Addict Behav [JOURNAL]
Sun
200 papers
Risk of opioid overdose during buprenorphine treatment for opioid use disorder in the fentanyl era.
Chambers LC, Hallowell BD, Zullo AR … +7 more , Rodriguez M, Khan MA, Berk J, Gaither R, Daly M, Wightman RS, Beaudoin FL
Addict Behav · 2026 Apr · PMID 41520431 · Full text
BACKGROUND: For patients who use fentanyl, higher than currently recommended maintenance doses of buprenorphine treatment for opioid use disorder (OUD) may be needed to prevent cravings and withdrawal, but some clinician...
BACKGROUND: For patients who use fentanyl, higher than currently recommended maintenance doses of buprenorphine treatment for opioid use disorder (OUD) may be needed to prevent cravings and withdrawal, but some clinicians and regulators are concerned that higher doses may increase overdose risk. We evaluated buprenorphine effectiveness for overdose prevention in the fentanyl era. METHODS: We conducted a retrospective cohort study of Rhode Island residents initiating buprenorphine for OUD (October 2016‒September 2022) using statewide administrative data. On each of 365 follow-up days, patients were classified as having an active buprenorphine prescription (yes/no) and a non-fatal or fatal opioid overdose (yes/no). Follow-up was discontinued if patients died or initiated methadone or naltrexone. Generalized estimating equations compared opioid overdose risk for days with versus without an active buprenorphine prescription, controlling for potential confounders and clustering by patient. RESULTS: Among 8,676 patients initiating buprenorphine, most were aged 25-44 years (56.0 %) and male (61.3 %). In the 365 days following initiation, 52.6 % of person-days were covered by an active buprenorphine prescription, 1,069 patients (12.3 %) had follow-up discontinued due to methadone initiation, and 411 patients (4.7 %) experienced 545 opioid overdoses. Opioid overdose risk was 61 % lower for days with versus without an active buprenorphine prescription (adjusted risk ratio = 0.39, 95 % confidence interval = 0.31-0.49). Daily doses prescribed on days with and without an opioid overdose event were similar (P = 0.261). CONCLUSIONS: Buprenorphine remains effective for overdose prevention in the fentanyl era among patients who remain in treatment. There was no evidence that higher doses were associated with greater overdose risk.
Synthesising the available evidence to identify the health impact of gambling harm and gambling problems.
Tulloch C, Browne M, Russell AMT … +1 more , Rockloff M
Addict Behav · 2026 Apr · PMID 41520430 · Publisher ↗
Gambling-related harm (GRH) significantly impacts health-related quality of life (HRQoL), though its measurement remains challenging due to varied methodologies. This study synthesises existing research on HRQoL effects...
Gambling-related harm (GRH) significantly impacts health-related quality of life (HRQoL), though its measurement remains challenging due to varied methodologies. This study synthesises existing research on HRQoL effects of gambling, highlighting the complementary strengths of direct and indirect elicitation methods. We reviewed studies measuring GRH's impact on HRQoL, focusing on the maximum effect of severe problems and the shape of the impact curve across the harm spectrum. Results revealed consistent maximum HRQoL disutility of approximately 0.45 for severe gambling problems in direct elicitation studies, while indirect methods showed scaling that implies an arguably implausible maximum. We propose a novel hybrid approach that leverages the strengths of both methods: using direct elicitation to establish the maximum impact and indirect methods to determine the relative impacts across the harm spectrum. This approach mitigates attribution biases in direct measures for lower levels of harm while still benefiting from their ability to accurately capture the impact of gambling at severe levels. To assess lower levels of impact, it uses relative scaling from indirect methods that better reflect how quality of life changes as harms accumulate. Our final best-of-both-worlds estimate synthesises available evidence of GRH's impact on HRQoL, grounded in recognised public health metrics.
Tobacco and cannabis co-use by route of administration in the United States, 2022/2023.
Gibson LP, Parks MJ, Kimmel HL … +11 more , Blanco C, Ciccolo JT, Creamer MR, Everard C, Freedman ND, Garcia M, Kingsbury JH, Lee YO, Marshall D, Compton WM, Kaufman A
Addict Behav · 2026 Apr · PMID 41518991 · Full text
Given recent increases in cannabis and tobacco co-use, alongside the rapidly evolving cannabis and tobacco use landscapes in the United States (US), updated national estimates of current co-use that account for route of...
Given recent increases in cannabis and tobacco co-use, alongside the rapidly evolving cannabis and tobacco use landscapes in the United States (US), updated national estimates of current co-use that account for route of administration are needed. Using data from Wave 7 (2022/2023) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study (N = 39,947), this study estimates the prevalence of current co-use among US youth and adults aged 12 years and older and examines the specific routes (e.g., combustible, vaping, oral) through which individuals co-use both substances. Data were weighted to produce representative estimates. An estimated 8.2 % of US youth and adults reported current (past 30-day) co-use between 2022 and 2023. Co-use of combustible tobacco and combustible cannabis products was the most common form of co-use, accounting for nearly one third of all co-using individuals. Co-use involving combustible tobacco and combustible cannabis was most common among co-using individuals aged 25-39 and 40+, while co-use involving nicotine vaping was most common among those aged 12-24. Use of multiple tobacco and/or cannabis administration routes was also common. These findings provide the first nationally representative estimates of co-use that account for specific administration routes for both tobacco and cannabis. Findings highlight the need for surveillance and intervention strategies that account for the full range of tobacco and cannabis administration routes available today.
Problematic cannabis use and attachment insecurities as Joint predictors of Depression: Cross-Sectional and longitudinal models.
Gliksberg O, Shmulewitz D, Skvirsky V … +5 more , Levitin MD, Feingold D, Kor A, Lev-Ran S, Mikulincer M
Addict Behav · 2026 Apr · PMID 41518990 · Publisher ↗
Cannabis use, depression, and attachment insecurities (anxiety, avoidance) have been previously linked, though typically examined using bivariate methods. This study tested cross-sectional and longitudinal associations a...
Cannabis use, depression, and attachment insecurities (anxiety, avoidance) have been previously linked, though typically examined using bivariate methods. This study tested cross-sectional and longitudinal associations among these constructs, assessing whether problematic cannabis use contributes to depression, and whether attachment insecurities exacerbate this effect. Data were collected from 1,745 Jewish Israeli adults at two timepoints (2024 = T1; 2025 = T2) of whom 412 reported lifetime cannabis use. Problematic cannabis use, depression, and attachments insecurities were assessed with the ASSIST, PHQ-9 and ECR ,respectively. Analyses in the full sample examined the full range of cannabis involvement, including no use, and in the lifetime-user subsample the impact of problematic use severity. Cross-sectional models at T1 and T2 tested whether depressive symptoms were predicted by problematic cannabis use and moderated by attachment anxiety and avoidance. A longitudinal model examined whether problematic cannabis use and attachment insecurities at T1 predicted changes in depression from T1 to T2. At both timepoints, attachment anxiety significantly moderated the cannabis-depression association (p = 0.013 at T1, p = 0.002 at T2), with a stronger link at higher anxiety levels. Similar patterns appeared in the lifetime-user subsample. Longitudinally, a significant three-way interaction (p = 0.014) indicated that increases in depression were greatest among individuals high in both anxiety and avoidance, while avoidance buffered this effect among users. Attachment insecurities are key vulnerability factors that intensify the depressive impact of problematic cannabis use. These findings underscore the importance of developing clinical interventions targeting both substance use and attachment-related vulnerabilities and emotional dysregulation.
Alcohol consumption patterns and Long-Term Anxiety: The influence of Sex, Age, and income.
D'Aquino S, Riordan B, Cook M … +1 more , Callinan S
Addict Behav · 2026 Apr · PMID 41506215 · Publisher ↗
OBJECTIVE: Alcohol consumption patterns have been associated with long-term anxiety, but evidence on how these associations vary across population subgroups remains limited. This study examines longitudinal associations...
OBJECTIVE: Alcohol consumption patterns have been associated with long-term anxiety, but evidence on how these associations vary across population subgroups remains limited. This study examines longitudinal associations between alcohol consumption frequency and quantity and subsequent anxiety, and tests whether these relationships were moderated by sex, age, and income level. METHODS: Participants were from a nationally representative sample of Australian adults (N = 21,405) from the Household, Income, and Labour Dynamics in Australia (HILDA) survey between 2006 and 2021. Linear mixed-effects models predicted anxiety based on alcohol consumption one-year prior up to eight times per participant. Moderation by sex (male, female), age-group (18-25, 26-37, 38-50, 51 + years), and income quartile were examined. Anxiety was measured using the Kessler-10 anxiety subscale and alcohol consumption was measured using self-reported alcohol consumption frequency (alcohol consumption occasions per week) and alcohol consumption quantity (standard drinks consumed on alcohol consumption occasions). RESULTS: An adjusted model demonstrated a small effect of frequency (IRR[95 % CI] = 0.98[0.98, 0.99]) and quantity (IRR[95 % CI] = 1.02[1.01, 1.03]) on anxiety one-year later. Age, but not sex nor income, moderated the relationship between alcohol consumption and anxiety. Specifically, frequency was associated with slightly lower longitudinal anxiety for 51 + year-olds (β[95 % CI] = -0.04[-0.05, -0.03]), but showed no association for 18-50-year-olds. Conversely, quantity was associated with slightly greater longitudinal anxiety for 51 + year-olds (β[95 % CI] = 0.03[.02, 0.05]) and 26-50-year-olds (β[95 % CI] = 0.02[.01, 0.03]), but not 18-25-year-olds. CONCLUSIONS: While the impact of alcohol consumption on anxiety appears very small, divergent relationships of drinking frequency versus quantity on long-term anxiety seem to emerge across the lifespan. Drinking larger amounts per occasion appears associated with slight increases in anxiety from early adulthood, while drinking more frequently but in smaller amounts appears associated with slight decreases in anxiety in older adulthood.
Consumer engagement with the US alcohol health warning: A nationally representative study.
Hall MG, Ruggles PR, Chelius C … +6 more , Lee CJY, Whitesell C, Lazard AJ, Brewer NT, Greenfield TK, Grummon AH
Addict Behav · 2026 Apr · PMID 41506214 · Publisher ↗
BACKGROUND: The US has had the same health warning on alcohol containers since 1989. We sought to estimate consumer noticing, reading, and recall of the current US alcohol health warning. METHODS: We recruited a national...
BACKGROUND: The US has had the same health warning on alcohol containers since 1989. We sought to estimate consumer noticing, reading, and recall of the current US alcohol health warning. METHODS: We recruited a nationally representative sample of 1,036 US alcohol consumers ages 21 + years. Participants completed an online survey in 2024 that assessed whether they had noticed or read the current US alcohol health warning, as well as aided recall of the topics in the warning. Analyses used multivariable logistic regression to examine correlates of reading the warning. RESULTS: About half of participants (52 %) reported noticing the alcohol health warning the last time they saw an alcohol container and 27 % reported reading the warning in the past month. Reading the warning was more common among Black people (vs. white, 43 % vs. 23 %, p = 0.02). When prompted with a list of possible warning topics, only 4 % of participants correctly recalled all five topics in the warning. Most (60 %) recalled that the warning discussed pregnancy, but less than half recalled the remaining topics in the warning (46 % driving a car, 44 % operating machinery, 41 % birth defects, and 33 % health problems). Recall was modestly higher among those who read the warning in the past month (improvements of 5-16 percentage points) compared to those who did not. However, fewer than two-thirds of people who said they had read the warning recalled each topic. CONCLUSIONS: The current US alcohol warning fails to actively engage many alcohol consumers. The US should require new, rotating alcohol warnings designed to heighten engagement and better inform consumers.
Protective behavioral strategies and planned drinking relate to high intensity drinking and consequences at the day level.
Merrill JE, Peterson R, Garcia CC … +5 more , Howe LK, Carey KB, Barnett NP, Jackson KM, Miller MB
Addict Behav · 2026 Apr · PMID 41500079 · Full text
BACKGROUND: Heavy episodic drinking (HED; 4 + [females]/5 + [males] drinks/occasion), high-intensity drinking (HID; 8 + [females]/10 + [males] drinks/occasion), and drinking events that are planned are all associated wit...
BACKGROUND: Heavy episodic drinking (HED; 4 + [females]/5 + [males] drinks/occasion), high-intensity drinking (HID; 8 + [females]/10 + [males] drinks/occasion), and drinking events that are planned are all associated with negative consequences. Protective behavioral strategies (PBS) are techniques to minimize alcohol-related consequences. In this day-level study, we hypothesized (1) PBS use would be associated with safer same-day drinking (lower odds of HID and negative consequences), and (2) risks of HID and consequences associated with planned drinking would be reduced on days with higher PBS use. Additionally, (3) on HID days, having planned to engage in HID was hypothesized to relate to use of fewer PBS. METHOD: Young adults (n = 203, 57 % female) completed a baseline assessment and 28-day ecological momentary assessment of drinking intentions, and number of drinks. RESULTS: In total, 2,467 drinking days were captured (52% planned, 27% HID). Using more PBS was associated with lower odds of HID (relative to HED but not moderate drinking), and fewer consequences, partially supporting our first hypothesis. PBS did not moderate effects of planned drinking on HID or negative consequence odds. On planned (vs unplanned) HID days, fewer PBS were used, supporting our third hypothesis. CONCLUSION: Planning to drink is linked reliably to heavier drinking and negative consequences, but day-level associations between PBS and risky drinking are complex. PBS appear to have less impact on consequences when drinking is planned. When HID in particular is planned, fewer PBS are used. For days when HID is planned, real-time reminders of PBS may add value to intervention efforts.
More high, less low? PTSD and the complex daily associations between cannabis use and depression in veterans.
Davis JP, Saba SK, Leightley D … +6 more , Pedersen ER, Prindle J, Cantor J, Dilkina B, Dworkin E, Sedano A
Addict Behav · 2026 Apr · PMID 41477917 · Publisher ↗
BACKGROUND AND AIMS: Cannabis use is increasingly prevalent among U.S. veterans, with high rates of both recreational and problematic use. Veterans often use cannabis to manage symptoms associated with mental health prob...
BACKGROUND AND AIMS: Cannabis use is increasingly prevalent among U.S. veterans, with high rates of both recreational and problematic use. Veterans often use cannabis to manage symptoms associated with mental health problems such as depression and posttraumatic stress disorder (PTSD). Prior work has noted mixed results on the longitudinal associations between cannabis use and depression. Studying these associations at the daily level can lead to improved clarity. DESIGN: The present study examined the daily associations between cannabis use and depression in veterans using dynamic structural equation modeling (DSEM). We also explored these associations for those veterans who screened positive for posttraumatic stress disorder (PTSD) compared to those who did not. SETTING: All participants were recruited using advertisements from BuildClinical, an NIH approved recruitment vendor. PARTICIPANTS: The sample consisted of 74 veterans who provided daily data for 87 consecutive days. MEASUREMENT: Cannabis was assessed asking how many hours each individual spent high each day, depressed mood was assessed using a sliding scale from not depressed to very depressed each day, and PTSD was assessed using the PTSD checklist. FINDINGS: Among the full veteran sample results revealed a bidirectional, negative, association. Specifically, on days when veterans reported greater depression, they reported fewer hours "high" the next day. Conversely, on days when veterans reported a greater number of hours high, they reported less depression the next day. Among veterans screening positive for PTSD, on days when they reported more depression, they reported fewer hours high the next day (no association was noted for cannabis use predicting depression). However, for those who did not screen positive for PTSD, on days when veterans reported greater number of hours high, they reported less depression the next day. CONCLUSIONS: These results highlight the need for further research on the effect of individual differences in cannabis use patterns among veterans with PTSD on health outcomes. Clinically, these results highlight the importance of targeting the pros and cons of cannabis use for depression symptom relief. Future research should incorporate daily objective measures of cannabis use to refine treatment strategies for veterans managing PTSD or depressive related distress.
Are older adults scheduled for lung cancer screening interested in trying electronic cigarettes when conventional smoking cessation treatment fails? A cross-sectional survey.
Avila JC, Tripathi N, Marotta CJ … +5 more , McCann CE, Reyen M, Haas JS, Park ER, Rigotti NA
Addict Behav · 2026 Apr · PMID 41447891 · Full text
INTRODUCTION: Lung cancer screening (LCS) provides an opportunity to offer tobacco cessation treatment, but most people who smoke are unable to quit, even with support. They might benefit from switching to electronic cig...
INTRODUCTION: Lung cancer screening (LCS) provides an opportunity to offer tobacco cessation treatment, but most people who smoke are unable to quit, even with support. They might benefit from switching to electronic cigarettes (EC), but their perceptions and interest in EC use are unknown. METHODS: Adults who participated in a smoking cessation clinical trial offered at LCS and still smoked at trial completion were surveyed about their interest in trying EC (primary outcome). Independent variables were EC use history and perceptions of health risks and benefits of EC vs combustible cigarettes (CC). Logistic regression models tested the association of EC use and perceptions with interest in trying EC, adjusting for covariates. RESULTS: 204/359 eligible participants (56.8 %) completed the survey. 56.4 % had never tried EC, and 30.9 % were interested in trying EC in the future. 60.3 % believed EC to be as or more harmful than CC, but 60.8 % thought that EC were likely to help people cut down smoking. Interest in trying EC was positively associated with previous EC experience (OR: 2.08, 95 %CI:1.1-3.9), and the belief that EC were less harmful than CC (OR: 8.9, 95 %CI: 3.2-24.9), or that EC can help people cut down on smoking (OR: 8.6, 95 %CI: 3.5-21.2). CONCLUSIONS: Adults undergoing LCS who smoke after cessation treatment ends believe that EC can help people cut down, but they overestimate EC health risks. A positive perception of EC is associated with greater interest in trying EC. Education to correct EC misperceptions might increase interest in trying EC as a harm reduction tool among those who smoke.
Perceptions of negative reinforcement in the natural environment: Characterizing subjective alcohol- and cannabis-contingent relief.
Wycoff AM, Trull TJ
Addict Behav · 2026 Apr · PMID 41442815 · Full text
Negative reinforcement is a major component of etiologic models of addiction. Recent work using ecological momentary assessment (EMA) implicates subjective substance-contingent relief as a negative reinforcer of substanc...
Negative reinforcement is a major component of etiologic models of addiction. Recent work using ecological momentary assessment (EMA) implicates subjective substance-contingent relief as a negative reinforcer of substance use rather than improvements in negative affect. This pre-registered secondary data analysis tested predictors of subjective alcohol- and cannabis-contingent relief to understand what factors contribute to perceived relief, if not actual improvements in negative affect. Adults (N = 87, mean age 25.2 years, 60.2% female, 85.2% white) who reported using alcohol and cannabis simultaneously at least twice per week completed 14 days of EMA. Morning surveys assessed hypothetical relief expectancies for that day. All surveys assessed affect, craving, alcohol and cannabis use, and subjective relief and pleasure from use. Multilevel models tested predictors of subjective relief. During alcohol use moments (n = 868), drinking-contingent pleasure (b = 0.25, SE = 0.06, p < .001) and relief expectancy reported that morning (b = 0.29, SE = 0.10, p = .005) predicted higher drinking-contingent relief. During cannabis use moments (n = 1519), cannabis-contingent pleasure (b = 0.29, SE = 0.06, p < .001) and relief expectancy reported that morning (b = 0.33, SE = 0.11, p = .004) predicted higher cannabis-contingent relief. Changes in affect and craving were not associated with relief. Results highlight subjective pleasure, which is more consistent with positive reinforcement, as a potential driver of perceived relief. Future work should disentangle the predictive direction of relief and pleasure to inform reinforcement mechanisms. Results also highlight the role of expectancies in subjective perceptions of use, above and beyond measurable changes in mood and craving. Collectively, findings add to a growing body of work seeking to articulate reinforcement processes in the natural environment.
Social attunement and alcohol use: The role of age and gender.
Romein C, Colyer-Patel K, Kroon E … +3 more , Larsen H, El Marroun H, Cousijn J
Addict Behav · 2026 Apr · PMID 41435756 · Publisher ↗
BACKGROUND: Alcohol use typically peaks during adolescence and early adulthood, when its social reinforcement value is high, and then decreases as individuals take on more adult-like responsibilities. The present study i...
BACKGROUND: Alcohol use typically peaks during adolescence and early adulthood, when its social reinforcement value is high, and then decreases as individuals take on more adult-like responsibilities. The present study investigates whether social attunement (SA) plays a role in higher alcohol use in adolescence as well as a lower alcohol use when aging. METHODS: This online study included an international sample of 683 alcohol users (16 - 81yrs). Participants completed a SA Questionnaire, an Implicit SA task (ISAT), and measures of alcohol use. The ISAT measured SA as the change in willingness to drink in response to peer feedback between two blocks of images representing social alcohol, social non-alcohol, and social non-drinking settings. Linear regressions were conducted to assess the association between SA and alcohol use, and the role of age and gender in these associations. RESULTS: Unlike expected, interactions between age and SA did not predict alcohol use across social situations regardless of feedback condition. However, exploratory post-hoc analyses using the total SA score per social condition showed significant interactions between age and SA in predicting alcohol use in social situations involving non-alcoholic or no drinks. In social non-alcohol drinking settings, SA was positively associated with alcohol use among younger participants, but this association became negative in older individuals. Contrastingly, in the social non-drinking condition, SA was negatively associated with alcohol use among younger participants, but this association became positive in older individuals. DISCUSSION: Depending on age and social setting, SA can both be a risk- or protective factor for alcohol use.
Longitudinal study of probable compulsive sexual behavior disorder and problematic pornography use profiles: their prospective impact on psychopathology during wartime.
Efrati Y, Shmulewitz D, Skvirsky V … +4 more , Vider M, Kor A, Lev-Ran S, Mikulincer M
Addict Behav · 2026 Apr · PMID 41435755 · Publisher ↗
Research has shown that compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU) are associated with mental disorders. However, less is known about how trajectories of probable CSBD and PPU prospe...
Research has shown that compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU) are associated with mental disorders. However, less is known about how trajectories of probable CSBD and PPU prospectively contribute to the evolvement of psychopathology during a stressful period. In this study, we applied latent profile analysis (LPA) to identify distinct latent profiles of participants' probable CSBD and PPU across 2018 and 2022, prior to the October 2023 attack in Israel (Iron Swords War), and to examine how these profiles prospectively predict the evolvement of psychopathology during wartime. A longitudinal study surveying the in a community sample of Jewish population in Israel, aged 18-70, was conducted before October 7th 2023 attack and during the subsequent war. Participants completed self-report measures of probable CSBD and PPU, psychopathology (global distress, emotional dysregulation, PTSD, anxiety, depression), and level and kind of exposure to the October 7th attack. LPA revealed four distinct probable CSBD/PPU profiles during the two pre-war waves: 'no disorder' (n = 952; 80.54 %),'recovery' (n = 138; 11.68 %),'delayed onset' (n = 50; 4.23 %), and 'chronic' (n = 42; 3.55 %). Using T3 and T4 for the trajectory results, the no-disorder group consistently demonstrated the lowest levels of psychopathology and out-of-control behaviors during wartime, while the chronic group reported significantly higher distress; differential impacts among probable CSBD/PPU trajectory groups showed that the no-disorder group reported decreasing anxiety and depression during wartime in contrast to the chronic group that experienced increased PTSD severity. This research offers a nuanced understanding of probable CSBD/PPU profiles, showing how these profiles impact the evolvement of psychopathology during wartime.
Functional disability and the risk of subsequent smoking initiation: A prospective cohort analysis.
Adebisi YA, Alshahrani NZ
Addict Behav · 2026 Apr · PMID 41412006 · Publisher ↗
BACKGROUND: Smoking initiation remains a major public health concern, yet little is known about whether functional disability independently increases the risk of becoming a smoker. METHODS: We conducted a prospective coh...
BACKGROUND: Smoking initiation remains a major public health concern, yet little is known about whether functional disability independently increases the risk of becoming a smoker. METHODS: We conducted a prospective cohort analysis using data from Waves 10 (2018-2019, baseline) and 14 (2022-2023, follow-up) of the UK Household Longitudinal Study. The analytic sample included 20,529 adults who were non-smokers at baseline and were prospectively followed over four years to assess smoking initiation at Wave 14. Functional disability was assessed across twelve domains; mobility, lifting or carrying objects, manual dexterity, continence, hearing, sight, physical coordination, personal care, memory/concentration/learning/understanding, communication/speech, recognising physical danger, and other health problems or disabilities; and was operationalised based on its presence, number of affected domains, and specific type of limitation reported. Modified Poisson regression with robust standard errors was used to estimate adjusted relative risks (RRs) of smoking initiation, controlling for age, sex, education, ethnicity, and urban/rural residence. RESULTS: At baseline, 25.1 % of participants (n = 5161) reported at least one functional disability. By follow-up, 379 participants (1.9 %) had initiated smoking. Individuals with functional disabilities had a higher risk of smoking initiation (RR = 1.42, 95 % CI: 1.12-1.80, p = 0.004) after adjustment. A significant trend was observed across increasing numbers of functional disabilities (p-trend < 0.001), with elevated risks among individuals reporting two or more (RR = 1.80, 95 % CI: 1.33-2.42, p < 0.001). Among new smokers, individuals with functional disabilities were also more likely to smoke ≥ 10 cigarettes per day (RR = 1.40, 95 % CI: 1.04-1.64, p = 0.020). Domain-specific analyses showed that mobility limitations (RR = 1.83, 95 % CI: 1.33-2.50, p < 0.001), lifting or carrying impairments (RR = 1.90, 95 % CI: 1.40-2.57, p < 0.001), personal care limitations (RR = 1.95, 95 % CI: 1.19-3.18, p = 0.008), and difficulties recognising physical danger (RR = 2.59, 95 % CI: 1.15-5.81, p = 0.021) were most strongly associated with smoking initiation. CONCLUSIONS: Functional disability is associated with an increased risk of smoking initiation. These findings highlight the need for inclusive tobacco prevention strategies that address the unique vulnerabilities and barriers faced by people with functional impairments.
Smartphones are not addictive: a proposal to distinguish between rewards and reward delivery vehicles.
Meshi D, Binder J
Addict Behav · 2026 Mar · PMID 41391346 · Publisher ↗
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Evaluating different patterns of problematic internet use using a unified self-report measure based on the ICD-11 framework: Psychometric properties of the Italian version of the ACSID-11.
Ghinassi S, Fioravanti G, Donati MA … +3 more , Primi C, Loscalzo Y, Casale S
Addict Behav · 2026 Mar · PMID 41391345 · Publisher ↗
The ACSID-11 was developed to assess five patterns of problematic Internet use-namely, gaming disorder, compulsive online shopping, problematic online pornography use, problematic social networks use, and online gambling...
The ACSID-11 was developed to assess five patterns of problematic Internet use-namely, gaming disorder, compulsive online shopping, problematic online pornography use, problematic social networks use, and online gambling disorder-using a unified set of items grounded in the ICD-11 framework. The present study examined the psychometric properties of the Italian version of the ACSID-11. A sample of 1263 participants (76.70 % females, M = 40.89, SD = 13.72, range = 18-83) completed the ACSID-11 and was included in the analysis of its factorial structure. A series of Confirmatory Factor Analyses (CFAs) confirmed the assumed four-factorial structure (i.e., Impaired Control, Increased Priority, Continuation/Escalation of Use, Functional Impairment in Daily Life/Marked Distress), which was superior to the unidimensional solution for all the patterns of problematic Internet use. Moreover, the second-order models demonstrated comparable fit to the four-factor solutions and supported the use of an overall composite score. A subsample of 999 participants (76.40 % females, M = 40.59, SD = 13.67, range = 18-83) also completed the Patient Health Questionnaire-9, the General Anxiety Disorder Scale-7, and the Satisfaction with Life Scale, whereas the number of participants who completed the measures used to assess convergent validity varied depending on whether they reported engaging in the corresponding behavior or not. Convergent and criterion validity were supported. These findings suggest that the Italian version of this unified item set is a valid and reliable tool for consistently assessing different patterns of problematic Internet use.
Alcohol demand and alcohol use disorder among adolescents and young adults who drink heavily: An exploratory analysis including sex differences.
Gex KS, Green R, Acuff SF … +5 more , Kirkland AE, Browning BD, Tomko RL, Gray KM, Squeglia LM
Addict Behav · 2026 Mar · PMID 41389503 · Full text
Behavioral economic alcohol demand, or the reward value of alcohol consumption, consistently shows associations between alcohol use and alcohol use disorder (AUD) in adults, yet research within clinical youth populations...
Behavioral economic alcohol demand, or the reward value of alcohol consumption, consistently shows associations between alcohol use and alcohol use disorder (AUD) in adults, yet research within clinical youth populations (considered to be ages 15-24) remains limited. It is critical to better understand how demand functions in clinical youth populations to predict alcohol related outcomes. Moreover, given the narrowing gap between male and female youth in alcohol use prevalence in recent years, exploring sex differences in alcohol demand and its role in the relationship between demand, alcohol use, alcohol-related problems, and AUD is important. The current study used data from two samples of adolescents and young adults from the community (N = 127; ages 16-25, M = 20.57, SD = 2.27; 56.35 % female; 91.27 % white), one treatment seeking (n = 94) and one non-treatment seeking (n = 33), to examine the relationship between demand indices and alcohol use outcomes and to explore the role of sex in these relationships. Demand intensity (the number of standard drinks a person would consume if drinks were $0), O (maximum money spent across prices, i.e., number of drinks purchased × price), and price sensitivity (α; the rate alcohol consumption decreases as prices increase) were significantly associated with alcohol use quantity and frequency outcomes, but not alcohol-related problems or AUD severity. Although male youth had significantly greater intensity relative to female youth, intensity was more strongly associated with drinking days in female youth. Broadly, our findings support the importance of evaluating alcohol demand in clinical youth as well as sex differences in alcohol demand. Our results also speak to the need for interventions targeting sex-specific mechanisms and moderators of alcohol use.
Hippocampal transcranial temporal interference stimulation reduced craving in methamphetamine use disorder.
Wang D, Du Z, Wen X … +12 more , Li Q, Liu Y, Tang J, Shui C, Yu P, Yang L, Tu P, Liu X, Yuan C, Yu D, Ma T, Yuan K
Addict Behav · 2026 Mar · PMID 41389502 · Publisher ↗
BACKGROUND: Craving is a key challenge in treating methamphetamine use disorder (MUD). The memory reconsolidation theory indicates that interference with MUD after drug memory retrieval helps to reduce craving. Previous...
BACKGROUND: Craving is a key challenge in treating methamphetamine use disorder (MUD). The memory reconsolidation theory indicates that interference with MUD after drug memory retrieval helps to reduce craving. Previous studies have demonstrated the importance of the hippocampus in memory consolidation, but traditional non-invasive interventions cannot effectively locate and intervene in the hippocampus. Although tTIS can accurately intervene in deep brain regions, it is still unknown whether tTIS intervention on the MUD hippocampus is effective in reducing craving. METHOD: A total of 40 male participants with MUD were randomized to active or sham tTIS. Active tTIS delivered a 10 Hz electric field to the hippocampus for 20 min per day over 10 consecutive days, while sham stimulation lasted only 1 min per day during the same period. We also assessed its effects on craving, cognitive function and emotional symptoms at baseline, post intervention and one month follow-up. RESULTS: A two-way repeated-measures analysis of variances (ANOVAs) on drug cue-induced craving revealed a significant group × time interaction effect (F (2, 108) = 5.652, P = 0.005). Post hoc paired t-test indicated a significant decrease in craving in the active tTIS group (t = 5.04, P = 0.002) after the intervention and one month follow-up (t = 6.04, P < 0.001). In contrast, no significant changes were observed in the sham group. CONCLUSIONS: In this trial, 10 Hz tTIS was effective for METH craving reduction in MUD. Further trials are needed to explore neural mechanisms of tTIS.
Investigation into the psychometric properties of the Brief Religious Coping Scale (Brief RCOPE) in adults with substance use disorder.
Manzler CA, Lewis B, Teitelbaum S … +1 more , Schlauch RC
Addict Behav · 2026 Mar · PMID 41385882 · Publisher ↗
Many individuals turn to religion in their efforts to deal with difficult times in their lives, and research has consistently linked indices of religious coping to measures of health and well-being. The Brief Religious C...
Many individuals turn to religion in their efforts to deal with difficult times in their lives, and research has consistently linked indices of religious coping to measures of health and well-being. The Brief Religious Coping Scale (Brief RCOPE) is the most commonly used measure of religious coping in the literature; however, relatively little has been reported about the psychometric properties of the brief version. Moreover, the examination of this scale among individuals with a substance use disorder (SUD), a disorder highly associated with major life stressors for which religious coping may serve as a principle form of coping, has been largely overlooked. Therefore, the current study sought to examine the psychometric properties of the Brief RCOPE in a sample of 1290 adults undergoing residential treatment for SUD. Results from confirmatory factor analyses supported the theorized two-factor structure of positive (PRC) and negative (NRC) religious coping, as well as measurement invariance across sex and across time. Validity was established through significant, differential associations between PRC and NRC at pre-treatment and a range of psychosocial outcomes at pre- and post-treatment. This study provides evidence that the Brief RCOPE is a reliable and valid tool for assessing religious coping among adults with SUD. Its strong psychometric performance supports its potential for use in clinical settings to help clinicians understand and address patients' spiritual experiences in recovery.
Performing identity and risk: chemsex, misogyny, and algorithmic exclusion in queer Reddit spaces.
Tunca S
Addict Behav · 2026 Mar · PMID 41385881 · Publisher ↗
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 50...
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.
Nicotine and cannabis vaping among U.S. emerging young adults: Findings from 2022 and 2023 National Survey on Drug Use and Health.
Kim N, Haizelden J, Avery G … +1 more , Mumba M
Addict Behav · 2026 Mar · PMID 41370901 · Publisher ↗
OBJECTIVES: 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 preva...
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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