Addictive behaviors最新文献

{"title":"Restricting choice of e-cigarette flavor and device type increases choices to use combusted cigarettes among adults who dual use both products: Results from a within-subjects randomized trial","authors":"Dana Rubenstein ,&nbsp;Lauren R. Pacek ,&nbsp;Michael J. Green ,&nbsp;Maggie M. Sweitzer ,&nbsp;Rachel Kozink ,&nbsp;Alicia Holloway ,&nbsp;Eric C. Donny ,&nbsp;Tracy T. Smith ,&nbsp;F. Joseph McClernon","doi":"10.1016/j.addbeh.2025.108578","DOIUrl":"10.1016/j.addbeh.2025.108578","url":null,"abstract":"<div><h3>Introduction</h3><div>Data from real-world e-cigarette (EC) flavor bans suggest that such bans may increase combusted cigarette (CC) use. However, experimental data are needed to better understand how EC characteristics affect EC appeal and CC use.</div></div><div><h3>Methods</h3><div>Participants were adults who used both CC and flavored EC. They made 10 choices per session between taking two puffs from an EC or CC (supplied by study) or abstaining. EC type was unblinded and varied across three counterbalanced sessions: 1) own device and flavor, 2) study device with a non-tobacco-flavored e-liquid, and 3) study device with a tobacco-flavored e-liquid. Analyses evaluated EC appeal and choices to use EC, CC, or abstain.</div></div><div><h3>Results</h3><div>Participants (n = 41) reported using CCs on 22.1 days/month and ECs on 26.9 days/month. Appeal of study EC was lower than participants’ own EC, and participants made fewer choices for EC during tobacco-flavor EC versus own device sessions (<em>p</em> = 0.006). Relative to own device sessions, participants made a greater number of choices for CC when study EC were available (<em>p</em>’s &lt; 0.05), regardless of flavor.</div></div><div><h3>Discussion</h3><div>Regulators and public health officials should be aware that restricting EC characteristics such as device type and flavor may increase consumption of CC among people who use both products, especially people who find restricted EC less appealing than their own device. Findings are consistent with real-world sales data following EC flavor bans.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"174 ","pages":"Article 108578"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679550","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 relationship between social media use, thin-ideal internalization, and college women’s use of electronic cigarettes for weight control: A mediation analysis","authors":"Kyra V. Newcombe ,&nbsp;Yu Lu ,&nbsp;Taylor Zingg ,&nbsp;Lois Coleman ,&nbsp;Jinhee Seo ,&nbsp;Glenn Leshner ,&nbsp;Marshall K. Cheney","doi":"10.1016/j.addbeh.2025.108555","DOIUrl":"10.1016/j.addbeh.2025.108555","url":null,"abstract":"<div><h3>Purpose</h3><div>Some college women report using electronic cigarettes (e-cigarettes) for weight control. Social media frequently promotes e-cigarettes for weight management and reinforces unrealistic body ideals, which may foster body dissatisfaction and unhealthy weight control behaviors. Given college women’s high rates of social media and e-cigarette use, this study examined the relationship between college women’s social media use, thin-ideal internalization, and e-cigarette use for weight control.</div></div><div><h3>Methods</h3><div>College women (N = 343, M_age = 20.88) who used e-cigarettes for weight control reasons participated in an online survey that measured their social media use, levels of thin-ideal internalization, and e-cigarette use behaviors. Mediation analysis was performed to test whether thin-ideal internalization mediated the relationship between social media use and e-cigarette use for weight control.</div></div><div><h3>Results</h3><div>Social media use positively predicted e-cigarette use for weight control purposes (B = 0.12, <em>p</em> &lt; 0.001). Thin-ideal internalization fully mediated this relationship (indirect effect: B = 0.06, 95 % CI [.03, 0.10]) as the direct effect became non-significant when accounting for the mediator (direct effect: B = 0.06, <em>p</em> = 0.10). Greater social media use significantly increased thin-ideal internalization (B = 1.01, <em>p</em> &lt; 0.001), which subsequently predicted greater e-cigarette use for weight control purposes (B = 0.06, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Findings highlight that greater social media exposure among college women strengthens thin-ideal internalization, which drives e-cigarette use for weight control purposes. These findings signal the importance of regulating e-cigarette content on social media, as well as prevention efforts that address social media’s thin-ideal content and promote body positivity.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"174 ","pages":"Article 108555"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555293","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":"Application of the differential susceptibility to media effects model to comprehend emerging adults’ problematic smartphone use: A one-year longitudinal study","authors":"Chun Feng ,&nbsp;Hengyue Zhang ,&nbsp;Ke Yu ,&nbsp;Wen Zhao ,&nbsp;Anise M.S. Wu","doi":"10.1016/j.addbeh.2025.108568","DOIUrl":"10.1016/j.addbeh.2025.108568","url":null,"abstract":"<div><div>Considering the pervasive integration of smartphones into the daily lives and high prevalence of problematic smartphone phone use (PSU) among emerging adults, there is an urgency for an integrated perspective to understand their PSU for better intervention insights. This study aims to apply a multi-level theoretical framework, the Differential Susceptibility to Media Effects Model (DSMM), to PSU and evaluate not only the direct effects of dispositional (i.e., neuroticism), social (i.e., family adaptability), and developmental factors (i.e., inclusion of smartphone in the self [ISS]) on PSU but also the potential indirect effect of ISS. We obtained a sample of 801 Chinese emerging adults (559 females; <em>M</em>_age = 19.02 and <em>SD</em>_age = 0.88) through a one-year longitudinal study with two surveys (at wave 1 [W1] and wave 2 [W2]). Hierarchical regression analysis indicated that all baseline susceptibility factors (neuroticism [W1], family adaptability [W1], and ISS [W1]) significantly predicted PSU (W2) after controlling for both demographics and PSU (W2). The results of structural equation modeling further suggested that neuroticism (W1) and family adaptability (W1) were longitudinally associated with ISS (W2), which was in turn associated with PSU (W2). This study provided not only longitudinal evidence to support the application of DSMM to explain PSU but also insights into interventions using targeted approaches.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"174 ","pages":"Article 108568"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622709","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 the apple fall far from the tree? when parenting styles disrupt the intergenerational pattern of substance use","authors":"Zila Sanchez ,&nbsp;Sheila Caetano ,&nbsp;Juliana Y. Valente ,&nbsp;Luis Eduardo Soares-Santos ,&nbsp;Hugo Cogo-Moreira","doi":"10.1016/j.addbeh.2025.108567","DOIUrl":"10.1016/j.addbeh.2025.108567","url":null,"abstract":"<div><div>This study investigates whether parenting styles can buffer the intergenerational transmission of substance use. Using a person-centered analytic strategy with 4,280 adolescent–parent dyads in Brazil, we applied Latent Class Analysis to identify substance use profiles in both generations and modeled their association using Latent Transition Analysis. Parental and adolescent profiles were strongly aligned, especially among abstainers. However, this similarity was not deterministic: authoritative parenting significantly reduced adolescents’ likelihood of polysubstance use – even among high-risk parents. Authoritarian parenting also reduced this risk but increased alcohol-specific transmission. Permissive and neglectful styles showed no protective effects. These findings underscore the role of parenting style and highlight the value of family-based interventions to disrupt intergenerational substance use patterns.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"174 ","pages":"Article 108567"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578461","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":"Nicotine and cannabis vaping among U.S. emerging young adults: Findings from 2022 and 2023 National Survey on Drug Use and Health","authors":"Nayoung Kim ,&nbsp;Joy Haizelden ,&nbsp;Gracie Avery ,&nbsp;Mercy Mumba","doi":"10.1016/j.addbeh.2025.108577","DOIUrl":"10.1016/j.addbeh.2025.108577","url":null,"abstract":"<div><h3>Objectives</h3><div>With recent rise in nicotine and cannabis vaping and growing evidence of their negative health effects, especially when co-vaped, understanding vaping patterns is important. This study examined national prevalence and factors associated with nicotine and cannabis vaping among U.S. emerging young adults.</div></div><div><h3>Methods</h3><div>Cross-sectional data from the 2022 and 2023 National Survey on Drug Use and Health were used to assess past-month rates of exclusive nicotine vaping, exclusive cannabis vaping, and co-vaping (versus no vaping) and examine its associations with sociodemographic characteristics, mental health, other substance use (e.g., tobacco, alcohol, binge drinking), substance use disorders (nicotine dependence, alcohol use disorder), and cannabis legalization.</div></div><div><h3>Results</h3><div>Among emerging adults, 16.0% reported exclusive nicotine vaping, 4.3% exclusive cannabis vaping, and 8.1% co-vaping in the past month. Non-Hispanic White individuals, those with lower education, and those identified as sexual minorities reported higher rates of vaping. Severe psychological distress, tobacco and alcohol co-use, and alcohol use disorder increased odds of all vaping behaviors. Medical cannabis legalization significantly increased odds of exclusive cannabis vaping and co-vaping, but not exclusive nicotine vaping.</div></div><div><h3>Conclusions</h3><div>Vaping patterns vary by certain sociodemographic characteristics and cannabis policy. Mental health challenges and substances co-use consistently elevated risks of all forms of vaping among this vulnerable population.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"174 ","pages":"Article 108577"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727604","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":"Latent profiles of cannabis use patterns and associations with eating pathology outcomes","authors":"Taylor B. Stanley ,&nbsp;Nathan T. Kearns ,&nbsp;April R. Smith","doi":"10.1016/j.addbeh.2025.108564","DOIUrl":"10.1016/j.addbeh.2025.108564","url":null,"abstract":"<div><div>As recreational cannabis increases among United States adults, there is growing interest in understanding potential health co-morbidities. Although past work supports cannabis use and eating disorder comorbidity, and cannabis enhances appetite and reward responses to food, little is known about how specific cannabis use patterns may relate to binge eating and other eating disorder symptoms. The purpose of this study is to identify distinct subgroups of recreational cannabis users based on several use characteristics, including subjective changes to appetite and hedonic properties of food using latent profile analysis, and to examine differences across profiles in binge eating, other eating disorder symptoms, and emotion regulation. Participants (<em>N</em> = 435, male = 189) were adults recruited through <em>Prolific</em> who endorsed past-month cannabis use and completed a battery of self-report measures assessing cannabis use characteristics, eating changes while using cannabis, eating disorder symptoms, and emotion regulation. Results identified four profiles: “Infrequent Users, Moderate Eating Changes, Low Risk,” “Intense Users, Low Eating Changes, Mild Risk,” “High-Risk Coping Users, Strong Eating Changes,” and “Frequent Users, Slight Eating Changes, Mild Risk.” All profiles reported more binge eating symptoms while under the influence of cannabis; the “High Risk Coping Users, Strong Eating Changes” profile reported the most severe sober binge eating, eating disorder, and emotion regulation difficulties. Findings highlight the utility of person-centered approaches for capturing co-morbidity risk and may help guide screening and intervention tools for determining eating disorder risk among those using cannabis.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"174 ","pages":"Article 108564"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555294","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":"Performing identity and risk: chemsex, misogyny, and algorithmic exclusion in queer Reddit spaces","authors":"Sezai Tunca","doi":"10.1016/j.addbeh.2025.108582","DOIUrl":"10.1016/j.addbeh.2025.108582","url":null,"abstract":"<div><div>This study examines how LGBTQ+ identities, chemsex experiences, and digital misogyny intersect and are discursively negotiated within Anglophone Reddit spaces. Adopting an integrative mixed-methods design, it analyzes 509,327 posts and comments drawn from four LGBTQ+ -oriented subreddits through semantic co-occurrence mapping, sentiment and subjectivity profiling, lexical diversity metrics, and qualitative thematic coding. The analytical framework connects three mutually constitutive axes—identity performance, affective discourse, and platform/algorithmic dynamics—to capture how individual narratives are shaped by both cultural hierarchies and sociotechnical infrastructures. Findings show that identity expressions cluster around themes of community belonging, family disclosure, and self-recognition, while trans and nonbinary users remain disproportionately exposed to hypersexualization and digital exclusion. Chemsex discourse is predominantly marked by negative affect—loneliness, shame, and stigma—but also includes solidarity and harm-reduction dialogue, revealing ambivalent forms of care within digital queer cultures. Digital misogyny and algorithmic silencing appear as layered phenomena, manifesting both in external harassment and intra-community norm enforcement. The study contributes theoretically by integrating critical chemsex scholarship with digital queer theory, demonstrating that affective harm is simultaneously interpersonal and infrastructural. Methodologically, it adapts a transparent computational–qualitative triad suitable for analyzing large-scale online discourse. Practically, the results inform platform governance (bias audits, transparent moderation) and public health communication (embedding community-based, empathetic language in harm-reduction outreach). While limited to English-language Reddit data, the framework offers transferable insights into how LGBTQ+ users negotiate vulnerability, resilience, and belonging in digital environments.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"174 ","pages":"Article 108582"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733304","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":"Clinical outcomes of addictive disorders six months after ADHD Diagnosis: Insights from the START study","authors":"Aude Begnaud ,&nbsp;Clémence Cabelguen ,&nbsp;Gaëlle Challet-Bouju ,&nbsp;Juliette Leboucher ,&nbsp;Benoit Schreck ,&nbsp;Marie Grall-Bronnec","doi":"10.1016/j.addbeh.2025.108557","DOIUrl":"10.1016/j.addbeh.2025.108557","url":null,"abstract":"<div><h3>Introduction</h3><div>Attention-Deficit/Hyperactivity Disorder (ADHD) is overrepresented in patients with addictive disorders but remains underdiagnosed. This comorbidity complicates clinical presentations and worsens prognosis. We aimed to evaluate addictive disorder outcomes six months after ADHD diagnosis in patients undergoing addiction treatment and to identify factors associated with a favorable outcome. Secondary objectives explored patient characteristics and therapeutic strategies.</div></div><div><h3>Method</h3><div>The START study (<strong>S</strong>tudy on the <strong>T</strong>reatment of <strong>A</strong>DHD and addiction comorbidity: a <strong>R</strong>e<strong>T</strong>rospective analysis of medical records) was an observational, retrospective analysis of electronic medical records from patients recently diagnosed with ADHD using the DIVA. Included patients had either substance use disorders (SUD) or behavioral addictions (eating, sex, gambling, gaming/screen use, shopping, and physical exercise), with diagnoses established by the referring physician according to clinical judgment, and attended at least two consultations six months apart. Descriptive analyses were conducted for the total sample and by clinical outcome, followed by multivariate logistic regression to identify predictors of improvement.</div></div><div><h3>Results</h3><div>Tobacco and cannabis use disorders were the most common (61.3 % each). Psychiatric comorbidities were frequent (lifetime 84.6 %, current 34.1 %). Methylphenidate initiation was delayed in 29 % of cases, primarily due to current psychiatric comorbidities or ongoing addiction. Improvement in addictive disorders was observed in 61.3 % of patients. Favorable outcomes were associated with older age (OR = 1.13, 95 % CI [1.04–1.23], p = 0.006) and living as a couple (OR = 3.84, 95 % CI [1.10–13.42], p = 0.035), whereas poorer outcomes were associated with the ADHD combined presentation (reference group), compared with the predominantly inattentive and hyperactive/impulsive presentations (OR = 0.16, 95 % CI [0.03–0.90], p = 0.037).</div></div><div><h3>Conclusion</h3><div>The study highlights socio-demographic and clinical predictors of outcome, advancing our understanding of ADHD-addiction comorbidity. Findings warrant confirmation in prospective longitudinal research.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"173 ","pages":"Article 108557"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497858","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":"Problematic social media use, boredom proneness, and psychological distress among university students in China and Japan: A cross-national network analysis","authors":"Zeyang Yang ,&nbsp;Zhixian Lian ,&nbsp;Zhihao Yan ,&nbsp;Tianyi Chen ,&nbsp;Meiting Liu ,&nbsp;Xue Dou","doi":"10.1016/j.addbeh.2025.108553","DOIUrl":"10.1016/j.addbeh.2025.108553","url":null,"abstract":"<div><div>Problematic social media use (PSMU) has been associated with negative effects such as depression and anxiety across different countries and cultures. However, research on specific symptoms of PSMU and its correlates across nations remains limited. The present study aimed to compare the relationships of PSMU, boredom proneness, and psychological distress symptoms in China and Japan using network analysis. Questionnaire surveys were conducted among undergraduates in China and Japan. Participants included 822 students in China (mean age = 18.36, SD = 0.80) and 698 in Japan (mean age = 19.66, SD = 2.16). Network analysis was employed to estimate the symptom network structures, identify the most central symptoms, and compare the networks across the two countries. Results show that the core PSMU symptoms were Craving/tolerance in China and Relapse/loss of control in Japan. In the comorbidity networks, the most influential symptoms in China were agitation, panic, frequent inactivity, and downheartedness. The most central ones in Japan were not looking forward, downhearted, touchy, and a pervasive lack of motivation. The present study improves understanding of the links between symptoms of PSMU, boredom proneness, and psychological distress in both countries, which can be helpful for the development of potential nationally specific interventions.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"173 ","pages":"Article 108553"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524801","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":"Witnessed overdose history and response among overdose survivors who use non-prescribed opioids in an overdose prevention trial","authors":"Nicole C. McCann ,&nbsp;Shapei Yan ,&nbsp;Vanessa M. McMahan ,&nbsp;Zachary C. Rich ,&nbsp;Emily Pope ,&nbsp;Andrew Rolles ,&nbsp;Sarah Brennan ,&nbsp;Xochitl Luna Marti ,&nbsp;Sarah Kosakowski ,&nbsp;Tim Matheson ,&nbsp;Phillip O. Coffin ,&nbsp;Alexander Y. Walley","doi":"10.1016/j.addbeh.2025.108558","DOIUrl":"10.1016/j.addbeh.2025.108558","url":null,"abstract":"<div><h3>Background</h3><div>The REpeated-dose Behavioral intervention to reduce Opioid Overdose Trial (REBOOT) evaluated motivational interviewing for overdose prevention, focusing partly on witnessed overdose response. We assessed participants’ witnessed overdose history and REBOOT’s impact on overdose response among opioid overdose survivors using non-prescribed opioids in Boston and San Francisco.</div></div><div><h3>Methods</h3><div>We described participants’ witnessed overdose and naloxone administration history over the four months preceding enrollment and the number and characteristics of witnessed overdoses reported during the study. We then used generalized estimating equations to test if the intervention affected if participants responded “me” to who, if anyone, responded to a witnessed overdose by assessing responsiveness, calling 911, performing rescue breathing, doing chest compressions, or administering naloxone during 16-month follow-up.</div></div><div><h3>Results</h3><div>Of 265 participants, most (83 %) witnessed at least one overdose in the four months preceding enrollment; 68 % of these participants had administered naloxone. In the 16-month post-enrollment follow-up, 250 (94 %) participants witnessed 597 overdoses. In 94 % of these, participants reported that somebody (themselves or others) responded. REBOOT had no significant impact on whether participants personally responded to overdoses: 67 % of control and 72 % of intervention participants personally responded pre-enrollment (<em>p</em> = 0.39), versus 63 % and 62 % post-enrollment (<em>p</em> = 0.97).</div></div><div><h3>Conclusion</h3><div>Most REBOOT participants witnessed a recent opioid overdose preceding enrollment. After enrollment, nearly all witnessed overdoses were responded to; the intervention had no effect on whether the participant personally responded. Given near-universal response, there was little room for improving overdose response. Future research should test similar interventions in communities with less prior overdose prevention exposure.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"173 ","pages":"Article 108558"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524708","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}