Hangover
Measuring Crack Cocaine and Its Impact
Roland Fryer et al.
Economic Inquiry, forthcoming
Abstract:
Numerous social indicators turned negative for Blacks in the 1980s and rebounded a decade later. We explore whether crack cocaine explains these patterns. Absent a direct measure, we construct a crack prevalence index using multiple proxies. Our index reproduces spatial and temporal patterns described in ethnographic accounts of the crack epidemic. It explains much of the 1980s rise in Black youth homicide and more moderate increases in adverse birth outcomes. Although our index remains high through the 1990s, crack's deleterious social impact fades. Changes over time in behavior, crack markets, and the user population may have mitigated crack's damaging impacts.
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The Effects of Earned Income Tax Credit Payment Expansion on Maternal Smoking
Susan Averett & Yang Wang
Health Economics, forthcoming
Abstract:
The Earned Income Tax Credit is the largest antipoverty program in the USA. In 1993, the Earned Income Tax Credit benefit levels were changed significantly based on the number of children in the family such that families with two or more children experienced an exogenous expansion in their incomes. Using data from the National Longitudinal Survey of Youth 1979 cohort, we use a triple-difference plus fixed effects framework to examine the effect of this change on the probability of smoking among low-educated mothers. We find that the probability of smoking for White low-educated mothers of two or more children significantly decreased relative to those with only one child, and this result is robust to various specification tests. This result provides new evidence on the protective effect of income on health through changes in a health-related behavior and therefore has important policy implications.
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Mike Vuolo
Drug and Alcohol Dependence, forthcoming
Introduction: Recent research has called upon investigators to exploit cross-national differences to uncover the cultural and structural factors influencing drug use. While the individual-level correlates are well-established, little is known about the association between cross-national variation in drug policies and young people's substance use. This study examines, net of individual-level predictors, the association between national-level drug policy and use of an illicit drug other than cannabis.
Methods: The study uses Eurobarometer repeated cross-sectional surveys in 2002 and 2004 of adolescents aged 15-24 drawn in multistage, random probability samples proportional to population size and density within regions of their country (N = 15,191). Participants completed self-reported measures of last month drug use, attitudes toward drugs, school and work participation, and demographics. Gathered from several international bodies, national-level policy measures include drug offense levels, possession decriminalization, and presence and usage of harm reduction strategies.
Results: Hierarchical logistic regression models demonstrate that, while controlling for important individual-level predictors, in countries where there is no restriction on possession of drugs for personal use, the odds of drug use in the last month are 79% lower (p < 0.05). On the other hand, higher usage of treatment and drug substitution are associated with higher levels of drug use. These results are robust to several alternate specifications.
Conclusions: Among the strongest and most consistent findings, eliminating punishments for possession for personal use is not associated with higher drug use. The results indicate that researchers should take national-level context into account in individual-level studies of drug use.
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Michael Slater & Kimberly Henry
Journal of Health Communication, forthcoming
Abstract:
The present study tests prospective effects of music-related media content (from television, Internet, and magazines) on youth alcohol, cigarette, and marijuana use initiation. Indirect effects through association with substance-using peers were tested in a 4-wave longitudinal data set (2,729 middle school students for the alcohol model, 2,716 students for the cigarette model, and 2,710 students for the marijuana model) from schools across the United States. In so doing, the authors examine theoretical claims regarding socialization mechanisms for effects of popular music listenership on substance use initiation. Results supported direct effects on alcohol and cigarette uptake, and indirect effects through association with substance-using peers on all 3 substances. This research, in combination with prior studies by several research teams, suggests elevated popular music involvement is a risk factor with respect to younger adolescents' substance use behavior. This influence is in part explained by the role of music-related media content in socialization to substance-using peer groups.
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The Persistent Effects of Minimum Legal Drinking Age Laws on Drinking Patterns Later in Life
Andrew Plunk et al.
Alcoholism, forthcoming
Background: Exposure to permissive minimum legal drinking age (MLDA) laws not only affects young adults in the short term, but also later in life; for example, individuals who could legally purchase alcohol before the age of 21 are more likely to suffer from drinking problems as older adults, long after the laws had been changed. However, it is not known how permissive MLDA exposure affects specific drinking behavior. This present study uses changes in MLDA laws during the 1970s and 1980s as a natural experiment to investigate the potential impact of permissive MLDA exposure on average alcohol consumption, frequency of drinking, and patterns of binging and more moderate, nonheavy drinking.
Methods: Policy exposure data were paired with alcohol use data from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey and the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions. Past-year drinkers born between 1949 and 1972 (n = 24,088) were included. Average daily intake, overall drinking frequency, and frequency of both binge episodes (5+ drinks) and days without a binge episode (nonheavy drinking) for the previous year at the time of interview were tracked for each respondent.
Results: Exposure to permissive MLDAs was associated with higher odds to report frequent binging and lower odds to report any moderate drinking; these associations were largely driven by men and those who did not attend college. Overall drinking frequency and average alcohol consumption were not affected by MLDA exposure.
Conclusions: The ability to legally purchase alcohol before the age of 21 does not seem to increase overall drinking frequency, but our findings suggest that it is associated with certain types of problematic drinking behaviors that persist into later adulthood: more frequent binge episodes and less frequent nonheavy drinking. We also propose that policymakers and critics should not focus on college drinking when evaluating the effectiveness of MLDAs.
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Drunk, but not blind: The effects of alcohol intoxication on change blindness
Gregory Colflesh & Jennifer Wiley
Consciousness and Cognition, March 2013, Pages 231-236
Abstract:
Alcohol use has long been assumed to alter cognition via attentional processes. To better understand the cognitive consequences of intoxication, the present study tested the effects of moderate intoxication (average BAC between .071 and .082) on attentional processing using complex working memory capacity (WMC) span tasks and a change blindness task. Intoxicated and sober participants were matched on baseline WMC performance, and intoxication significantly decreased performance on the complex span tasks. Surprisingly, intoxication improved performance on the change blindness task. The results are interpreted as evidence that intoxication decreases attentional control, causing either a shift towards more passive processing and/or a more diffuse attentional state. This may result in decreased performance on tasks where attentional control or focus are required, but may actually facilitate performance in some contexts.
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The Effects of Alcohol on the Emotional Displays of Whites in Interracial Groups
Catharine Fairbairn et al.
Emotion, forthcoming
Abstract:
Discomfort during interracial interactions is common among Whites in the U.S. and is linked to avoidance of interracial encounters. While the negative consequences of interracial discomfort are well-documented, understanding of its causes is still incomplete. Alcohol consumption has been shown to decrease negative emotions caused by self-presentational concern but increase negative emotions associated with racial prejudice. Using novel behavioral-expressive measures of emotion, we examined the impact of alcohol on displays of discomfort among 92 White individuals interacting in all-White or interracial groups. We used the Facial Action Coding System and comprehensive content-free speech analyses to examine affective and behavioral dynamics during these 36-min exchanges (7.9 million frames of video data). Among Whites consuming nonalcoholic beverages, those assigned to interracial groups evidenced more facial and speech displays of discomfort than those in all-White groups. In contrast, among intoxicated Whites there were no differences in displays of discomfort between interracial and all-White groups. Results highlight the central role of self-presentational concerns in interracial discomfort and offer new directions for applying theory and methods from emotion science to the examination of intergroup relations.
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Susan Calcaterra, Jason Glanz & Ingrid Binswanger
Drug and Alcohol Dependence, forthcoming
Background: Pharmaceutical opioid related deaths have increased. This study aimed to place pharmaceutical opioid overdose deaths within the context of heroin, cocaine, psychostimulants, and pharmaceutical sedative hypnotics examine demographic trends, and describe common combinations of substances involved in opioid related deaths.
Methods: We reviewed deaths among 15-64 year olds in the US from 1999-2009 using death certificate data available through the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) Database. We identified International Classification of Disease-10 codes describing accidental overdose deaths, including poisonings related to stimulants, pharmaceutical drugs, and heroin. We used crude and age adjusted death rates (deaths/100,000 person years [p-y] and 95% confidence interval [CI] and multivariable Poisson regression models, yielding incident rate ratios; IRRs), for analysis.
Results: The age adjusted death rate related to pharmaceutical opioids increased almost 4-fold from 1999 to 2009 (1.54/100,000 p-y [95% CI 1.49-1.60] to 6.05/100,000 p-y [95% CI 5.95-6.16; p < 0.001). From 1999 to 2009, pharmaceutical opioids were responsible for the highest relative increase in overdose death rates (IRR 4.22, 95% CI 3.03-5.87) followed by sedative hypnotics (IRR 3.53, 95% CI 2.11-5.90). Heroin related overdose death rates increased from 2007 to 2009 (1.05/100,000 persons [95% CI 1.00-1.09] to 1.43/100,000 persons [95% CI 1.38-1.48; p < 0.001). From 2005-2009 the combination of pharmaceutical opioids and benzodiazepines was the most common cause of polysubstance overdose deaths (1.27/100,000 p-y (95% CI 1.25-1.30).
Conclusion: Strategies, such as wider implementation of naloxone, expanded access to treatment, and development of new interventions are needed to curb the pharmaceutical opioid overdose epidemic.
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Sarah Zemore et al.
Journal of Studies on Alcohol and Drugs, January 2013, Pages 9-20
Objective: We examined whether race/ethnicity was related to exposure to acute economic losses in the 2008-2009 recession, even accounting for individual-level and geographic variables, and whether it influenced associations between economic losses and drinking patterns and problems.
Method: Data were from the 2010 National Alcohol Survey (N = 5,382). Surveys assessed both severe losses (i.e., job and housing loss) and moderate losses (i.e., reduced hours/pay and trouble paying the rent/mortgage) attributed to the 2008-2009 recession. Alcohol outcomes included total annual volume, monthly drunkenness, drinking consequences, and alcohol dependence (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).
Results: Compared with Whites, Blacks reported significantly greater exposure to job loss and trouble paying the rent/mortgage, and Latinos reported greater exposure to all economic losses. However, only Black-White differences were robust in multivariate analyses. Interaction tests suggested that associations between exposure to economic loss and alcohol problems were stronger among Blacks than Whites. Given severe (vs. no) loss, Blacks had about 13 times the odds of both two or more drinking consequences and alcohol dependence, whereas the corresponding odds ratios for Whites were less than 3. Conversely, associations between economic loss and alcohol outcomes were weak and ambiguous among Latinos.
Conclusions: Results suggest greater exposure to economic loss for both Blacks and Latinos (vs. Whites) and that the Black population may be particularly vulnerable to the negative effects of economic hardship on the development and/or maintenance of alcohol problems. Findings extend the economic literature and signal policy makers and service providers that Blacks and Latinos may be at special risk during economic downturns.
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The Contribution of Smoking to Black-White Differences in U.S. Mortality
Jessica Ho & Irma Elo
Demography, forthcoming
Abstract:
Smoking has significantly impacted American mortality and remains a major cause of morbidity and mortality. No previous study has systematically examined the contribution of smoking-attributable deaths to mortality trends among blacks or to black-white mortality differences at older ages over time in the United States. In this article, we employ multiple methods and data sources to provide a comprehensive assessment of this contribution. We find that smoking has contributed to the black-white gap in life expectancy at age 50 for males, accounting for 20 % to 48 % of the gap between 1980 and 2005, but not for females. The fraction of deaths attributable to smoking at ages above 50 is greater for black males than for white males; and among men, current smoking status explains about 20 % of the black excess relative risk in all-cause mortality at ages above 50 without adjustment for socioeconomic characteristics. These findings advance our understanding of the contribution of smoking to contemporary mortality trends and differences and reinforce the need for interventions that better address the needs of all groups.
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Revisiting the Hispanic mortality advantage in the United States: The role of smoking
Andrew Fenelon
Social Science & Medicine, forthcoming
Abstract:
More than three decades of health disparities research in the United States has consistently found lower adult mortality risks among Hispanics than their non-Hispanic white counterparts, despite lower socioeconomic status among Hispanics. Explanations for the "Hispanic Paradox" include selective migration and cultural factors, though neither has received convincing support. This paper uses a large nationally representative survey of health and smoking behavior to examine whether smoking can explain life expectancy advantage of Hispanics over US-born non-Hispanics whites, with special attention to individuals of Mexican origin. It tests the selective migration hypothesis using data on smoking among Mexico-to-US migrants in Mexico and the United States. Both US-born and foreign-born Mexican-Americans exhibit a life expectancy advantage vis-à-vis whites. All other Hispanics only show a longevity advantage among the foreign-born, while those born in the United States are disadvantaged relative to whites. Smoking-attributable mortality explains the majority of the advantage for Mexican-Americans, with more than 60% of the gap deriving from lower rates of smoking among Mexican-Americans. There is no evidence of selective migration with respect to smoking; Mexicans who migrate to the US smoke at similar rates to Mexicans who remain in Mexico, with both groups smoking substantially less than non-Hispanic whites in the US. The results suggest that more research is needed to effectively explain the low burden of smoking among Mexican-Americans in the United States.
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Ole Rogeberg
Proceedings of the National Academy of Sciences, forthcoming
Abstract:
Does cannabis use have substantial and permanent effects on neuropsychological functioning? Renewed and intense attention to the issue has followed recent research on the Dunedin cohort, which found a positive association between, on the one hand, adolescent-onset cannabis use and dependence and, on the other hand, a decline in IQ from childhood to adulthood [Meier et al. (2012) Proc Natl Acad Sci USA 109(40):E2657-E2664]. The association is given a causal interpretation by the authors, but existing research suggests an alternative confounding model based on time-varying effects of socioeconomic status on IQ. A simulation of the confounding model reproduces the reported associations from the Dunedin cohort, suggesting that the causal effects estimated in Meier et al. are likely to be overestimates, and that the true effect could be zero. Further analyses of the Dunedin cohort are proposed to distinguish between the competing interpretations. Although it would be too strong to say that the results have been discredited, the methodology is flawed and the causal inference drawn from the results premature.
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Neighborhood characteristics and the initiation of marijuana use and binge drinking
Joan Tucker et al.
Drug and Alcohol Dependence, 1 February 2013, Pages 83-89
Background: This study examines whether residential neighborhood characteristics influence the initiation of marijuana use and binge drinking, and if these neighborhood factors heighten or dampen peer influences on substance use.
Methods: Predictors of marijuana (N = 6516) and binge drinking (N = 6630) initiation over a 1-year period were identified using data from the National Longitudinal Study of Adolescent Health. Participants were of ages 12-19 years at baseline. The main predictor variables were neighborhood characteristics, using both objective (proportion of households below the poverty line and female-headed, unemployment rate, residential stability) and subjective (perceived cohesion and safety) measures. Binge drinking was defined as 5 or more drinks in a row.
Results: Initiation occurred for 12.9% of adolescents in the case of marijuana and 16.4% for binge drinking. Marijuana initiation was more likely among adolescents who lived in neighborhoods with a higher unemployment rate, and binge drinking initiation was more likely among those who perceived greater safety in their neighborhood, after adjusting for other neighborhood characteristics, demographics, friend characteristics, and behavioral and family risk factors. There was no evidence that neighborhood context moderates the associations of peer factors on initiation.
Conclusions: Select neighborhood characteristics appear relevant to the initiation of marijuana use and binge drinking, although the mechanisms appear to be distinct for each substance. If these results are found to be robust, future research should aim to better understand how neighborhood context influences the initiation of adolescent substance use in order to inform prevention efforts.
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Exposure to Alcohol Advertisements and Teenage Alcohol-Related Problems
Jerry Grenard, Clyde Dent & Alan Stacy
Pediatrics, February 2013, Pages e369-e379
Objective: This study used prospective data to test the hypothesis that exposure to alcohol advertising contributes to an increase in underage drinking and that an increase in underage drinking then leads to problems associated with drinking alcohol.
Methods: A total of 3890 students were surveyed once per year across 4 years from the 7th through the 10th grades. Assessments included several measures of exposure to alcohol advertising, alcohol use, problems related to alcohol use, and a range of covariates, such as age, drinking by peers, drinking by close adults, playing sports, general TV watching, acculturation, parents' jobs, and parents' education.
Results: Structural equation modeling of alcohol consumption showed that exposure to alcohol ads and/or liking of those ads in seventh grade were predictive of the latent growth factors for alcohol use (past 30 days and past 6 months) after controlling for covariates. In addition, there was a significant total effect for boys and a significant mediated effect for girls of exposure to alcohol ads and liking of those ads in 7th grade through latent growth factors for alcohol use on alcohol-related problems in 10th grade.
Conclusions: Younger adolescents appear to be susceptible to the persuasive messages contained in alcohol commercials broadcast on TV, which sometimes results in a positive affective reaction to the ads. Alcohol ad exposure and the affective reaction to those ads influence some youth to drink more and experience drinking-related problems later in adolescence.
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Giovanni Battistella et al.
PLoS ONE, January 2013
Abstract:
Marijuana is the most widely used illicit drug, however its effects on cognitive functions underling safe driving remain mostly unexplored. Our goal was to evaluate the impact of cannabis on the driving ability of occasional smokers, by investigating changes in the brain network involved in a tracking task. The subject characteristics, the percentage of Δ9-Tetrahydrocannabinol in the joint, and the inhaled dose were in accordance with real-life conditions. Thirty-one male volunteers were enrolled in this study that includes clinical and toxicological aspects together with functional magnetic resonance imaging of the brain and measurements of psychomotor skills. The fMRI paradigm was based on a visuo-motor tracking task, alternating active tracking blocks with passive tracking viewing and rest condition. We show that cannabis smoking, even at low Δ9-Tetrahydrocannabinol blood concentrations, decreases psychomotor skills and alters the activity of the brain networks involved in cognition. The relative decrease of Blood Oxygen Level Dependent response (BOLD) after cannabis smoking in the anterior insula, dorsomedial thalamus, and striatum compared to placebo smoking suggests an alteration of the network involved in saliency detection. In addition, the decrease of BOLD response in the right superior parietal cortex and in the dorsolateral prefrontal cortex indicates the involvement of the Control Executive network known to operate once the saliencies are identified. Furthermore, cannabis increases activity in the rostral anterior cingulate cortex and ventromedial prefrontal cortices, suggesting an increase in self-oriented mental activity. Subjects are more attracted by intrapersonal stimuli ("self") and fail to attend to task performance, leading to an insufficient allocation of task-oriented resources and to sub-optimal performance. These effects correlate with the subjective feeling of confusion rather than with the blood level of Δ9-Tetrahydrocannabinol. These findings bolster the zero-tolerance policy adopted in several countries that prohibits the presence of any amount of drugs in blood while driving.
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Matthew Rousu & James Thrasher
Applied Economic Perspectives and Policy, March 2013, Pages 171-184
Abstract:
We report the results of experimental auctions with U.S. smokers, assessing the percentage of U.S. smokers whose demand for cigarettes decreases when bidding on packs with text and pictorial warnings, relative to packs with text-only warnings. We find that pictorial labels and pictorial labels accompanied by plain packaging are more effective at reducing demand for cigarettes than only a front text warning label. We also find that pictorial labels were most effective at encouraging younger smokers to reduce their demand for cigarettes, and plain packaging was most effective at reducing demand among less educated smokers.
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Charu Mathur et al.
American Journal of Public Health, March 2013, Pages 543-548
Objectives: We examined the prospective effects of parental education (as a proxy for individual socioeconomic status [SES]) and neighborhood SES on adolescent smoking trajectories and whether the prospective effects of individual SES varied across neighborhood SES.
Methods: The study included 3635 randomly recruited adolescents from 5 age cohorts (12-16 years) assessed semiannually for 3 years in the Minnesota Adolescent Community Cohort study. We employed a cohort-sequential latent growth model to examine smoking from age 12 to 18 years with predictors.
Results: Lower individual SES predicted increased levels of smoking over time. Whereas neighborhood SES had no direct effect, the interaction between individual and neighborhood SES was significant. Among higher and lower neighborhood SES, lower individual SES predicted increased levels of smoking; however, the magnitude of association between lower individual SES and higher smoking levels was significantly greater for higher neighborhood SES.
Conclusions: We found evidence for differential effects of individual SES on adolescent smoking for higher and lower neighborhood SES. The group differences underscore social conditions as fundamental causes of disease and development of interventions and policies to address inequality in the resources.
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Aimei Mao, Katie Bristow & Jude Robinson
Health Education Research, February 2013, Pages 153-164
Abstract:
Intimate relationships influence family members' health practices. Although cigarette smoking in China is predominantly a male behavior, (non-smoking) women's roles should be taken into account for the development of home-smoking interventions. Drawing on ethnographic interviews with 22 families in a rural area of China, this article explores non-smoking women's attitudes towards male smoking. The findings suggest that women's ability to influence male behavior is largely determined by culturally defined gender roles, underpinned by ideologies of familism and collectivism. Despite concerns about the adverse results of smoking to their family members and households, non-smoking women ultimately maintain the (male) smokers' argument that smoking plays an important role in construction and maintenance of intra- and extra-family relationships. By accepting male smoking and men's engagement in the social practice of smoking and cigarette exchanges, women maintain their identities as supportive wives, filial daughters/in-law and responsible family members who pursue family collective interests at the expense of their own personal beliefs. Future smoking control initiatives that target non-smoking women to influence male smoking should take into account the women's overarching need to maintain the status and harmony of their families.
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Magdalena Cerdá et al.
Drug and Alcohol Dependence, forthcoming
Background: The drug overdose mortality rate tripled between 1990 and 2006; prescription opioids have driven this epidemic. We examined the period 1990-2006 to inform our understanding of how the current prescription opioid overdose epidemic emerged in urban areas.
Methods: We used data from the Office of the Chief Medical Examiner to examine changes in demographic and spatial patterns in overdose fatalities induced by prescription opioids (i.e., analgesics and methadone) in New York City (NYC) in 1990-2006, and what factors were associated with death from prescription opioids vs. heroin, historically the most prevalent form of opioid overdose in urban areas.
Results: Analgesic-induced overdose fatalities were the only types of overdose fatalities to increase in 1990-2006 in NYC; the fatality rate increased sevenfold from 0.39 in 1990 to 2.7 per 100,000 persons in 2006. Whites and Latinos were the only racial/ethnic groups to exhibit an increase in overdose-related mortality. Relative to heroin overdose decedents, analgesic and methadone overdose decedents were more likely to be female and to concurrently use psychotherapeutic drugs, but less likely to concurrently use alcohol or cocaine. Analgesic overdose decedents were less likely to be Black or Hispanic, while methadone overdose decedents were more likely to be Black or Hispanic in contrast to heroin overdose decedents.
Conclusions: The distinct epidemiologic profiles exhibited by analgesic and methadone overdose fatalities highlight the need to define drug-specific public health prevention efforts.
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Chris Delcher, Rachel Johnson & Mildred Maldonado-Molina
Journal of Adolescent Health, forthcoming
Purpose: National guidelines for alcohol screening and brief interventions advise practitioners to consider age, drinking frequency, and context to identify at-risk youth. The purpose of this study was to identify the contextual risk and protective factors in high school-aged adolescents associated with future driving after drinking (Drinking Under the Influence [DUI] at age 21) by race/ethnicity.
Methods: Data included 10,271 adolescents (67% white, 12% Hispanic, 16% black, 3.6% Asian; 49% Male) who participated in the National Longitudinal Study of Adolescent Health (Waves I, II, and III) from 1995 to 2001. A lagged panel design and survey logistic regression was used to examine the association between multiple contextual factors (e.g., demographics, parents, peers, social context) during adolescence and self-reported DUI in young adulthood.
Results: As expected, the likelihood of DUI was higher among whites followed by Hispanics, Asians, and blacks in all models. Perception of easy home access to alcohol increased risk for future DUI for whites (OR: 1.25 CI: 1.04-1.49), Hispanics (OR: 2.02 CI: 1.29-3.16), and Asians (OR: 1.90 CI: 1.13-3.22), but not for black youth. Drinking frequency and prior DUI were not risk factors for Hispanics. Risk-taking attitudes, marijuana use, and religious affiliation were risk factors for whites only.
Conclusions: Findings suggest that in addition to screening for drinking behaviors, brief interventions and prevention efforts should assess perceived home access to alcohol and other race-specific factors to reduce alcohol-related injuries and harm.
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Nonverbal Displays of Shame Predict Relapse and Declining Health in Recovering Alcoholics
Daniel Randles & Jessica Tracy
Clinical Psychological Science, forthcoming
Abstract:
Public shaming has long been thought to promote positive behavioral change. However, studies suggest that shame may be a detrimental response to problematic behavior because it motivates hiding, escape, and general avoidance of the problem. We tested whether shame about one's past addictive drinking (measured via nonverbal displays and self-report) predicts future drinking behaviors and changes in health among newly recovering alcoholics (i.e., sober < 6.5 months; N = 105; Wave 2, n = 46), recruited from Alcoholics Anonymous meetings. Results showed that nonverbal behavioral displays of shame expressed while discussing past drinking strongly predicted (a) the tendency to relapse over the next 3 to 11 months, (b) the severity of that relapse, and (c) declines in health. All results held controlling for a range of potential confounders (e.g., alcohol dependence, health, personality). These findings suggest that shame about one's problematic past may increase, rather than decrease, future occurrences of problem behaviors.
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Implicit Drinking Identity: Drinker + Me Associations Predict College Student Drinking Consistently
Kristen Lindgren et al.
Addictive Behaviors, forthcoming
Abstract:
Predicting hazardous drinking in college students continues to be a serious priority. Emerging evidence suggests that implicit measures may offer additional insight in predicting unique variance in alcohol outcomes. Implicit drinking identity, in particular, may be a powerful predictor of alcohol use. The current study examined the predictive validity of three alcohol-related associations (e.g., drinking identity, alcohol approach, and alcohol cope) using adaptations of the Implicit Association Test (IAT) in a sample of 243 undergraduates. Confirming previous findings, drinking identity associations were the most consistent predictor of alcohol consumption and alcohol problems. They were the only associations that were unique predictors of alcohol use after controlling for other implicit associations. In comparison, alcohol cope and alcohol approach associations were weak but consistent predictors of alcohol consumption and alcohol problems. Although positively correlated with all drinking outcomes, neither set of associations predicted unique variance in the drinking outcomes when all implicit associations were included in the same model. Collectively, these results extend previous findings that implicit drinking identity may be a uniquely powerful tool for predicting alcohol outcomes and a potential target for clinical intervention and prevention efforts.
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Alcohol-dependent individuals discount sex at higher rates than controls
David Jarmolowicz, Warren Bickel & Kirstin Gatchalian
Drug and Alcohol Dependence, forthcoming
Background: Research on delay discounting has expanded our understanding of substance dependence in many ways. Recently, orderly discounting of sexual rewards has been demonstrated in both substance-dependent individuals, and healthy controls. Less clear, however, is if rates of sexual discounting are higher than controls in alcohol-dependent-individuals.
Methods: 20 alcohol-dependent individuals and 21 healthy control participants completed two delay-discounting tasks. One task involved monetary rewards, whereas the other involved the discounting of sexual rewards (i.e., number of sex acts).
Results: Alcohol dependent individuals discounted sexual rewards at significantly higher rates than did controls. There was a trend toward, but not a similarly significant relation for the discounting of monetary rewards.
Conclusions: Rates of sexual discounting are elevated in alcohol dependent individuals. If this relation is replicated in other at risk populations, the rapid devaluation of sexual rewards may be a laboratory marker of impulsive sexual choices.
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Campaign to counter a deteriorating consumer market: Philip Morris's Project Sunrise
M. Givel
Public Health, forthcoming
Objectives: From 1997 to 2000, Philip Morris implemented Project Sunrise. This paper discusses the impact of this project on national and Philip Morris's cigarette unit sales, public opinion about smoking and secondhand tobacco smoke, and national prevalence trends for tobacco use.
Study design: A qualitative archival content analysis of Project Sunrise from 1997 to 2000, and a descriptive statistical analysis of cigarette unit sales and operating profits, acceptability of smoking and secondhand tobacco smoke, and national prevalence trends for tobacco use from 1996 to 2006.
Methods: Qualitative data sources related to Project Sunrise found on WebCat, Pubmed.com, LexisNexis Academic and Philip Morris's website, and archived tobacco industry documents were analysed using NVivo Version 9.0. A descriptive statistical analysis of cigarette unit sales, public opinion about smoking and secondhand tobacco smoke, and national prevalence trends for tobacco use was undertaken.
Results: Project Sunrise was a high-level strategic corporate plan to maintain profits that included four possible scenarios resulting in seven interwoven strategies. However, national prevalence rates for tobacco use declined, sales of national and Philip Morris cigarettes declined, operating profits remained at substantially lower levels after 2000 from 2001 to 2006, and a large majority of Americans agreed that there were significant health dangers associated with smoking and secondhand tobacco smoke.
Conclusion: The impact of Project Sunrise, including countering the anti-tobacco movement, was less than successful in the USA.
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Jennifer Cantrell et al.
PLoS ONE, January 2013
Background: The U.S. Family Smoking Prevention and Tobacco Control Act of 2009 requires updating of the existing text-only health warning labels on tobacco packaging with nine new warning statements accompanied by pictorial images. Survey and experimental research in the U.S. and other countries supports the effectiveness of pictorial health warning labels compared with text-only warnings for informing smokers about the risks of smoking and encouraging cessation. Yet very little research has examined differences in reactions to warning labels by race/ethnicity, education or income despite evidence that population subgroups may differ in their ability to process health information. The purpose of the present study was to evaluate the potential impact of pictorial warning labels compared with text-only labels among U.S. adult smokers from diverse racial/ethnic and socioeconomic subgroups.
Methods/Findings: Participants were adult smokers recruited from two online research panels (n = 3,371) into a web-based experimental study to view either the new pictorial warnings or text-only warnings. Participants viewed the labels and reported their reactions. Adjusted regression models demonstrated significantly stronger reactions for the pictorial condition for each outcome salience (b = 0.62, p<.001); perceived impact (b = 0.44, p<.001); credibility (OR = 1.41, 95% CI = 1.22-1.62), and intention to quit (OR = 1.30, 95% CI = 1.10-1.53). No significant results were found for interactions between condition and race/ethnicity, education, or income. The only exception concerned the intention to quit outcome, where the condition-by-education interaction was nearly significant (p = 0.057).
Conclusions: Findings suggest that the greater impact of the pictorial warning label compared to the text-only warning is consistent across diverse racial/ethnic and socioeconomic populations. Given their great reach, pictorial health warning labels may be one of the few tobacco control policies that have the potential to reduce communication inequalities across groups. Policies that establish strong pictorial warning labels on tobacco packaging may be instrumental in reducing the toll of the tobacco epidemic, particularly within vulnerable communities.
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Hospital Admissions for Childhood Asthma After Smoke-Free Legislation in England
Christopher Millett et al.
Pediatrics, February 2013, Pages e495-e501
Objective: To assess whether the implementation of English smoke-free legislation in July 2007 was associated with a reduction in hospital admissions for childhood asthma.
Methods: Interrupted time series study using Hospital Episodes Statistics data from April 2002 to November 2010. Sample consisted of all children (aged ≤14 years) having an emergency hospital admission with a principle diagnosis of asthma.
Results: Before the implementation of the legislation, the admission rate for childhood asthma was increasing by 2.2% per year (adjusted rate ratio 1.02; 95% confidence interval [CI]: 1.02-1.03). After implementation of the legislation, there was a significant immediate change in the admission rate of -8.9% (adjusted rate ratio 0.91; 95% CI: 0.89-0.93) and change in time trend of -3.4% per year (adjusted rate ratio 0.97; 95% CI: 0.96-0.98). This change was equivalent to 6802 fewer hospital admissions in the first 3 years after implementation. There were similar reductions in asthma admission rates among children from different age, gender, and socioeconomic status groups and among those residing in urban and rural locations.
Conclusions: These findings confirm those from a small number of previous studies suggesting that the well-documented population health benefits of comprehensive smoke-free legislation appear to extend to reducing hospital admissions for childhood asthma.
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S.A. Magrys et al.
Psychophysiology, February 2013, Pages 204-209
Abstract:
Ambiguous biochemical and subjective responses to alcohol may relate to preexisting individual differences in alcohol expectations, experience, or impulsivity. This study examined cortisol and alpha-amylase responses to alcohol and their association with trait impulsivity, alcohol expectancy, and subjective reports of alcohol's effects. Eighty-seven males assigned to an alcohol, sober, or placebo group provided biochemical and self-report measures. Both cortisol and alpha-amylase increased following alcohol administration. Impulsivity correlated with cortisol changes, and the greatest rise in cortisol correlated with high stimulating effects in the alcohol group. These findings emphasize the importance of individual differences in alcohol responses and support a relationship between hormonal responses and alcohol use.
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Opioid abusers' ability to differentiate an opioid from placebo in laboratory challenge testing
Denis Antoine et al.
Drug and Alcohol Dependence, forthcoming
Background: Abuse liability assessments influence drug development, federal regulation, and clinical care. One suggested procedure to reduce variability of assessments is a qualification phase, which assesses whether study applicants adequately distinguish active drug from placebo; applicants failing to make this distinction are disqualified. The present analyses assessed differences between qualification phase qualifiers and non-qualifiers.
Methods: Data were collected from 23 completers of the qualification phase of an abuse liability study. Opioid abusing participants received 30 mg oxycodone and placebo orally on separate days, and were characterized as qualifiers (vs. non-qualifiers) if their peak visual analog scale liking rating for oxycodone was at least 20 points higher than placebo's peak rating. Groups were compared on demographic characteristics, drug history, and physiologic, subject and observer ratings.
Results: 61% of participants were qualifiers and 39% were non-qualifiers. Groups had similar demographic characteristics, drug use histories, and pupillary constriction responses. However, unlike qualifiers, non-qualifiers had an exaggerated placebo response for the liking score (p = 0.03) and an attenuated oxycodone response for the liking score (p < 0.0001). Non-qualifiers' failure to differentiate oxycodone versus placebo was evident for subject and observer ratings.
Conclusion: Different subjective responses to identical stimuli support the use of a qualification phase in abuse liability assessments. Further research should explore objective measures that may better account for these differences, determine optimal qualification criteria, and explore the developmental course of drug use. This study also documents certain opioid abusers fail to differentiate 30 mg of oxycodone from placebo, a phenomenon deserving further study.