 95% CI 1.93, 5.03) snus use.</p><p><strong>Conclusions: </strong>Snus use has increased among the general adult population in Finland during 2000 to 2020 yet remains less common than smoking. Snus use and dual use share some common risk factors. Snus use should be considered in cessation services, with support for quitting developed and targeted predominantly for men, younger adults, and persons drinking to intoxication.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}