Addictive behaviors最新文献

{"title":"Sleep quality and duration as predictors of alcohol and cannabis use motives in daily life","authors":"Katie R. Moskal ,&nbsp;Mary Beth Miller ,&nbsp;Sydney D. Shoemaker ,&nbsp;Timothy J. Trull ,&nbsp;Andrea M. Wycoff","doi":"10.1016/j.addbeh.2024.108237","DOIUrl":"10.1016/j.addbeh.2024.108237","url":null,"abstract":"<div><h3>Objective</h3><div>Alcohol and cannabis are two of the most widely used substances in the United States, where sleep problems are also prominent. Although poor sleep is linked to substance use, little is known about how prior-night sleep contributes to next-day decisions to use substances in daily life. This study tested the impact of prior-night sleep duration and quality on momentary motives for alcohol (Aim 1) and cannabis use (Aim 2).</div></div><div><h3>Methods</h3><div>Adults reporting simultaneous use of alcohol and cannabis at least twice per week (<em>N</em> = 88; 60 % female, 85 % White, <em>M</em>age = 25.22) completed 14 days of ecological momentary assessment with 5 + surveys per day. Morning surveys assessed prior-night sleep duration and quality, and all surveys assessed alcohol and cannabis use and motives for use. Multilevel models tested each aim.</div></div><div><h3>Results</h3><div>For Aim 1, at the within-person level, longer prior-night sleep duration was associated with greater endorsement of depression-coping motives for alcohol, but only among those reporting relatively high levels of depression at baseline. Better prior-night sleep quality was associated with greater enhancement drinking motives the next day. For Aim 2, at the within-person level, longer prior night sleep duration was associated with lower enhancement motives for cannabis use.</div></div><div><h3>Conclusion</h3><div>Enhancement motives for alcohol and cannabis use change as a function of day-to-day changes in sleep duration and quality. Findings highlight the idea that treatment for sleep disturbance could influence substance use motives, perhaps thereby reducing subsequent use and related consequences.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"163 ","pages":"Article 108237"},"PeriodicalIF":3.7,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973739","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":"Serious harm reduction protective behavioral strategies reduce consequences associated with alcohol-induced blackouts in college students","authors":"Veronica L. Richards ,&nbsp;Robert J. Turrisi ,&nbsp;Shannon D. Glenn ,&nbsp;Kimberly A. Mallett ,&nbsp;Alyssa Altstaedter ,&nbsp;Sarah Ackerman ,&nbsp;Michael A. Russell","doi":"10.1016/j.addbeh.2024.108234","DOIUrl":"10.1016/j.addbeh.2024.108234","url":null,"abstract":"<div><h3>Objective</h3><div>Alcohol-induced blackouts (AIBs) have been associated with increased alcohol-related consequences. Serious harm reduction (SHR) protective behavioral strategies may reduce consequences when students are drinking heavily. We examined whether SHR weakened the relationship between AIBs and a) total consequences and b) serious consequences (e.g., sexual assault) only.</div></div><div><h3>Methods</h3><div>Students were eligible if they were aged 18–22  years, in their second or third year of college, reported drinking 4 + drinks on a typical Friday or Saturday, experienced ≥ 1 AIB in the past semester, owned an iPhone, and were willing to wear a sensor for 3  days each weekend. Students (<em>N</em> = 79, 55.7 % female, 86.1 % White, <em>M</em>age = 20.1) wore sensors and completed daily diaries over four consecutive weekends (852 total surveys; 89.9 % completion rate). Linear multilevel models were conducted to test for moderating effects of SHR.</div></div><div><h3>Results</h3><div>SHR weakened the association between AIBs and total consequences. At low (−1 <em>SD</em>) SHR, days with an AIB had an additional 1.46 consequences compared to days without an AIB, on average. At high (+1 <em>SD</em>) SHR, days with an AIB had an additional 0.94 consequences compared to days without an AIB, on average. SHR did not change the association between AIBs and serious consequences.</div></div><div><h3>Conclusions</h3><div>Students experienced approximately 50% more consequences on nights when they had an AIB and used below average numbers of SHR compared to nights when they had an AIB and used above average numbers of SHR. These findings suggest that student drinking interventions should include SHR to reduce harm associated with drinking and AIBs.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"162 ","pages":"Article 108234"},"PeriodicalIF":3.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878950","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":"Gambling motives and problem gambling: Exploring psychological moderators in the pathways model","authors":"S.E. Dias ,&nbsp;S.S. Merkouris ,&nbsp;S.N. Rodda ,&nbsp;N.A. Dowling","doi":"10.1016/j.addbeh.2024.108235","DOIUrl":"10.1016/j.addbeh.2024.108235","url":null,"abstract":"<div><h3>Background</h3><div>Relationships between gambling motives and problem gambling have been identified in previous research. There is, however, evidence of moderate-to-high heterogeneity in these associations, suggesting that further research is required to elucidate which gamblers are more susceptible to the influence of different types of motives. This study aims to (1) explore the relationship between gambling motives (Gambling Motives Questionnaire-Financial coping, enhancement, social, financial) and problem gambling (Problem Gambling Severity Index); and (2) investigate the degree to which psychological variables implicated by the pathways model (positive reinforcement high-risk situations, negative reinforcement high-risk situations, psychological distress, emotional dysregulation, distress intolerance and impulsivity) moderate these relationships.</div></div><div><h3>Methods</h3><div>A convenience sample of 342 past-month gamblers (<em>M</em> = 29.09, <em>SD</em> = 10.39), who were mostly classified with low-risk, moderate-risk or problem gambling (90.14 %), completed an online survey including an assessment of gambling motives, problem gambling, and these psychological variables.</div></div><div><h3>Results</h3><div>All gambling motives positively predicted problem gambling (OR = 1.18–1.59, <em>p</em> &lt; 0.001). In the moderation analyses, significant interaction effects were found between coping motives and lack of clarity (emotional clarity) (OR = 1.05, <em>p =</em> 0.024), all motives and distress tolerance (OR = 0.95–0.96, <em>p=&lt;</em> 0.001–0.006), and enhancement motives and positive urgency (OR = 1.03, <em>p =</em> 0.020).</div></div><div><h3>Conclusions</h3><div>This is the first known study to use psychological variables explicated by the pathways model to moderate the relationship between gambling motives and problem gambling, with a view to explaining some of the heterogeneity in these relationships. The identification of significant interactions has clinical implications for the development of targeted prevention and intervention programs.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"162 ","pages":"Article 108235"},"PeriodicalIF":3.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873058","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":"The roles of coping style and social support in the experience of harm and distress among people affected by another person’s gambling","authors":"Catherine Tulloch ,&nbsp;Matthew Browne ,&nbsp;Matthew Rockloff ,&nbsp;Nerilee Hing ,&nbsp;Margo Hilbrecht","doi":"10.1016/j.addbeh.2024.108236","DOIUrl":"10.1016/j.addbeh.2024.108236","url":null,"abstract":"<div><h3>Background</h3><div>Gambling-related harms can negatively impact the health and wellbeing of those around the person who gambles (affected others, AOs). The stress–strain-coping-support (SSCS) model proposes that the type of coping strategies AOs use, and the availability of social support, can effectively reduce some of these negative consequences. The current study aimed to explore the assumptions in the SSCS model by examining the role of coping styles and social support on the experience of harm and psychological distress in AOs.</div></div><div><h3>Method</h3><div>A community sample (N = 1,131) of AOs completed the Problem Gambling Severity Index (PGSI), Gambling Harm Scale for Affected Others (GHS-AO-20; harm), Significant Other Closeness Scale, Kessler-6 (K6; psychological distress), Brief Coping Questionnaire (coping styles) and the Multidimensional Scale of Perceived Social Support (social support). Data were analysed using hierarchical multiple regression.</div></div><div><h3>Results</h3><div>The use of maladaptive coping styles was positively associated with harm and psychological distress. Social support was significantly negatively correlated with harm and distress. When all predictors were included in regression analyses, the only significant predictors of harm and distress were being exposed to a more severe gambling problem, being closer to the person with the gambling problem, greater use of maladaptive coping styles, and lower levels of social support. Some interaction effects were identified.</div></div><div><h3>Conclusions</h3><div>Some commonly used coping behaviours may inadvertently exacerbate harm and distress, while social support appears to be protective against negative health impacts. Education, treatment, and support to AOs could provide options that address these findings.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"162 ","pages":"Article 108236"},"PeriodicalIF":3.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873214","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":"Day-level associations among alcohol use, simultaneous alcohol and cannabis use, and both regretted and positive romantic/sexual experiences","authors":"Gabriela López ,&nbsp;Holly K. Boyle ,&nbsp;Michelle Haikalis ,&nbsp;Mary Beth Miller ,&nbsp;Kristina M. Jackson ,&nbsp;Kate B. Carey ,&nbsp;Jennifer E. Merrill","doi":"10.1016/j.addbeh.2024.108232","DOIUrl":"10.1016/j.addbeh.2024.108232","url":null,"abstract":"<div><h3>Background</h3><div>Young adults who drink heavily, including those who simultaneously use cannabis, experience both positive and regretted romantic/sexual experiences. Both gender and past sexual assault severity may also play a role in the valence of romantic/sexual experiences. The current study focuses on day-level correlates of romantic/sexual experiences, assessing whether: (1) number of drinks or simultaneous alcohol and cannabis use (vs. alcohol only) are associated with likelihood of regretted or positive romantic/sexual experiences and (2) past sexual assault severity or gender moderate these associations.</div></div><div><h3>Methods</h3><div>Two hundred and one young adults (M_age = 22.06) reporting high intensity drinking (8+/10+ drinks for females/males) completed baseline and 28 daily assessments of alcohol use, simultaneous use, and romantic/sexual experiences.</div></div><div><h3>Results</h3><div>Consumption of more drinks increased likelihood of both positive and regretted romantic/sexual experiences. Simultaneous alcohol and cannabis use had no effect on positive romantic/sexual experiences. There was a significant interaction between simultaneous use and gender in the prediction of a regretted romantic/sexual experience when controlling for number of drinks. Among women, simultaneous use (vs. alcohol only) significantly <em>decreased</em> likelihood of regretted romantic/sexual experiences. Among men, simultaneous use was unrelated to likelihood of regretted romantic/sexual experiences. Past sexual assault was not a significant moderator of effects of either number of drinks or simultaneous use.</div></div><div><h3>Conclusions</h3><div>Among heavy-drinking young adults, a greater number of drinks is associated with both more regretted and positive romantic/sexual experiences. Findings highlight a unique protective effect of simultaneous use for women, even when controlling for how much alcohol is being consumed.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"162 ","pages":"Article 108232"},"PeriodicalIF":3.7,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873648","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":"Momentary predictors of tobacco lapse among African Americans during a quit attempt","authors":"Lindsey N. Potter ,&nbsp;Dusti R. Jones ,&nbsp;Chelsey R. Schlechter ,&nbsp;Cho Y. Lam ,&nbsp;Inbal Nahum-Shani ,&nbsp;Christopher P. Fagundes ,&nbsp;David W. Wetter","doi":"10.1016/j.addbeh.2024.108231","DOIUrl":"10.1016/j.addbeh.2024.108231","url":null,"abstract":"<div><h3>Background and Aims</h3><div>African American smokers are less likely to successfully quit and experience a greater burden of tobacco-related health outcomes than White individuals. There is a profound need to understand factors that impact tobacco cessation among African Americans who are undergoing a quit attempt. This study aimed to examine the within- and between-person associations of risk factors (motivation, self-efficacy, urge, positive affect, negative affect, smoking expectancies, and cigarette availability) with lapse.</div></div><div><h3>Design and Setting</h3><div>Observational study in the Houston, TX area that used ecological momentary assessment (EMA) to collect data for 10 days following a smoking quit attempt. Multilevel modeling was used to test associations between risk factors and lapse.</div></div><div><h3>Participants</h3><div>N = 211 African American adults, 51 % female, and ages 18–74.</div></div><div><h3>Measurements</h3><div>EMA was used to assess risk factors (motivation, self-efficacy, urge, positive affect, negative affect, smoking expectancies, and cigarette availability) and lapse.</div></div><div><h3>Findings</h3><div>At the within-person level, moments characterized by greater urge, smoking expectancies, and cigarette availability were associated with greater risk of lapse in daily life. At the between-person level, those who had lower motivation and self-efficacy and greater urge, smoking expectancies, and cigarette availability were more likely to lapse in daily life.</div></div><div><h3>Conclusions</h3><div>The current study addresses important theoretical underpinnings regarding the dynamic nature of predictors of lapse. Although some predictors (urge, smoking expectancies, cigarette availability) did have a significant effect with lapse in expected directions, between person effects may be increasingly important in this population, and additional momentary predictors should be explored in future research.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"162 ","pages":"Article 108231"},"PeriodicalIF":3.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856892","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":"Perceived harm of e-cigarettes relative to conventional cigarettes: Comparison among different measures in the US and Vietnam","authors":"Thi Phuong Thao Tran ,&nbsp;Thi Tuyet Hanh Tran ,&nbsp;Thi Hai Phan ,&nbsp;Van Minh Hoang ,&nbsp;Lucy Popova","doi":"10.1016/j.addbeh.2024.108230","DOIUrl":"10.1016/j.addbeh.2024.108230","url":null,"abstract":"<div><h3>Introduction</h3><div>Evidence shows the inconsistencies in perceived harm of e-cigarettes between direct (single question) and indirect (assessing perceived harm separately by a single question and subtracting their score) measures. While the validity of both measures was tested by assessing their association with criterion variables (i.e., ever-trying e-cigarettes), further validation research is needed given existing limitations.</div></div><div><h3>Methods</h3><div>We analyzed data from Population Assessment of Tobacco and Health Study Wave 6 in the US and a provincial version of the Global Adult Tobacco Survey 2020 in Vietnam. Comparative harm of cigarettes and e-cigarettes was measured using direct and indirect method. A new criterion validity measure – “I use e-cigarettes because they might be less harmful to me than smoking cigarettes” – was introduced.</div></div><div><h3>Results</h3><div>In the general US population, a higher proportion of participants perceived e-cigarettes as less harmful than cigarettes when assessed using the indirect method compared to the direct method (31.56% vs. 13.70%). Additionally, although many US e-cigarette users indicated that they used e-cigarettes because they might be less harmful than cigarettes, among these people only 61.43% reported e-cigarettes to be less harmful when using the direct method but this proportion was higher (67.28%) for the indirect method. In Vietnam, this proportion was higher, at 76.68% using the direct method.</div></div><div><h3>Conclusion</h3><div>This study emphasizes the significance of including and reporting multiple measures within a single survey to achieve a comprehensive understanding of perceived harm.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"162 ","pages":"Article 108230"},"PeriodicalIF":3.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901062","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":"Problematic smartphone use in a representative sample of US adults: Prevalence and predictors","authors":"Lucien Rochat ,&nbsp;Germano Vera Cruz ,&nbsp;Elias Aboujaoude ,&nbsp;Robert Courtois ,&nbsp;Farah Ben Brahim ,&nbsp;Riaz Khan ,&nbsp;Yasser Khazaal","doi":"10.1016/j.addbeh.2024.108228","DOIUrl":"10.1016/j.addbeh.2024.108228","url":null,"abstract":"<div><div>The exponential growth in worldwide smartphone adoption has led to mounting concerns about problematic smartphone use (PSU), with some studies of variably defined PSU yielding prevalence rates as high as 20 to 30%. The present study aims to (a) estimate the prevalence of PSU while emphasizing functional impairment, and (b) examine the degree to which a set of demographic, contextual, behavioral and mental health variables can predict PSU. A representative U.S. sample of 1,989 participants completed an online survey using a cross-sectional design aimed at examining PSU. Data were analyzed using two different but complementary machine learning algorithms. The results indicate a PSU prevalence of 0.75% to 1.2 % when a functional impairment criterion is required. The most important predictors of PSU are related to smartphone use behavior, followed by contextual factors (being a parent of under-age children, increase in use during the COVID-19 pandemic), age and some psychopathological factors. Overall, the study suggests that the prevalence of functionally impairing PSU may be much lower than what has been reported based on less stringent definitions. The results highlight the necessity to account for impact on key spheres of functioning in diagnosing PSU to avoid pathologizing a ubiquitous behavior that may be intensive but not necessarily pathological. They also open up relevant perspectives for the prevention of PSU.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"162 ","pages":"Article 108228"},"PeriodicalIF":3.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866573","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":"Effects of narrative versus non-narrative pictorial warning labels on visual attention and alcohol-related cancer risk perceptions: An eye-tracking study","authors":"Zexin Ma ,&nbsp;Joshua Haworth ,&nbsp;Jun Hu","doi":"10.1016/j.addbeh.2024.108229","DOIUrl":"10.1016/j.addbeh.2024.108229","url":null,"abstract":"<div><h3>Background</h3><div>Alcohol use is a preventable risk factor for cancer, but public awareness remains low. A promising approach to raising awareness is to include pictorial warning labels (PWLs) on alcohol-containing products, but the typical graphic images used in such warnings can cause inattention. This study investigated whether narrative PWLs (depicting the lived experiences) could lead to greater attention and higher risk perceptions than graphic, non-narrative PWLs (showing graphic health effects).</div></div><div><h3>Methods</h3><div>Moderate and heavy drinkers participated in an online, webcam-based eye-tracking experiment (<em>N</em> = 649). They were randomized to view an order-randomized stimulus set containing either three narrative PWLs or three non-narrative PWLs. Visual attention was assessed by metrics of participant eye movements, including the visit count and dwell time to separate image and text area of interest (AOI) while viewing each PWL. Risk perceptions were assessed by participant responses to questions presented after viewing all PWLs.</div></div><div><h3>Results</h3><div>Participants paid more attention to the image than the text AOI on both metrics (<em>p</em>’s &lt; 0.05). They also spent more time viewing narrative versus non-narrative PWLs (<em>p</em>’s &lt; 0.05). However, PWL type had no significant effect on risk perceptions (<em>p</em>’s &gt; 0.1), and visual attention did not mediate this relationship.</div></div><div><h3>Conclusions</h3><div>Our findings highlight the potential of narrative PWLs to visually engage alcohol consumers’ attention. Further research is needed to understand why narrative PWLs do not outperform non-narrative PWLs in shaping risk perceptions either directly or through attention, the proposed mediator.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"162 ","pages":"Article 108229"},"PeriodicalIF":3.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822828","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":"Does cannabis substitute or complement alcohol after recreational cannabis legalization in the Washington State? A three-level mixed-effects modeling","authors":"Yachen Zhu,&nbsp;Pamela J. Trangenstein,&nbsp;William C. Kerr","doi":"10.1016/j.addbeh.2024.108218","DOIUrl":"10.1016/j.addbeh.2024.108218","url":null,"abstract":"<div><h3>Background</h3><div>Whether cannabis substitute or complement alcohol remains inconclusive. Little is known about the daily-level associations between cannabis and alcohol use by cannabis user type (medical vs. recreational use) in people who use alcohol and cannabis within a legalized environment.</div></div><div><h3>Methods</h3><div>Adult participants were from four waves of Washington Panel Survey during 2014–2016, who consumed both cannabis and alcohol in the past six months. Daily measurements of alcohol and cannabis use in the past week were collected at each wave. Our outcome variable was continuous alcoholic drinks, the exposure was any cannabis use. We applied three-level negative binomial models to account for within-person wave-to-wave and between-person variations, deriving pure within-person within-wave associations between cannabis and alcohol use at the daily level. A cross-level interaction between day-level cannabis use and wave-level medical cannabis recommendation investigated the potential differential substitution/complementarity patterns by medical recommendation status.</div></div><div><h3>Results</h3><div>259 respondents with 440 person-waves and 3,051 daily observations were included. We found a statistically significant pure Level 1 (within-person daily-level) effect of cannabis use among recreational cannabis users (IRR = 1.37, 95 % CI: 1.05–1.79, p = 0.02), showing a complementary use pattern. We also found a statistically significant cross-level interaction between medical cannabis recommendation and cannabis use at Level 1 (IRR = 0.57, 95 % CI: 0.34–0.96, p = 0.03), indicating that, differently from recreational users, medical cannabis users may have a substitution use pattern.</div></div><div><h3>Conclusions</h3><div>Cannabis user type may inform co-use patterns. This study suggested recreational cannabis users tended to use alcohol and cannabis in a complementary manner in Washington State following the legalization of recreational use.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"162 ","pages":"Article 108218"},"PeriodicalIF":3.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792987","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}