Addict Behav [JOURNAL]
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200 papers
Longitudinal trends in the past 30-day co-use of nicotine/tobacco, alcohol, and cannabis among youth and adults in the PATH study.
Sokolovsky AW, Micalizzi L, Murphy CM
Addict Behav · 2026 May · PMID 41650519 · Full text
INTRODUCTION: The co-use of substances confers risks above single-product use and has significant public health implications. This study investigated trends in past 30-day co-use of nicotine/tobacco products with alcohol...
INTRODUCTION: The co-use of substances confers risks above single-product use and has significant public health implications. This study investigated trends in past 30-day co-use of nicotine/tobacco products with alcohol and cannabis in the US using Population Assessment of Tobacco and Health Study data from Waves 4-6 (December 2016-November 2021). METHODS: All wave 4-6 PATH participants age 15+ were included in analyses. Changes across wave in past 30-day co-use of cigarettes, e-cigarettes, and other tobacco products (OTP; cigars, filtered cigars, smokeless, hookah, snus, and cigarillo) with alcohol and cannabis, moderated by age (15-17,18-24, 25-34,35-64, 65+), and controlling for demographics were investigated. RESULTS: Changes in co-use of tobacco products with cannabis and alcohol varied across age and product. Cigarette and alcohol co-use was most prevalent across all adult ages, with rates declining over time among young adults (18-24, 25-34) but stable in older adults (65+). Rates of e-cigarette and alcohol co-use increased among young adults, possibly supplanting alcohol and cigarette co-use. E-cigarette and alcohol co-use was the most popular pattern of co-use in youth, with initially increasing and then declining prevalence. Co-use of e-cigarette and cannabis increased at Wave 5 among those 15-17, 18-24, and 25-34, although this increase lessened in all groups except those age 25-34 at Wave 6. Cigarette and cannabis co-use rates, and co-use rates of OTP with both cannabis and alcohol were generally stable or decreasing. CONCLUSIONS: Findings highlight the complex interplay between substance use patterns and developmental stages and the dynamic nature of co-use in ever-evolving tobacco and cannabis marketplaces.
Treating those not ready to quit smoking: Doing harm while trying to help?
Betts JM, Klemperer EM, Baker TB … +3 more , Loh WY, Coleman SRM, Cook JW
Addict Behav · 2026 May · PMID 41650518 · Full text
INTRODUCTION: Motivation-phase smoking treatment can increase treatment reach and abstinence in persons unmotivated to quit smoking. However, Motivation-phase treatment is modestly and inconsistently effective. This rese...
INTRODUCTION: Motivation-phase smoking treatment can increase treatment reach and abstinence in persons unmotivated to quit smoking. However, Motivation-phase treatment is modestly and inconsistently effective. This research aims to identify factors that may influence the effectiveness of the two intervention components most commonly used in Motivation-phase treatment: nicotine replacement therapy (NRT) and reduction counseling. METHODS: An exploratory, secondary analysis of a 4-factor, randomized trial enrolled 577 primary care patients who were willing to reduce, but not quit, smoking. Participants were randomized to the following interventions: smoking reduction counseling, nicotine mini-lozenge, behavioral activation counseling, and 5Rs-motivational counseling. Using a precision medicine approach, machine learning analyses determined whether demographic and smoking variables identified persons more likely to benefit from the interventions with regard to 24-hour quit attempts, entry into cessation treatment, and self-reported 7-day point prevalence abstinence at 1 year. RESULTS: Quitting self-efficacy predicted the likelihood of making a quit attempt and entering cessation treatment. At high levels of self-efficacy (>3.5 out of 5), there were no significant effects of interventions. At low levels of self-efficacy (≤3.5 out of 5), receiving reduction counseling reduced the odds of making a quit attempt (OR = 0.51, p = 0.002), and receiving mini-lozenge reduced the odds of entering cessation treatment (OR = 0.55, p = 0.02). No significant effects were found for smoking abstinence. CONCLUSIONS: Baseline quitting self-efficacy may identify persons who will not be aided by standard Motivation-phase treatment and thus require a different therapeutic approach. These results raise questions about whom to treat, and how to treat, individuals who decline cessation treatment.
Cannabis use in pregnancy: Key findings from 2021-2023 National Survey on Drug Use and Health data.
Wysota CN, Sherman SE, Abroms LC … +4 more , Ghassabian A, Hernandez S, Young-Wolff KC, Rogers ES
Addict Behav · 2026 May · PMID 41643368 · Publisher ↗
OBJECTIVE: It is critical to understand the characteristics of people who use cannabis during pregnancy. We examined the prevalence and sociodemographic and clinical correlates of current, recent, former, and never canna...
OBJECTIVE: It is critical to understand the characteristics of people who use cannabis during pregnancy. We examined the prevalence and sociodemographic and clinical correlates of current, recent, former, and never cannabis use among pregnant individuals in the U.S. METHODS: We analyzed pooled data from 1,992 pregnant participants in the National Survey on Drug Use and Health (NSDUH) from 2021 to 2023. We used multinomial regression to identify correlates of cannabis use status (i.e., never use vs. current [past 30-day], recent [past 2-12-month], and former [nonuse in the past year], respectively). RESULTS: Overall, nearly 7% of pregnant participants reported current cannabis use. Among current users, 31% reported any doctor-recommended cannabis use in the past year and 52% bought their cannabis from a dispensary. Compared to never users, current cannabis use was more likely among those aged 18-25 (vs. 26+; Relative Risk Ratio [RRR] = 2.08, 95% CI: 1.04-4.18), unmarried (vs. married; RRR = 2.54, 95% CI: 1.05-6.14), with greater education (vs. < high school; RRR = 2.97, 95% CI: 1.42-6.23), past 30-day cigarette use (RRR = 2.57, 95% CI: 1.11-5.94), alcohol use (RRR = 7.24, 95% CI: 1.52-34.49), e-cigarette use (RRR = 4.92, 95% CI: 1.71-14.10), or serious psychological distress (RRR = 6.25, 95% CI: 2.46-15.85); current use was less likely among those perceiving some risk of weekly cannabis use (vs. no risk; RRR = 0.07, 95% CI: 0.03-0.14). Recent use (vs. never use) was less likely in states where cannabis was illegal (RRR = 0.45, 95% CI: 0.22-0.95). CONCLUSION: Cannabis use during pregnancy remains high among certain subgroups. Future research should develop tailored interventions targeting motivations of cannabis use during pregnancy, such as risk perceptions and polysubstance use, which negatively impact maternal and fetal health.
CBD, cannabis, or both? Examining use patterns and associated factors among U.S. youth and adults.
Dai HD, Puga TB
Addict Behav · 2026 May · PMID 41643367 · Publisher ↗
BACKGROUND: Cannabis and cannabidiol (CBD) use have grown recently among U.S. adults, yet little is known about their exclusive or combined use at the population level. This study sought to assess the prevalence and cont...
BACKGROUND: Cannabis and cannabidiol (CBD) use have grown recently among U.S. adults, yet little is known about their exclusive or combined use at the population level. This study sought to assess the prevalence and contributing factors of distinct use patterns. METHODS: Data from the 2023 National Survey of Drug Use and Health study were analyzed for adolescents (12-17,n = 11,572) and adults (18+,n = 45,133). Past-month cannabis and CBD use over the past 30 days, including patterns (non-use, exclusive, and dual-use), were reported and associated factors were examined by multinomial regressions. RESULTS: In 2023, 15.4% and 9.8% of participants reported past-month cannabis and CBD use, respectively; while 8.9, 3.4%, and 6.4% reported exclusive cannabis use, exclusive CBD use, and dual-use, respectively. Cannabis and CBD use were most common among individuals aged 18-34, while dual use was highest in 18-25-year-olds (10.8%). Exclusive cannabis use peaked in 26-34-year-olds (14.8%), and exclusive CBD use was most prevalent in adults 65+ (5.0%). Youth females (vs. males) and those living above the poverty line (vs. in poverty) were more likely to report exclusive CBD use. Adolescents with fair or poor health (vs. excellent/good) were more likely to report exclusive cannabis (AOR = 3.2,p < 0.001), exclusive CBD (AOR = 3.0,p = 0.002), and dual-use (AOR = 3.0, p < 0.001). Based on adolescent regression results, state medical cannabis legalization was associated with higher exclusive cannabis use(AOR = 1.8,p = 0.01). Based on adult regression results, state medical cannabis legalization was associated with higher exclusive cannabis use (AOR = 1.5, p < 0.001) and dual-use (AOR = 1.5, p < 0.001). CONCLUSIONS: Cannabis and CBD use exhibited distinct usage patterns. As cannabis legalization policies continue to evolve, public health professionals should focus on tailored interventions to mitigate potential side effects associated with complex cannabis use.
Problematic smartphone use and disengagement in first-year college students: A daily diary study of between- and within-person differences.
Yu JJ
Addict Behav · 2026 May · PMID 41633115 · Publisher ↗
Existing evidence suggests that problematic smartphone use (PSU) and disengagement may form part of a spiraling process. This investigation explores this process among first-year undergraduates, distinguishing within-per...
Existing evidence suggests that problematic smartphone use (PSU) and disengagement may form part of a spiraling process. This investigation explores this process among first-year undergraduates, distinguishing within-person fluctuations from between-person rank order stability. Over 30 consecutive days, 104 first-year undergraduates in China (M = 18.62, SD = 0.96, 55.1% female) completed daily surveys that assessed PSU and disengagement. Dynamic structural equation modeling indicated a bidirectional lagged association whereby higher-than-usual PSU on a given day was prospectively associated with higher-than-usual disengagement the next day, and higher-than-usual disengagement on a given day was prospectively associated with higher-than-usual PSU the next day. Individuals with higher PSU than their peers tended to report greater disengagement, with PSU consistently amplifying its impact on disengagement. Neither family socioeconomic status nor gender significantly influenced the model. The findings highlight a harmful cycle of daily reinforcement at the within-person level, coupled with consistent associations at the between-person level. Given the importance of the first year of university, the findings underscore the need for targeted interventions that address both PSU and disengagement and aim to attenuate their bidirectional association.
Gambling participation and risk over time associated with type of gambling activity: Trends in Australian general population 2015-2022.
Chilver MR, Butterworth P, Suomi A
Addict Behav · 2026 May · PMID 41621350 · Publisher ↗
There is limited longitudinal data examining national gambling trends in Australia. This study examines longitudinal trends in gambling participation and higher-risk gambling in Australia from 2015 to 2022 using data fro...
There is limited longitudinal data examining national gambling trends in Australia. This study examines longitudinal trends in gambling participation and higher-risk gambling in Australia from 2015 to 2022 using data from the nationally representative Household Income and Labour Dynamics in Australia (HILDA) panel study. Study participants were HILDA respondents aged 15 and older in 2015, 2018, or 2022 who completed the Problem Gambling Severity Index (PGSI; N = 44,836 observations). Gambling participation was based on self-reported typical monthly expenditure on 10 gambling activities. Gambling risk was assessed using the 9-item PGSI and categorised as low-risk (0-2) or higher-risk (3+) gambling. Age and sex were included as socio-demographic variables. The results indicated that monthly gambling participation declined from 37.1% in 2015 to 32.9% in 2022 but levels of higher-risk gambling did not reduce at the same rate. Higher-risk gambling was independently associated with participation in electronic gaming machines (EGMs; OR = 8.0, p < 0.001), race betting (OR = 2.3, p < 0.001) and sports betting (OR = 1.5, p = 0.01). These were the most popular forms of gambling among those aged under 25. Although overall gambling participation in Australia has declined to 2022, this did not result in a reduction to higher-risk gambling. Young adults were the least likely to gamble, but show disproportionate participation in EGMs, race, and sports betting, and an increasing rate of higher-risk gambling.
Social norms modulate asymmetric effects of group opinions on cue-induced smoking craving.
Jung W, Seon H, Sul S … +1 more , Chung D
Addict Behav · 2026 May · PMID 41616556 · Publisher ↗
The social environment is an important predictor of smoking behavior. However, it remains unknown if social factors shape beliefs about whether certain cues trigger their urge to smoke, known as cue-induced smoking cravi...
The social environment is an important predictor of smoking behavior. However, it remains unknown if social factors shape beliefs about whether certain cues trigger their urge to smoke, known as cue-induced smoking craving. Across two studies (total N = 300), we investigated whether group opinions influence cue-induced smoking craving in current- and past-smokers. Individuals rated their level of craving for each presented image, followed by exposure to group opinions. In Study 1, we found that individuals' smoking craving shifted in response to group opinions, with stronger conformity to lower group opinions compared with equal or higher group opinions. Study 2, a pre-registered follow-up study, replicated these findings and further demonstrated that biased social norms modulate the degree of social influence on smoking craving. Specifically, individuals conformed more to low group opinions when biased social norms favored low ratings, and to high group opinions when norms favored high ratings. Our data demonstrate that group opinions can influence cue-induced smoking craving, highlighting the pivotal role of the social environment in shaping smoking-related beliefs and, consequently, smoking behavior.
Longitudinal associations between fear of missing out, problematic social media use, and problematic smartphone use.
Hou X, Xu L, Zhou N … +3 more , Zhu X, Mõttus R, Johnson W
Addict Behav · 2026 Apr · PMID 41610631 · Publisher ↗
Fear of missing out (FoMO) has been linked to problematic smartphone use (PSU) and problematic social media use (PSMU), but it remains unclear whether these associations reflect stable between-person differences or dynam...
Fear of missing out (FoMO) has been linked to problematic smartphone use (PSU) and problematic social media use (PSMU), but it remains unclear whether these associations reflect stable between-person differences or dynamic within-person processes over time. To address this, we analyzed five-wave longitudinal data (N = 1,596, females = 1,055, M = 19.70, SD = 1.60) using Random-Intercept Cross-Lagged Panel Models (RI-CLPMs) to disentangle between- and within-person associations longitudinally. Our observations revealed that: (1) PSU and PSMU were strongly correlated across time, indicating substantial overlap between the two behaviors; (2) FoMO positively predicted both PSU and PSMU, and these behaviors also predicted higher subsequent FoMO, suggesting bidirectional relations; and (3) FoMO and PSU exhibited moderate temporal stability. These observations underscore a subtle but persistent interplay between FoMO, PSU, and PSMU over time.
Passive data do not improve prediction or detection of alcohol consumption beyond temporal patterns in major depression: A 90-day cross-validated study.
Langener AM, Haddox D, Mackin DM … +10 more , Price GD, Lekkas D, Collins AC, Griffin TZ, Heinz MV, Nemesure MD, Nepal S, Pillai A, Campbell AT, Jacobson NC
Addict Behav · 2026 Apr · PMID 41610630 · Publisher ↗
Major Depressive Disorder (MDD) is one of the most prevalent psychological disorders and frequently co-occurs with alcohol use disorders, increasing the risk of functional impairment. Monitoring alcohol use during depres...
Major Depressive Disorder (MDD) is one of the most prevalent psychological disorders and frequently co-occurs with alcohol use disorders, increasing the risk of functional impairment. Monitoring alcohol use during depression treatment is therefore critical for early intervention. Passively collected data via devices like smartphones and smartwatches, offers a low-burden method for monitoring behavior in real time. This study investigated whether deep learning models trained on passively collected data (i.e., accelerometer, heart rate, respiratory rate, screen usage, and GPS data) could detect and predict alcohol use in individuals with MDD. Data were collected from 300 clinically depressed individuals who were enrolled in the Tracking Depression Study, a 90-day longitudinal study. Participants self-reported their alcohol use every week by completing the Timeline FollowBack. We trained models to predict same-day and next-day alcohol use. To validate these models, we split the data by participant, so that predictions were made on individuals who were not included in the training set. The models achieved moderate performance (mean AUC = 0.67 for both prediction tasks) when capturing both interindividual (between-person) and intraindividual (within-person) variability. Similar performances were observed when evaluating the model exclusively on predicting intraindividual variability (AUCs = 0.69 same-day, 0.68 next-day). However, model performance remained comparable to a baseline using only the day of week as predictor. These findings suggest that much of the predictive signal derives from temporal patterns. This indicates that interventions aligned with such temporal cues may already be effective, and that the added value of our model appears limited.
PTSD symptoms and substance use problems in traumatic injury patients: A 24-month follow-up.
Fendrich M, Petranu K, Nickel L … +2 more , Larson CL, deRoon-Cassini TA
Addict Behav · 2026 Apr · PMID 41605128 · Publisher ↗
BACKGROUND: People who experience traumatic injuries may be at risk for a variety of post-injury emotional and behavioral sequalae. In particular, the level of trauma experienced in relation to those injuries may place i...
BACKGROUND: People who experience traumatic injuries may be at risk for a variety of post-injury emotional and behavioral sequalae. In particular, the level of trauma experienced in relation to those injuries may place individuals at increased risk for substance use-related problems. Given the lack of research directly investigating the impact of injury-related PTSD on substance use problems post-injury, we conducted a secondary analysis of a study of injured patients to explore this issue. METHODS: To address the hypothesis that those experiencing more trauma at baseline were at increased risk for substance use problems at follow-up, this study utilized a prospective longitudinal design to investigate the relationship between traumatic injury, PTSD symptoms, and drug use problems over a 24-month follow-up period in 215 patients with traumatic injuries admitted for treatment to an urban Level 1 trauma center. The main study aim was to investigate whether the baseline major of trauma was associated with higher levels of substance use problems at follow-up, controlling for key background variables. Accordingly, we conducted mixed model longitudinal regression analysis where the 10-item DAST was regressed on time, demographic variables (age, sex, race, and income), and initial post-injury PTSD symptoms (as measured by the PCL-5 assessed two weeks post-injury). Separate analyses were conducted using continuous and binary measures of the DAST-10. RESULTS: Forty-two percent of the sample exceeded the clinical threshold for PTSD. Elevated PTSD symptoms increased the risk for the emergence of substance use problems over the follow-up period. The impact of PTSD symptoms remained when we looked at continuous and binary indicators of substance use problems, and when we controlled for retrospectively reported substance use problems. Male sex, older age, and lower income were also associated with the emergence of substance use problems. CONCLUSION: PTSD symptoms occurring immediately post-injury, when elevated, lead to an increased risk for the emergence of substance use problems at follow-up. Substance use problems at follow-up are not merely a continuation of problems experienced before the injury. These findings underscore the importance of screening and of psychologically focused interventions soon after the traumatic injury experience.
Metacognitive beliefs and addictions: A systematic review and meta-analysis with emphasis on the mediating role of desire thinking.
Akbari M, Rahmani M, Navab Safiadin MS … +2 more , Forootan R, Mansueto G
Addict Behav · 2026 Apr · PMID 41579781 · Publisher ↗
The Self-Regulatory Executive Function model and the Elaborated Intrusion Theory of desire highlight how dysfunctional metacognitions and desire thinking sustain addictive behaviors. Although some evidence suggests that...
The Self-Regulatory Executive Function model and the Elaborated Intrusion Theory of desire highlight how dysfunctional metacognitions and desire thinking sustain addictive behaviors. Although some evidence suggests that desire thinking may act as a bridge linking metacognitive beliefs to addictive behaviors, no meta-analysis has investigated the potential mediating role of desire thinking in this relationship. To address this, we conducted a systematic review and meta-analysis in line with PRISMA guidelines. Searches across seven databases through May 2025 identified 156,312 records; after screening and eligibility checks, 14 studies (N = 7,093, male = 51.90%, mean age = 32.08, SD = 12.43) met inclusion criteria. Metacognitions showed robust positive associations with addictive behaviors (r = 0.29-.74), strongest for negative metacognitions about desire thinking and problematic smartphone/social media use. Positive metacognitions also correlated significantly, though effect sizes were smaller. Metacognitions were strongly related to desire thinking (r up to 0.62), particularly between negative metacognitions and verbal perseveration. Desire thinking itself was moderately to strongly associated with addictive behaviors (r = 0.34-.67), with imaginal prefiguration strongly predicting smartphone overuse (r = 0.63). Mediation analyses confirmed that both verbal perseveration and imaginal prefiguration transmitted effects of metacognitions onto addictive behaviors, with imagery-based pathways especially relevant for smartphone use. Moderator analyses revealed age, sex, and population type as significant moderators in selected models, highlighting stronger effects for females and general population samples. Findings highlight desire thinking as a process closely associated with various forms of addictive behaviors, underscoring its clinical relevance. Focusing on this association can enhance metacognitive interventions and deepen our understanding of addictive behaviors across different domains.
ADHD symptoms and problematic digital media use in emerging adults: Investigating the role of cognitive deficits as mediators.
Todorovic L, Baumer J, Larsen H
Addict Behav · 2026 Apr · PMID 41558234 · Publisher ↗
This study examined the relationship between ADHD symptoms and problematic social media use (PSMU) and problematic gaming (PG) in a community sample of emerging adults. Cognitive deficits underlying ADHD - inhibitory con...
This study examined the relationship between ADHD symptoms and problematic social media use (PSMU) and problematic gaming (PG) in a community sample of emerging adults. Cognitive deficits underlying ADHD - inhibitory control deficits, reward sensitivity, and temporal processing deficits - were investigated as potential mechanisms linking ADHD symptoms to PSMU and PG. In a sample of 111 emerging adults (M = 21.2, SD = 2.7; 84% female), ADHD symptoms, PSMU, and PG were assessed using self-report scales, while cognitive deficits were evaluated through both self-report scales and behavioural tasks. Parallel mediation analyses revealed significant positive direct effects between ADHD symptoms and both PSMU and PG, but found no significant mediating effects of the hypothesised mechanisms. Exploratory analyses suggested that inhibitory control and temporal processing deficits may play a role in linking hyperactivity/impulsivity symptoms to PSMU, and inhibitory control deficits emerged as a possible transdiagnostic factor for concurrent ADHD symptoms and PSMU. Nonetheless, the main analyses did not support mediation by cognitive deficits, indicating no evidence that they explained the associations between ADHD symptoms and problematic digital media use. Future research may explore such prospective mechanisms in longitudinal designs with representative samples to inform interventions which may reduce problematic digital media use in individuals with elevated ADHD symptoms.
Gender-specific risk factors for gambling-related suicidal ideation: Evidence from a help-seeking population.
Marionneau V, Havuaho S, Wall H
Addict Behav · 2026 Apr · PMID 41548500 · Publisher ↗
People suffering from gambling problems are at a heightened risk of suicidal behaviours and ideations. Emerging evidence suggests that gambling-related suicidality may be more common amongst women, those with gambling-re...
People suffering from gambling problems are at a heightened risk of suicidal behaviours and ideations. Emerging evidence suggests that gambling-related suicidality may be more common amongst women, those with gambling-related debt and those gambling with fast-paced products such as electronic gambling machines. This study aims to investigate associations between gambling-related suicidal ideations and risk factors using logistic regression analysis. The analyses are conducted separately for women and men. The data consisted of questionnaire responses from 2,800 help-seekers (1,746 men, 1,054 women), who enrolled in a Finnish online help service for gambling problems during 2019-2024. The survey focused on the following questionnaire measures: self-reported suicidal ideation (MARDS), problematic gambling products, gambling-related debt, at-risk alcohol use (AUDIT-C), problem gambling (NODS) and social support. 19.8 percent of all respondents reported suicidal ideation (25.5% of women, 16.4% of men). Both genders reported online EGMs, online casino products and land-based EGMs as causing most harm. However, we found no statistically significant associations between gambling products and suicidal ideation. Gambling-related debt was a significant risk factor for suicidal ideation for both genders. At-risk alcohol use was a risk factor for suicidality amongst women. Lack of social support was a risk factor for both genders. In conclusion, we found that some risk factors for gambling-related suicidal ideation can differ across genders. Gambling-related debt can increase the risk of suicidality for both genders. Policy action is needed to prevent significant financial harm from gambling.
Predictors of past 30-day vaping abstinence among young e-cigarette users: Machine learning analysis of a longitudinal cohort.
Kundu A, Selby P, Felsky D … +2 more , Moraes TJ, Chaiton M
Addict Behav · 2026 Apr · PMID 41548499 · Publisher ↗
INTRODUCTION: Our existing knowledge on factors influencing vaping abstinence are still limited. The objective of this study was to build a machine learning (ML)-based model to predict past 30-day vaping abstinence and i...
INTRODUCTION: Our existing knowledge on factors influencing vaping abstinence are still limited. The objective of this study was to build a machine learning (ML)-based model to predict past 30-day vaping abstinence and identify predictors among young e-cigarette users. METHODS: Data was taken from a Canadian past 30-day e-cigarette users aged 16-25 (n = 1,659), who were followed-up from 2020 to 2023 across 9 waves. For each outcome, predictors were taken from the immediately preceding wave, resulting in a dataset of 6,435 observations. This dataset was split into a training and testing set in 4:1 ratio and three ML models- random forest, gradient boosting machine, extreme gradient boosting were built on the training set to predict past 30-day vaping abstinence. Model performance was evaluated on the testing set and the best performing model was selected for further Shapley Additive ExPlanations analysis. RESULTS: The random forest model achieved the highest performance (AUC 0.737), and sensitivity analysis showed the robustness of the model. The topmost key predictors of past 30-day vaping abstinence were past month frequency of vaping and different measures of e-cigarette dependence. In addition, product characteristics (i.e., nicotine strength, flavor), intention to quit, and harm perception of nicotine vaping emerged as important predictors across different models. The model was used to estimate individual probability of abstinence and identify the barriers of successful cessation for each individual user. CONCLUSION: While these findings can inform targeted vaping cessation strategies for young people, further research is needed to develop a more generalizable and higher-performing model.
Investigating the impact of loss accumulation periods on the predictive relationship between loss chasing and potential gambling harms.
Edson TC, Tom MA, LaPlante DA
Addict Behav · 2026 Apr · PMID 41547048 · Publisher ↗
This study builds on a growing body of research seeking to define multidimensional loss chasing. Analyzing data from 36,325 online sports bettors, the focus was to identify which loss accumulation period (loss period; i....
This study builds on a growing body of research seeking to define multidimensional loss chasing. Analyzing data from 36,325 online sports bettors, the focus was to identify which loss accumulation period (loss period; i.e., immediate losses vs. daily, weekly, monthly, and total cumulative losses) maximizes the predictive relationship between loss chasing and diverse potential harm outcomes. We found that the daily loss period yielded the best predictive efficacy for two harm outcomes (loss trajectory and voluntary self-exclusion [VSE]). Loss chasing was not associated with a third harm outcome (percent change in net loss) for any loss period. Overall, the findings suggest that the loss accumulation period for loss chasing matters for predicting harms, with daily losses presenting the most potential importance and relevance to potential gambling harm. These findings can be used to inform new predictive models for identifying risk for gambling harm from betting records.
Social media interventions and the moderation of baseline substance use: A secondary data analysis.
Tomlinson DC, Bonar EE, Florimbio AR … +3 more , Goldstick JE, Young SD, Walton MA
Addict Behav · 2026 Apr · PMID 41539117 · Full text
BACKGROUND: Substance use is a significant public health problem with peak prevalence among adolescents and emerging adults (EAs). We present a secondary data analysis evaluating the moderating effect of baseline substan...
BACKGROUND: Substance use is a significant public health problem with peak prevalence among adolescents and emerging adults (EAs). We present a secondary data analysis evaluating the moderating effect of baseline substance use on intervention outcomes from a randomized controlled trial of social media-delivered interventions for risky drinking among adolescents and EAs. METHODS: Adolescents and EAs (ages 16 to 24; N = 955, 54.5 % female, 62.6 % white) were randomized to one of three conditions: social media intervention (SMI), social media intervention + incentives (SMI + I), and control. Using negative binomial regression models, we examined the extent to which baseline substance use (an index of the sum of frequencies of use for nine substances) moderated the effect of the SMI and SMI + I conditions on 3-, 6-, and 12-month substance use outcomes. RESULTS: The interaction between baseline substance use and the SMI + I treatment condition, compared to control, was significant at 3-months (estimate = -0.024; p = 0.009), wherein individuals with higher baseline substance use had lower substance use at 3-months compared to the control condition. The interaction was not statistically significant at 6-months (p = 0.055) or 12-months (p = 0.782). The interaction with baseline substance use index was not significant for the SMI condition compared to the control condition. CONCLUSIONS: Individuals in the SMI + I condition with higher baseline substance use had lower substance use at the 3-month follow-up compared to the control condition, suggesting that additional incentives for interaction benefited individuals in the short-term, particularly those with higher baseline substance use. Future work should explore the moderating role of subgroup characteristics to inform future tailoring of intervention content for substance use.
Efficacy of combined nicotine replacement therapy (NRT) and bupropion compared to bupropion alone for smoking cessation: a systematic review and meta-analysis.
Wang M, Liu Z, Zhou X … +7 more , Shi Y, Ji T, He J, Cheng A, Zhao L, Xiao D, Wang C
Addict Behav · 2026 Apr · PMID 41539116 · Publisher ↗
INTRODUCTION: Smoking is a major preventable cause of morbidity and premature death worldwide. Both bupropion and NRT help achieve smoking cessation. However, evidence on whether the combination of bupropion and NRT is m...
INTRODUCTION: Smoking is a major preventable cause of morbidity and premature death worldwide. Both bupropion and NRT help achieve smoking cessation. However, evidence on whether the combination of bupropion and NRT is more effective than bupropion alone remains uncertain. The aim of this study was to compare the efficacy and safety of bupropion combined with NRT with bupropion monotherapy. METHODS: The Cochrane Library, Embase, PubMed, and Web of Science were systematically searched for original articles published in English. Randomized controlled trials (RCTs) that compared bupropion plus NRT therapy with bupropion were included. Qualitative and quantitative analyses were conducted and the risk of bias was assessed using the Cochrane Risk of Bias 2 tool. RESULTS: Nine RCTs involving 4005 participants (53.8% female) were included in this study. The mean age across studies ranged from 27 to 55 years. The risk of bias results showed that two RCTs were rated as high, one was low, and six were unclear. Pooled analysis indicated that bupropion combined with NRT significantly improved biochemically validated 7-day point prevalence abstinence at the end of treatment [risk ratio (RR) = 1.35, 95% confidence interval (CI): 1.22-1.50, I = 21%]. At long-term follow-up (≥6 months), bupropion plus NRT showed a non-significant benefit over bupropion monotherapy (RR = 1.10, 95% CI: 0.90-1.34, I = 52%). Adverse events were generally comparable between groups, except for a higher incidence of nausea in the combination therapy group (10.9% vs. 7.3%; RR = 1.42, 95% CI 1.04-1.94, I = 0%). No significant subgroup differences were found based on the types of NRT (nicotine patch, gum, or lozenge) (χ = 0.89, p = 0.64). CONCLUSION: Combination therapy of bupropion and NRT was associated with superior short-term smoking cessation outcome compared with bupropion alone, with a comparable safety profile except for increased risk of nausea. However, the long-term benefit of combination therapy over bupropion monotherapy was attenuated and non-significant. Further high-quality RCTs with adequate long-term follow- up are needed to confirm these findings.
Acute effects of subjective alcohol effects and negative alcohol consequences on next-day positive alcohol expectancies.
Waddell JT, Acuff SF, Schultz ME … +1 more , Lee CM
Addict Behav · 2026 Apr · PMID 41534262 · Full text
BACKGROUND: Acute subjective alcohol effects are theorized to impact next-day alcohol expectancies and future drinking likelihood. However, little research has focused on the acute impact of distinct subjective alcohol-r...
BACKGROUND: Acute subjective alcohol effects are theorized to impact next-day alcohol expectancies and future drinking likelihood. However, little research has focused on the acute impact of distinct subjective alcohol-related effects (i.e., high-arousal-positive/stimulation vs. low-arousal-positive/relaxation) on next-day expectancies and drinking likelihood, despite the two having divergent alcohol outcomes. Further, such relations may be dampened when simultaneously experiencing negative alcohol consequences. The current study fills these voids in the literature. METHODS: Young adults (N = 131) completed 21 days of ecological momentary assessments, reporting (1) subjective effects during user-initiated drink reports and (2) expectancies and use behavior during next-day reports. Two-level multilevel mediation models tested whether subjective effects and negative consequences experienced from past-day drinking episodes indirectly predicted changes in next-day drinking likelihood via changes in next-day expectancies, and whether negative consequences experienced moderated such links. RESULTS: Past-day high- and low-arousal-positive subjective effects predicted increased next-day high- and low-arousal-positive expectancies, respectively. Further, past-day experiences of negative alcohol consequences predicted decreased next-day high (but not low) arousal positive expectancies. Thus, high-arousal-positive effects indirectly predicted higher likelihood of next-day drinking via increased next-day high-arousal-positive expectancies, whereas negative consequences predicted lower likelihood of next-day drinking via dampened next-day high-arousal-positive expectancies. Negative consequences moderated relations between low (but not high) arousal positive subjective effects and next-day expectancies, wherein past-day low-arousal-positive effects translated into stronger next-day low-arousal-positive expectancies when, surprisingly, experiencing higher-than-average (vs. lower-than-average) negative consequences. CONCLUSIONS: Subjective effect-to-expectancy relations were present for both high- and low-arousal-positive effects, but negative consequences only served a "teachable moment" in terms of modifying next-day high arousal positive expectancies.
The role of cumulative adverse childhood experiences in the interrelationships among addictive behaviors: A network analysis study.
Veneziani G, Giraldi E, Panagini G … +4 more , Marano G, Festa GM, Mazza M, Lai C
Addict Behav · 2026 Apr · PMID 41529544 · Publisher ↗
BACKGROUND: Adverse childhood experiences have been identified as important risk factors for addictive behaviors, particularly when cumulatively occurring. The present cross-sectional study aimed to investigate the diffe...
BACKGROUND: Adverse childhood experiences have been identified as important risk factors for addictive behaviors, particularly when cumulatively occurring. The present cross-sectional study aimed to investigate the differences and interrelationships of addictive behaviors (both substance and behavior-related, such as gaming and overeating) according to adverse childhood experiences. METHOD: A total of 802 participants recruited from the Italian general population completed the brief Screener for Substance and Behavioral Addiction and Childhood Traumatic Events Scale. Based on reported adverse childhood experiences, participants were divided into three groups: no adverse experience, single adverse experience, and multiple adverse experiences. The interrelationships among addictive behaviors in the groups were assessed using a network analysis approach. RESULTS: The multiple adverse experiences group reported significantly higher levels of addictive behaviors related to tobacco, overeating, and sex. Network analysis showed that in the multiple adverse experiences group, addictive behaviors were more interrelated, displaying a greater number of associations among each other than in the no adverse experience and single adverse experience groups. Particularly, in the multiple adverse experiences group, substance-related addictive behaviors (alcohol, tobacco, cannabis, cocaine) showed strong interrelationships, suggesting a pattern of polysubstance use. Moreover, in the multiple adverse experiences group, overeating showed associations with the other types of addictive behaviors. Lastly, in each group, compulsive sex was associated with most of the other types of addictive behaviors, and, specifically, in the multiple adverse experiences group, it showed connections with shopping and overworking, while in the no adverse experience group, with cannabis, videogaming, and overeating. CONCLUSIONS: The main findings of the study showed that individuals with cumulative adverse childhood experiences not only reported higher severity of single addictive behaviors, but also greater interrelationships among each other, highlighting in these individuals a potential pattern of mutual reinforcement and links between several addictive behaviors.
The impact of cannabis co-use and cannabis use disorder on interest in and barriers to tobacco cessation.
Graham FJL, Pravosud V, Keyhani S … +5 more , Hoggatt KJ, Ling P, Hasin D, Nguyen N, Cohen BE
Addict Behav · 2026 Apr · PMID 41525756 · Publisher ↗
BACKGROUND: Co-use of cannabis and tobacco is increasing, but its impact on smoking cessation is not completely understood. It is unclear whether any cannabis use, or only problematic use such as cannabis use disorder (C...
BACKGROUND: Co-use of cannabis and tobacco is increasing, but its impact on smoking cessation is not completely understood. It is unclear whether any cannabis use, or only problematic use such as cannabis use disorder (CUD), impacts smoking cessation. METHOD: In 2023, we conducted an online, national survey of US adults (n = 2,271) currently smoking cigarettes. We examined the association of past 30-day cannabis use (divided into three groups: co-use with CUD, co-use without CUD, and no cannabis use) with outcomes that can impact smoking cessation: self-rated importance, readiness, and confidence in quitting, barriers to cessation (Barriers to Cessation Scale, score range 0 to 57), and specific types of barriers (Addiction, Internal, and External barriers subscales). RESULTS: Interest in quitting smoking and self-rated importance was lowest in those with co-use without CUD, but self-rated readiness and confidence did not significantly differ among the three groups. Those with CUD reported the highest levels of barriers overall (total score of 20.3 for co-use with CUD, 15.2 for co-use use without CUD, and 16.4 for no cannabis use) and across all subscales. Adjusted subscale scores were higher for adults with CUD vs. cannabis use without CUD (Addiction: p = 0.03, External: p= 0<.001, Internal: <.001) and vs. no cannabis use (Addiction: p = 0.03, External: p = 0.02, Internal: p < 0.001). CONCLUSIONS: Adults who smoke cigarettes and use cannabis (vs. those smoking without cannabis co-use) report similar levels of readiness and confidence in quitting smoking. However, interest in and importance of quitting smoking was lowest in those reporting co-use without CUD and barriers were greatest in those reporting co-use with CUD. These populations may benefit from targeted interventions to address their unique challenges and improve smoking cessation.
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