Addict Behav [JOURNAL]
Sun
200 papers
The relationship between subjective (arousal and craving) and physiological (heart rate variability) stress- and alcohol cue-reactivity in young adults who engaged in hazardous drinking: a counterbalanced study.
Firdaus I, Kleiboer A, Kaag AM … +1 more , Huizink AC
Addict Behav · 2026 Jun · PMID 42335515 · Publisher ↗
Alcohol use disorder (AUD) is marked by sensitivity to alcohol cues and stress, increasing craving and stress. Stress typically lowers heart rate variability (HRV), whereas alcohol cues may increase or decrease HRV; howe...
Alcohol use disorder (AUD) is marked by sensitivity to alcohol cues and stress, increasing craving and stress. Stress typically lowers heart rate variability (HRV), whereas alcohol cues may increase or decrease HRV; however, their combined effects remain unclear. We examined (1) subjective craving, stress, and HRV responses to alcohol cue exposure and stress exposure, and (2) whether exposure order (stress-alcohol vs alcohol-stress) influenced these responses. Additional exploratory analyses examined associations between subjective and physiological reactivity. Fifty-six young adult who engaged in hazardous drinking (37 women; median age = 20 years, IQR = 3) with AUDIT scores ≥ 8 (median = 14, IQR = 6) and minimal other substance use were randomized to two conditions: stress-alcohol or alcohol-stress exposure. Alcohol cues included visual, olfactory, and tactile stimuli, and stress was induced using a computerized mental arithmetic task (MAT). Craving and stress were rated on Likert scales, and HRV was continuously recorded via a portable electroencephalograph (ECG) device. Alcohol cues increased craving. While stress exposure followed by alcohol cues reduced subjective stress. Alcohol cues increased HRV, while stress-exposure raised stress without affecting craving. In an exploratory subgroup analysis, HRV reactivity during MAT was observed only in participants whose craving remained unchanged change following MAT, suggesting an inverse association between craving and autonomic responsiveness. These findings highlight linked effects of stress exposure and alcohol cues on autonomic regulation in hazardous drinking and may offer preliminary insights into mechanisms that could be relevant for relapse prevention.
Distinct EEG cue-reactivity profiles associated with virtual-reality treatment responses in methamphetamine use disorder.
Ikram Z, Nour El Houda BY
Addict Behav · 2026 Jun · PMID 42322965 · Publisher ↗
Methamphetamine use disorder (MUD) is associated with abnormal neural cue-reactivity dynamics that contribute to craving and relapse vulnerability. Using electroencephalography (EEG), virtual reality (VR)-based cue expos...
Methamphetamine use disorder (MUD) is associated with abnormal neural cue-reactivity dynamics that contribute to craving and relapse vulnerability. Using electroencephalography (EEG), virtual reality (VR)-based cue exposure, and VR intervention, we examined Cue-Rest spectral modulation across addiction-related neural systems before and after treatment. Principal Component Analysis(PCA)-based subgrouping method identified two distinct EEG cue-reactivity profiles characterized by relatively higher versus lower Cue-Rest spectral modulation patterns. During VR-cue exposure, widespread abnormalities were observed across delta, theta, alpha, beta, and gamma-band systems involving prefrontal, cortico-striatal, default mode network (DMN), orbitofrontal(OFC), and temporo-limbic networks. The first MUD profile demonstrated greater positive Cue-Rest spectral modulation across nearly all analyzed neural systems relative to the second profile, suggesting preserved neural cue responsivity, whereas the second subgroup showed attenuated or blunted modulation profiles. Following VR treatment, the first profile exhibited widespread reductions in low-frequency and high-frequency Cue-Rest spectral modulation across prefrontal, dorsolateral prefrontal (DLPFC) , cortico-striatal, DMN, and temporo-limbic regions, suggesting substantial modulation of cue-reactivity-related neural activity following treatment. In contrast, the second profile showed comparatively limited longitudinal EEG modulation despite significant reductions in subjective craving-related behavioral responses. Both profiles showed robust decreases in craving, drug-use urge, and drug liking following treatment. These findings demonstrate substantial heterogeneity in methamphetamine (METH) cue-reactivity dynamics and suggest that VR-related neurophysiological treatment responses differs according to baseline EEG cue-reactivity profiles, supporting EEG the potential utility of EEG spectral modulation measures for characterizing treatment-related neural changes in MUD.
Is it safe to just try? A longitudinal study of adolescent patterns of drinking and smoking via latent transition analyses.
Espejo-Siles R, Rodríguez-Ruiz J, Zych I
Addict Behav · 2026 Jun · PMID 42322964 · Publisher ↗
PURPOSE: A growing body of research reports fruitful evidence about longitudinal patterns of alcohol and tobacco use. However, it is still necessary to understand longitudinal patterns of alcohol and tobacco use separate...
PURPOSE: A growing body of research reports fruitful evidence about longitudinal patterns of alcohol and tobacco use. However, it is still necessary to understand longitudinal patterns of alcohol and tobacco use separately especially to describe if their sporadic use in adolescence is indeed sporadic or leads to escalation. This study aimed at exploring stability and change in alcohol and tobacco use. METHODS: This was a prospective longitudinal study with three waves of yearly data collection in Spain. The sample at T1 (2020) included 889 adolescents (48.3 % female, M = 12.6; SD = 0.83). Alcohol and tobacco use were measured with a validated questionnaire. Two Latent Transition Analyses were conducted. RESULTS: Three statuses were found for alcohol and tobacco use: non-user, sporadic user, and frequent user. Non-users and frequent users were highly stable over time, with the vast majority remining in their respective group one year later. Escalation from non-users to frequent users was rare and occurred only in 4-5 % of alcohol non-users and 3-5 % of tobacco non-users. On the other hand, sporadic users were likely to escalate to frequent users (>45 %) and unlikely to de-escalate to non-users (0-13 %). Similarly, sporadic tobacco users were relatively likely to escalate to frequent users (18-27 %) and 15-21 % de-escalated to non-users. CONCLUSIONS: While non-users were relatively stable over time, the risk of escalation in alcohol and tobacco use after having tried these substances once or twice in adolescence was relatively high. Thus, interventions should discourage even sporadic experimentation with these substances and strengthening protective factors.
A systematic review of the prevalence of ADHD and autism among those experiencing gambling harm.
Timms-McLean L, Nguyen H, Thomas S … +4 more , Browning C, Young A, Chamberlain D, Rintoul A
Addict Behav · 2026 Jun · PMID 42314257 · Publisher ↗
BACKGROUND: There is a growing body of research reporting complex correlations between neurodivergence and gambling - raising concern about targeted predatory gambling practices of operators, underlining the urgency for...
BACKGROUND: There is a growing body of research reporting complex correlations between neurodivergence and gambling - raising concern about targeted predatory gambling practices of operators, underlining the urgency for specialised harm prevention and reduction measures. This review provides new estimates of the prevalence of ADHD and autism in individuals experiencing gambling harm. METHODS: We performed a systematic review using frameworks by Munn et al. (2015), reviewing peer-reviewed observational studies across 4 databases - MEDLINE, PsycINFO, CINAHL and PubMed, searched on the 21st of May 2025. Results from each database were uploaded to Covidence as a RIS file to be screened and extracted. A meta-analysis was conducted included studies reporting ADHD data using a random effects model to estimate pooled prevalence, while included studies reporting data on autism had a narrative summary of their results. RESULTS: Our analysis included 14 studies, 2 of which reported autism data. The prevalence for ADHD in gambling harm was 0.24 (95 % CI 0.18; 0.29) or 24 %, compared with a prevalence of 2.58 % in the general population (Song et al., 2021). The data had a high rate of heterogeneity, suggesting the results of our meta-analysis may be inflated due to some studies reporting higher rates than others. CONCLUSION: Elevated prevalence of ADHD in those experiencing gambling harms is suggested by the results of this review. While autism is plausibly equally as important, more research is needed in this area to better understand the likely prevalence of this condition for those experiencing gambling harm.
Latent profile analysis of personality characteristics among US young adults in relation to cannabis use and intentions over time.
Cui Y, Wang Y, Yang YT … +2 more , Cavazos-Rehg PA, Berg CJ
Addict Behav · 2026 May · PMID 42302331 · Publisher ↗
OBJECTIVES: Young adults may use cannabis for distinct reasons, for example, related to their personalities or lifestyles. This study examined young adults' personality profiles and associations with cannabis use-related...
OBJECTIVES: Young adults may use cannabis for distinct reasons, for example, related to their personalities or lifestyles. This study examined young adults' personality profiles and associations with cannabis use-related outcomes. METHODS: Using 3 waves of survey data (2023-2024) among 4,031 US young adults (M = 26.29, 59.8% female, 19.4% Hispanic, 14.0% Black, 14.1% Asian), latent profile analysis was conducted based on 5 personality characteristics (emotional stability, extraversion, openness, agreeableness, conscientiousness). Generalized estimating equations assessed class in relation to past-month use and use intentions and their changes over time. Models controlled for state non-medical cannabis legalization and sociodemographics. RESULTS: Three classes emerged: 1) the All-high-trait class (highest scores on all 5 personality characteristics; 21.1%); 2) the Moderate-extraversion/low-other-trait class (37.1%); and 3) the Low-extraversion/moderate-other-trait class (41.8%). At W1, past-month cannabis use was higher in the All-high-trait (52.2%) and Moderate-extraversion/low-other-trait classes vs. the Low-extraversion/moderate-other-trait class (43.3%). At W1, compared to the All-high-trait class, Low-extraversion/moderate-other-trait reported lower odds of use (aOR = 0.75, 95%CI = 0.63-0.90), and both Moderate-extraversion/low-other-trait and Low-extraversion/moderate-other-trait reported lower intentions (Moderate-extraversion/low-other-trait: B = -0.22, SE = 0.07; Low-extraversion/moderate-other-trait: B = -0.28, SE = 0.07). While odds of use and intentions generally decreased overall, class-by-time interactions indicated that: 1) odds of use decreased less from W1 to W2 in Low-extraversion/moderate-other-trait vs. Moderate-extraversion/low-other-trait (aOR = 1.23, 95%CI = 1.07-1.42); and 2) use intentions increased more from W1 to W2 in Moderate-extraversion/low-other-trait vs. All-high-trait (B = 0.18, SE = 0.09) and decreased less from W2 to W3 in Low-extraversion/moderate-other-trait vs. Moderate-extraversion/low-other-trait (B = 0.15, SE = 0.07). CONCLUSIONS: Intervention efforts should consider distinct personality profiles of young adults and potentially distinct mechanisms (e.g., social, emotional) underlying their cannabis use.
Moderators of the impact of e-cigarette provision on smoking cessation: secondary analyses from a large naturalistic randomized clinical trial in the US.
Koval KR, Smith TT, Wahlquist AE … +3 more , Klemperer EM, Michael Cummings K, Carpenter MJ
Addict Behav · 2026 Jun · PMID 42302330 · Publisher ↗
BACKGROUND AND AIMS: Growing evidence suggests that e-cigarettes can facilitate smoking cessation among adults who smoke (AWS). Whether these effects differ by characteristics of individuals with varying demographic or s...
BACKGROUND AND AIMS: Growing evidence suggests that e-cigarettes can facilitate smoking cessation among adults who smoke (AWS). Whether these effects differ by characteristics of individuals with varying demographic or smoking related histories is unclear. This study uses data from a recently completed RCT testing e-cigarette sampling among AWS to evaluate moderators of smoking behavior outcomes. METHODS: Analyses are based on a large, naturalistic RCT conducted across the US, in which AWS (N = 638) were randomized (2:1) to receive a 4-week supply of e-cigarettes, or not. Provision of e-cigarettes included minimal guidance on use and emphasized participants' self-determined decisions and patterns of use. Outcomes were tracked through week 24 follow-up. Secondary analyses focus on group-by-moderator (demographic, smoking history) interactions on three principal outcomes: 1) incidence of 24hr quit attempts, 2) incidence of reducing smoking (cigarettes per day; CPD) by ≥ 50%, and 3) 7-day point prevalence abstinence (PPA), each captured at week 4 and week 24. RESULTS: Among 10 + demographic and smoking history variables assessed at baseline, none of the group by moderator interactions were significant, for any outcome at either timepoint. Raw cessation outcomes were higher among AWS with higher motivation to quit (MTQ), but the relative risk (RR) for achieving ≥ 50% reduction in CPD after 4 weeks was similar across MTQ levels. DISCUSSION AND CONCLUSIONS: The effects of e-cigarettes on smoking cessation outcomes were similar across multiple demographic and smoking history subgroups. The absence of any significant moderating variables is unlikely attributable to limited power since the vast majority of subgroup differences were < 10%.
Inter-subject variability in brain connectivity predicts nicotine dependence severity and differentiates smokers via machine learning.
Cui S, Xu X, Yang B … +3 more , Zheng Y, Li X, Dong GH
Addict Behav · 2026 Jun · PMID 42289141 · Publisher ↗
BACKGROUND: Tobacco use disorder (TUD) is a major public health issue with significant individual differences. A deeper understanding of its neurobiology and reliable biomarkers is needed. This study investigated whether...
BACKGROUND: Tobacco use disorder (TUD) is a major public health issue with significant individual differences. A deeper understanding of its neurobiology and reliable biomarkers is needed. This study investigated whether inter-subject variability in resting-state brain functional connectivity (IVFC) could serve as such a marker for TUD. METHODS: Resting-state fMRI data from 123 male TUD patients and 123 healthy controls (HCs) were collected and analyzed. IVFC was computed within seven major brain lobes. Five machine learning models (random forest, gradient boosting, extra trees, multi-layer perceptron, and support vector machine) were trained to classify the groups based on IVFC features. Univariate regression was conducted with each lobe's IVFC predicting clinical scores. Multivariate stepwise regression was then performed to identify the best combination of IVFC predictors for dependence severity. RESULTS: TUD showed significantly altered IVFC in six brain lobes compared to controls, with the largest difference in the insular lobe. The machine learning models, particularly the extra trees classifier, achieved high accuracy (up to 88 %) in classifying TUD, primarily utilizing features from the temporal and limbic lobes. Univariate regression showed that higher IVFC in frontal, insular, limbic, and temporal lobes was associated with lower nicotine dependence severity. Multivariate stepwise regression identified insular lobe IVFC as the sole independent predictor. CONCLUSIONS: These findings suggest that widespread alterations in IVFC may characterize TUD and relate to its clinical severity, indicating the potential value of this measure as a neurobiological marker. The combination of IVFC analysis with machine learning appears to offer a promising approach for distinguishing TUD, which could contribute to advancing our understanding of its underlying brain mechanisms.
Theory-based smoking cessation interventions for young adults: A systematic review of randomized controlled trials.
Srejon RR, Gonzalez-Alvarez A, Grigsby TJ
Addict Behav · 2026 Jun · PMID 42289140 · Publisher ↗
BACKGROUND: Young adulthood is a critical developmental window for establishing long-term smoking behaviors, yet cessation success remains low due to limited access to theory-based interventions. This systematic review e...
BACKGROUND: Young adulthood is a critical developmental window for establishing long-term smoking behaviors, yet cessation success remains low due to limited access to theory-based interventions. This systematic review evaluated the effectiveness of behavioral theory-informed smoking cessation interventions targeting this group. METHODS: A systematic search was conducted in PubMed, PsycINFO, Scopus, and the Cochrane Library for English-language randomized controlled trials (RCTs) published between 2010 and 2025. Included studies evaluated cessation interventions for young adults (18-29 years) and explicitly described their theoretical framework. Primary outcome was abstinence. Screening, selection, and data extraction followed standard systematic review procedures. Risk of bias was assessed using the Joanna Briggs Institute Appraisal Tool. A narrative synthesis was performed due to heterogeneity. RESULTS: Fourteen RCTs (11,038 participants) across seven countries were included, though only five specifically targeted young adults (18-29 years). Interventions spanned 3 to 40 weeks via face-to-face, app, and text-based delivery. Frameworks included SCT, TTM, SDT, and CBT. CBT and SDT produced the most sustained outcomes, with CBT showing robust effects (e.g., OR=4.68 at 26 weeks). SCT demonstrated mixed results: personalized formats were effective (OR=2.03), while non-personalized digital messaging was limited (OR=0.36). Digital and COM-B-based interventions yielded high engagement, but lower long-term maintenance compared to intensive, face-to-face programs. Most studies (71 %) had moderate risk of bias, with unclear allocation concealment and limited blinding. CONCLUSIONS: Theory-based interventions support smoking cessation among young adults, yet their long-term efficacy is often limited by high relapse rates. While multimodal strategies combining digital scalability with more intensive, face-to-face support appear most promising, sustained abstinence remains challenging to achieve. Future research should prioritize well-powered longitudinal trials that identify and test active behavioral mechanisms of change and directly evaluate integrative theoretical frameworks to improve long-term cessation outcomes during this critical developmental period.
Examining stable and dynamic factors associated with daily problematic mobile phone use: Evidence from a 14-day diary study using machine learning and network analysis.
Zhou H, Zheng Q, Jiang H … +1 more , Lu J
Addict Behav · 2026 Jun · PMID 42287844 · Publisher ↗
This study used machine learning with SHAP to identify key predictors of daily problematic mobile phone use (PMPU), and then applied network analysis to examine the associations between these selected key factors and PMP...
This study used machine learning with SHAP to identify key predictors of daily problematic mobile phone use (PMPU), and then applied network analysis to examine the associations between these selected key factors and PMPU across between-person, within-day, and across-day levels. A total of 279 undergraduate students in China completed a baseline assessment and a 14-day daily diary investigation. The results showed that the Random Forest model achieved meaningful out-of-sample prediction of next-day PMPU. SHAP analysis indicated that day-level factors contributed most to prediction (e.g., daily boredom, daily stress, daily loneliness), whereas stable factors showed comparatively smaller contributions. In the between-person network, PMPU was most strongly associated with average daily boredom, while anxiety and stress was the central nodes. In the contemporaneous network, PMPU was most strongly associated with same-day boredom, followed by stress. In the temporal network, prior-day stress, rumination, and boredom emerged as the most prominent lagged predictors of next-day PMPU, and reciprocal paths indicated that higher PMPU predicted increases in next-day stress and boredom. Together, these findings suggest that daily PMPU is shaped primarily by proximal psychological experiences and that boredom and stress constitute core processes in the maintenance of PMPU. The results offer empirical guidance for early identification and for developing targeted prevention and intervention strategies focused on daily stress management and boredom regulation in university students' everyday lives.
Longitudinal relationships between perceived stress and problematic smartphone use among college students: The mediating role of executive function.
Shen Y, Tang R, Wang C … +2 more , Li X, Wang D
Addict Behav · 2026 Jun · PMID 42287843 · Publisher ↗
BACKGROUND: Although existing research have suggested a positive association between perceived stress and problematic smartphone use (PSU), most studies have examined only unidirectional relationships. The potential bidi...
BACKGROUND: Although existing research have suggested a positive association between perceived stress and problematic smartphone use (PSU), most studies have examined only unidirectional relationships. The potential bidirectional effects and underlying cognitive mechanisms remain insufficiently explored. This study employed a Random Intercept Cross-Lagged Panel Model to examine the bidirectional association between perceived stress and PSU among college students, as well as the mediating role of executive function. METHODS: A total of 6,153 Chinese college students (M = 21.04, SD = 1.30; 79.9 % females) participated in this three-wave longitudinal design with six-month intervals. RESULTS: Results revealed a significant bidirectional association between perceived stress and PSU, with executive function mediating the effect of perceived stress on PSU, but not vice versa. Furthermore, multigroup analyses indicated no significant gender differences in these associations. DISCUSSION AND CONCLUSIONS: This study highlights the role of executive function in the stress-addiction relationship and suggests that enhancing cognitive regulation abilities may help break the cycle between stress and PSU among college students.
Evaluation of a brief school-based e-cigarette prevention program for elementary school students.
Gerson MA, Lung H, Halpern-Felsher B
Addict Behav · 2026 Jun · PMID 42275794 · Publisher ↗
OBJECTIVES: E-cigarette use remains high among children and adolescents. School-based programs that address reasons for use, provide education on risks, and improve refusal skills are important in preventing e-cigarette...
OBJECTIVES: E-cigarette use remains high among children and adolescents. School-based programs that address reasons for use, provide education on risks, and improve refusal skills are important in preventing e-cigarette use. However, we lack evidence-based e-cigarette prevention programs for elementary school students. This program evaluation assesses changes in learning outcomes, refusal skills, coping skills, social self-efficacy, and intentions to use e-cigarettes following implementation of a school-based e-cigarette prevention curriculum. METHODS: Participants in this pre-post evaluation design were 165 fifth-graders from three elementary schools in the San Francisco Bay Area who participated in Stanford REACH Lab's You and Me, Together Vape-free two-session elementary school vaping prevention curriculum. Participants completed pre- and post-curriculum surveys to assess exposure to use, learning outcomes, refusal skills, coping skills, self-efficacy, and intentions to use. The final sample was N = 130, as 130 of the 165 pre-post responses were successfully linked. RESULTS: Participants demonstrated improvements in all eight knowledge questions (p's < 0.01), two self-efficacy questions, and one refusal skills question (p's < 0.05). More than 43% of participants (44.2% pre-curriculum survey and 43.8% post-curriculum survey) responded "True" to the statement, "I have somebody close to me, such as a parent, sibling, or friend who uses e-cigarettes/vapes." All participating teachers who responded to a feedback survey (n = 5) indicated vaping either is currently a problem at their elementary school or that it is becoming one. CONCLUSION: Evaluation of this elementary school-based e-cigarette prevention curriculum indicated that the curriculum increased knowledge of e-cigarettes and related harms.
Does social anxiety influence reporting of cannabis consequences? A differential item functioning analysis of the Brief Marijuana Consequences Questionnaire (B-MACQ).
Berry KA, Cole-French WS, Looby A … +1 more , Stimulant Norms and Prevalence 4 (SNAP4) Study Team
Addict Behav · 2026 Jun · PMID 42259091 · Publisher ↗
Undergraduates with social anxiety disorder (SAD) are at a heightened risk for experiencing cannabis-related consequences, despite using cannabis at similar rates as those without SAD. One possible explanation may be tha...
Undergraduates with social anxiety disorder (SAD) are at a heightened risk for experiencing cannabis-related consequences, despite using cannabis at similar rates as those without SAD. One possible explanation may be that there are systematic differences in how individuals with SAD respond to self-report measures of cannabis-related consequences, particularly for items relying on subjective appraisal. The present study conducted a differential item functioning (DIF) analysis on the Brief Marijuana Consequences Questionnaire (B-MACQ) to determine whether any items were biased toward undergraduates with clinically significant SAD symptoms. Undergraduates (N = 1,261; M = 19.33; 73.7% female; 68.7% white; 45.8% with clinically significant SAD symptoms) from six U.S. universities who reported past-month cannabis use completed an online survey assessing SAD, cannabis use, and cannabis-related problems. DIF analyses indicated that only one B-MACQ item functioned differently across groups, whereby students with clinically significant SAD symptoms were more likely than those without SAD to endorse the item, "I have felt anxiety, irritable, lost my appetite or had stomach pains after stopping or cutting down on marijuana use." After removing this item, an ANCOVA controlling for past-month cannabis frequency demonstrated that students with clinically significant SAD symptoms continue to report greater B-MACQ total scores than those without SAD. Findings indicate that one B-MACQ item demonstrated measurement bias and should be interpreted with caution when administering the measure to individuals with SAD. Yet even after accounting for this bias, students with clinically significant SAD symptoms reported heightened cannabis-related consequences, highlighting the need for interventions that concurrently address SAD and cannabis use.
Cannabis use and cannabis use disorder in adults with chronic medical conditions in the United States.
González-Roz A, Secades-Villa R, Belisario KL … +1 more , MacKillop J
Addict Behav · 2026 Jun · PMID 42259090 · Publisher ↗
INTRODUCTION: People with chronic medical conditions are particularly vulnerable to adverse outcomes associated with cannabis use, but research on the correlates of cannabis use and related problems in this population re...
INTRODUCTION: People with chronic medical conditions are particularly vulnerable to adverse outcomes associated with cannabis use, but research on the correlates of cannabis use and related problems in this population remains limited. This study sought to estimate the prevalence and correlates of cannabis use and cannabis use disorder (CUD) among US adults with cardiovascular disease (CVD) risk conditions, respiratory diseases, kidney and liver diseases, and HIV/AIDS. METHODS: Participants were 47,100 adults (aged 18+) from the 2022 National Survey on Drug Use and Health (NSDUH). Analyses included weighted prevalence estimates, bivariate analyses, and survey-weighted logistic regression models. RESULTS: Rates of past-year and past-month cannabis use were lower in participants with medical conditions compared to those without, except among individuals with respiratory diseases and HIV/AIDS. Past-year and past-month weighted prevalences were 16.7% and 11.75% for individuals with CVD risk conditions, 26.76% and 18.73% for those with respiratory diseases, 21.22% and 16.12% for those with kidney and liver diseases, and 51.58% and 37.33% for those with HIV/AIDS. CUD prevalence was lower among participants with medical conditions (5.78% vs 7.71%), except for those with respiratory diseases (9.10% vs 6.58%). Adults aged 35 or older were less likely to have CUD than those aged 18-25. Other common correlates of CUD included past-year illicit drug use, nicotine dependence, and past-year major depressive episode. Associations between annual income and CUD were inconsistent across medical conditions. CONCLUSIONS: These findings underscore the need for screening and referral to evidence-based treatment for cannabis users with chronic medical conditions.
Exploring unique longitudinal associations between cigarette smoking and symptom-level depression among Chinese adult males: A psychopathological network perspective.
Yang X
Addict Behav · 2026 Jun · PMID 42250456 · Publisher ↗
BACKGROUND: It is well-established that cigarette smoking is associated with depression, yet the literature presents conflicting results, with numerous studies suggesting that smoking increases the risk of depression whi...
BACKGROUND: It is well-established that cigarette smoking is associated with depression, yet the literature presents conflicting results, with numerous studies suggesting that smoking increases the risk of depression while other evidence indicates that smoking may temporarily relieve depressive symptoms. The network theory of psychopathology implies that the smoking-depression link may exhibit heterogeneity at the symptom level, thereby providing a valuable perspective for understanding these inconsistencies. Accordingly, this study explored unique longitudinal associations between smoking and symptom-level depression among adult males in China, where smoking prevalence is among the highest globally. METHODS: Four-wave longitudinal data from the China Family Panel Studies (CFPS) were used, comprising 7,693 Chinese adult males who smoked. A cross-lagged panel network (CLPN) analysis was employed to investigate symptom-level relationships between smoking and depression, and to identify key symptoms within the temporal, directional network. RESULTS: After controlling for potential confounding covariates, autoregressive effects, and all other symptoms at the previous occasion, the CLPN model revealed divergent associations between cigarette smoking and depressive symptoms. Specifically, earlier smoking was positively associated with later "tiredness" and "pessimism about the future", whereas it was negatively associated with subsequent "loneliness" and "loss of enjoyment". Moreover, certain symptoms, such as "pessimism about the future", emerged as key symptoms. CONCLUSIONS: These findings offer preliminary but novel insights into the ongoing debate regarding the controversial smoking-depression link and contribute to the literature by being the first to explore the networked and dynamic interplay between smoking and symptom-level depression. Although these findings should be considered exploratory due to the modest effect sizes, this study could be a springboard for further investigation into the associations between smoking and depressive symptoms from the psychopathology network perspective.
Latent profile analysis reveals diverse perceptions of tobacco product risks among youth.
Liu J, Zulkiewicz B, Moran M … +1 more , Tan AS
Addict Behav · 2026 Jun · PMID 42247984 · Publisher ↗
OBJECTIVES: We examined how youth differentiate the harms of four commonly used tobacco products. METHODS: Using monthly online repeated cross-sectional surveys among N = 1,858 New England youth (13-17) from April 2021 t...
OBJECTIVES: We examined how youth differentiate the harms of four commonly used tobacco products. METHODS: Using monthly online repeated cross-sectional surveys among N = 1,858 New England youth (13-17) from April 2021 to August 2022, we conducted a latent profile analysis to identify classes of perceived harm across e-cigarettes, cigarettes, smokeless tobacco, and cigars/cigarillos/little cigars and multinomial logistic regression to model the odds of belonging to each class, including time, sociodemographic factors, tobacco advertising exposure, and tobacco product use. RESULTS: We identified four classes: low harm across all products (Class 1, 8.5%), all products as equally somewhat harmful (Class 2, 40.0%), all products as very harmful (Class 3, 46.6%), and cigarettes as most harmful (Class 4, 4.9%, comparison class). Older youth had lower odds of perceiving low harm across all products. Past-30-day e-cigarette use was associated with higher odds of perceiving low harm across all products (RRR: 2.54, CI: 1.21-5.35) and lower odds for perceiving all products as very harmful (RRR: 0.20, CI: 0.10-0.40). Ever cigarette use was associated with higher odds of perceiving low harm across all products (RRR: 3.40, CI: 1.61-8.61). Past-30-day cigarette use was associated with higher odds of perceiving low harm across all products (RRR: 4.07, CI: 1.26-13.19) and lower odds of perceiving all products as equally somewhat harmful (RRR: 0.23, CI: 0.07-0.79). Past-30-day cigar use was associated with lower odds of perceiving all products as equally somewhat harmful (RRR: 0.23, CI: 0.07-0.79). There were geographic differences in harm perceptions. DISCUSSION: Findings can inform youth education on the relative risks of tobacco products.
Bidirectional associations between protective behavioral strategies for cannabis use and cannabis outcomes: A cross-lagged longitudinal approach.
Romero-Pérez N, Carmona-Márquez J, Parrado-González A … +3 more , González-Ponce BM, Marín-Morales A, Fernández-Calderón F
Addict Behav · 2026 May · PMID 42247983 · Publisher ↗
Although the use of cannabis Protective Behavioral Strategies (PBS) is associated with lower consumption and fewer harms, most research has relied on cross-sectional designs, leaving the within-person directionality of t...
Although the use of cannabis Protective Behavioral Strategies (PBS) is associated with lower consumption and fewer harms, most research has relied on cross-sectional designs, leaving the within-person directionality of these associations unclear. This study examined the bidirectional associations between PBS use and cannabis outcomes (frequency, quantity, and negative consequences) over a 15-month period and explored sex differences. We employed a three-wave longitudinal design (baseline, 3-, and 15-month follow-ups) and used a targeted sampling procedure to recruit a community-based sample of young adults who reported past-month cannabis use (n = 612; M = 21.04; 61.2% = male; 40.8% = university students). Random-intercept cross-lagged panel models disentangled stable between-person differences from within-person change and tested for sex invariance. At the between-person level, greater PBS use was associated with lower cannabis frequency, quantity, and negative consequences. At the within-person level, increased PBS use predicted subsequent reductions in cannabis use frequency, but not in quantity or consequences. Conversely, experiencing higher-than-usual negative consequences predicted subsequent increases in PBS use. No other significant cross-lagged effects were observed. Multigroup analyses revealed that these longitudinal associations were invariant across sex. Overall, findings provide novel evidence of the dynamic role of PBS, indicating that they function both as a protective factor and as a self-regulatory mechanism activated by adverse experiences. The stability of these associations across sex suggests that PBS-based interventions may operate through similar longitudinal mechanisms for men and women.
Active and passive exposure to e-cigarette-related content online and patterns of tobacco use among U.S. adolescents: A multigroup latent class analysis.
Wong KH, Cho A, Sun T … +2 more , Chung JYC, Lim CCW
Addict Behav · 2026 Oct · PMID 42229276 · Publisher ↗
BACKGROUND: Most studies have examined exposure to e-cigarette-related content on social media without distinguishing between passive exposure and active engagement or considering broader patterns of tobacco and nicotine...
BACKGROUND: Most studies have examined exposure to e-cigarette-related content on social media without distinguishing between passive exposure and active engagement or considering broader patterns of tobacco and nicotine use. Distinguishing these forms of exposure allows clearer interpretation of whether associations reflect platform-driven content delivery or user interaction. This study identified the latent classes of tobacco and nicotine product use among U.S. adolescents (2021-2023) and examined the associations between passive and active exposure to e-cigarette content on social media and latent class membership. METHODS: Data were drawn from the 2021-23 U.S. National Youth Tobacco Survey (N = 70,773). Multigroup latent class analysis was used to identify tobacco use patterns across survey years. Multinomial logistic regression was used to examine the associations between passive (viewing e-cigarette-related content) and active (liking, commenting, or sharing such content) exposure and predicted class membership. RESULTS: Three classes were identified: i) minimal/non-users (∼96%), ii) predominantly e-cigarette use (∼3%), and iii) poly-tobacco use (∼1%). Higher frequency passive exposure was associated with greater odds of predominantly e-cigarette use, while active engagement was associated with higher odds of both predominantly e-cigarette and poly-tobacco use, with stronger associations observed at higher exposure frequencies. Associations strengthened with increasing exposure frequency, with active engagement showing larger effect sizes, particularly for poly-tobacco use. CONCLUSIONS: Distinguishing passive exposure from active engagement improves understanding of how adolescents' online interactions with e-cigarette content align with higher-risk tobacco use patterns.
Sleep traits, screen use, and emotional and behavioral problems: A short-term longitudinal cross-lagged panel network analysis.
Li L, Lu X, Jiang G … +5 more , Guo Y, Peng S, Liu Q, Xiao D, Guo L
Addict Behav · 2026 Oct · PMID 42229275 · Publisher ↗
BACKGROUND: The longitudinal associations between multidimensional sleep traits, distinct types of screen time, and emotional and behavioral problems (EBPs) in adolescents remain inadequately understood, with traditional...
BACKGROUND: The longitudinal associations between multidimensional sleep traits, distinct types of screen time, and emotional and behavioral problems (EBPs) in adolescents remain inadequately understood, with traditional analytical methods struggling to capture their directional, symptom-level dynamics. METHODS: This longitudinal study included 4,800 Chinese adolescents (57.2% female; mean [SD] age, 15.84 [0.57] years) who completed baseline and 6-month follow-up surveys. Sleep traits, screen use, and EBPs were assessed using validated scales. A cross-lagged panel network (CLPN) model was employed to map directional predictive pathways, with centrality analyses (out-expected influence [OEI], in-expected influence [IEI], and bridge expected influence [BEI]) identifying core and bridge symptoms. Gender-specific subgroup networks were also estimated and compared. RESULTS: EBPs demonstrated high temporal stability and dense internal connectivity, with "hyperactivity" (HA) and "emotional symptoms" (ES) serving as central nodes. Prosocial behaviors (PB) negatively predicted subsequent HA. Bridge pathways indicated that daytime dysfunction (DDF) and sleep disturbance (SDT) predicted subsequent ES and HA. Bidirectional associations were observed between HA and playing video games. Centrality analyses showed that ES, HA, DDF, and SDT were influential nodes with high OEIs and BEIs. Gender-specific networks were highly correlated (Pearson's r = 0.733). CONCLUSIONS: ES and HA were central in the short-term longitudinal network linking sleep traits, screen use, and EBPs. Sleep-related problems, particularly DDF and SDT, emerged as key bridging symptoms connecting sleep and EBPs and may precede maladaptive screen use. These findings highlight potential targets for strategies for early identification and intervention to disrupt self-reinforcing cycles of adolescent EBPs.
Validation and measurement invariance of a modified version of the marijuana craving questionnaire-short form across community and clinical samples.
Bustamante F, Arriaza T, Román C … +4 more , Huerta I, Cordero M, Alvarado ME, Vergés A
Addict Behav · 2026 Oct · PMID 42225013 · Publisher ↗
INTRODUCTION: The Marijuana Craving Questionnaire 12-item Short Form (MCQ-SF) was developed to assess marijuana craving. Few validations exist, and none have been conducted for Spanish-speaking countries. This study aime...
INTRODUCTION: The Marijuana Craving Questionnaire 12-item Short Form (MCQ-SF) was developed to assess marijuana craving. Few validations exist, and none have been conducted for Spanish-speaking countries. This study aimed to validate a modified version of the MCQ-SF, the Modified Marijuana Craving Questionnaire (MMCQ), in Spanish. METHODS: A sample of 373 Chilean adults (mean age: 26.10 years, 57.37% male, 71.31% secondary education) who reported Marijuana use completed the MMCQ, Impaired Control Scale (ICS), Cannabis Withdrawal Scale (CWS), and a sociodemographic and substance use characteristics questionnaire. We performed confirmatory factor analysis, using weighted least squares mean and variance adjusted, to test different factor structures. A unifactorial model was selected as the best-fitted solution and tested for measurement invariance by sex (male/female) and sample type (general population/clinical population). Convergent validity was examined through correlations between the MMCQ and the ICS, CWS, and age of onset of marijuana use. RESULTS: Four and two-factor models exhibited issues related to discriminant validity, as their factors were highly correlated, whereas a unifactorial model with one correlated residual showed the best fit. Measurement invariance using the selected model was met across sex and type of sample. The MMCQ correlated positively with the perceived control dimension of the ICS and the CWS, and negatively with age of onset. CONCLUSION: The unifactorial MMCQ, with one correlated residual, is a valid scale for research and clinical assessment of marijuana craving that can be used among the Spanish-speaking population.
Baseline quitting self-efficacy as a predictor of duration of vaping abstinence in a vaping cessation intervention.
Tian J, Kundu A, Schwartz R … +1 more , Chaiton M
Addict Behav · 2026 Oct · PMID 42214300 · Publisher ↗
BACKGROUND: While there is considerable interest in vaping cessation interventions, limited research has investigated predictors of successful vaping cessation. Self-efficacy strongly predicts smoking cessation, but its...
BACKGROUND: While there is considerable interest in vaping cessation interventions, limited research has investigated predictors of successful vaping cessation. Self-efficacy strongly predicts smoking cessation, but its role in vaping cessation remains understudied. METHODS: We conducted analyses from 389 participants who completed 488 quit challenges in total using the Stop Vaping Challenge mobile app between 2021 and April 2025. Baseline self-efficacy for quitting was measured on a 1-10 scale and treated as continuous , except for dichotomizing as low (1-5) or high (6-10) for Kaplan Meier plots and analyses. Cox proportional hazard models were used to examine the relationship between baseline quitting self-efficacy in predicting time to vaping relapse, controlling for demographics, past quitting attempts, intention to quit, and mental health status. RESULTS: Overall, 71.5% of challenges resulted in relapse. Participants with high baseline self-efficacy demonstrated significantly longer abstinence duration compared to those with low self-efficacy (median duration: 2.19 versus 0.68 days, p < 0.05). Higher self-efficacy was associated with reduced risk of vaping relapse (HR 0.94, 95% CI 0.89-0.98, p = 0.006). At 48 h and 7 days, those with lower self-efficacy were 21.6% and 17.6% more likely to relapse, respectively. DISCUSSION: Baseline self-efficacy is a significant predictor of duration of proximal vaping abstinence in a short-term digital cessation intervention. Those with higher self-efficacy abstained an average 2 days longer than those with lower self-efficacy. These findings highlight the importance of accounting for strategies to enhance quitting self-efficacy in vaping cessation programs to improve effectiveness and support sustained quit vaping attempts.
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