Publications by authors named "LaTrice Montgomery"

42 Publications

The effect of varenicline on smoking and drinking outcomes among Black and White adults with alcohol use disorder and co-occurring cigarette smoking: A secondary analysis of two clinical trials.

Addict Behav 2021 Nov 1;122:106970. Epub 2021 May 1.

Yale School of Medicine, Department of Psychiatry, New Haven, CT 06511, United States; Yale Cancer Center and Smilow Cancer Hospital at Yale-New Haven Hospital, New Haven, CT 06511, United States.

Introduction: Varenicline is an FDA-approved medication for smoking cessation and has demonstrated promise in reducing alcohol use. This study sought to compare the efficacy of varenicline in reducing smoking and drinking among Black and White people seeking alcohol treatment.

Methods: Linear mixed modeling was conducted using data from two multi-site placebo-controlled randomized clinical trials examining the effects of varenicline for treatment of Alcohol Use Disorder (AUD; O'Malley et al., 2018; Litten et al., 2013) among Black and White adults with AUD and co-occurring cigarette smoking. The primary analyses were conducted in a sample of 117 adults (O'Malley trial: 29.1% female, 55.2% Black), and replicated in an independent sample of 73 adults (Litten trial: 23.3% female, 45.2% Black).

Results: Black participants smoked fewer cigarettes per day compared to White participants (O'Malley trial: F = 8.95, p = .003; Litten trial: F = 4.74p = .03). Linear mixed models revealed a marginal effect of varenicline on reducing cigarettes smoked per day regardless of race in the O'Malley trial (F = 3.34, p = .07), which was replicated in the Litten trial (F = 20.77p < .0001). Participants reduced the number of drinks consumed regardless of treatment condition or race in both trials (O'Malley trial: F = 131.69, p < .0001; Litten trial:F = 60.36, p < .0001).

Conclusions: Our adjusted model findings suggest varenicline reduced smoking among Black and White people with AUD and co-occurring cigarette smoking. However, these findings should be replicated in a larger sample.
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http://dx.doi.org/10.1016/j.addbeh.2021.106970DOI Listing
November 2021

Reductions in tobacco use in naltrexone, relative to buprenorphine-maintained individuals with opioid use disorder: Secondary analysis from the National Drug Abuse Treatment Clinical Trials Network.

J Subst Abuse Treat 2021 May 21;130:108489. Epub 2021 May 21.

Department of Psychiatry, NYU Grossman School of Medicine, One Park Avenue, New York, NY 10016, USA.

Background: Smoking prevalence in individuals with opioid use disorder (OUD) is over 80%. Research suggests that opioid use significantly increases smoking, which could account for the strikingly low smoking-cessation rates observed in both methadone- and buprenorphine-maintained patients, even with the use of first-line smoking-cessation interventions. If opioids present a barrier to smoking-cessation, then better smoking outcomes should be observed in OUD patients treated with extended-release naltrexone (XR-NTX, an opioid antagonist) compared to those receiving buprenorphine (BUP-NX, a partial opioid agonist).

Methods: The current study is a secondary analysis of a 24-week, multi-site, open-label, randomized clinical trial conducted within the National Drug Abuse Treatment Clinical Trials Network comparing the effectiveness of XR-NTX vs. BUP-NX for adults with OUD. Longitudinal mixed effects models were used to determine if there was a significant reduction in cigarette use among daily smokers successfully inducted to treatment (n = 373) and a subset of those who completed treatment (n = 169).

Results: Among daily smokers inducted onto OUD medication, those in the XR-NTX group smoked fewer cigarettes per day (M = 11.36, SE = 0.62) relative to smokers in the BUP-NX group (M = 13.33, SE = 0.58) across all study visits, (b (SE) = -1.97 (0.55), p < .01). Results were similar for the treatment completers.

Conclusions: OUD patients treated with XR-NTX reduced cigarette use more than those treated with BUP-NX, suggesting that XR-NTX in combination with other smoking cessation interventions might be a better choice for OUD smokers interested in reducing their tobacco use.
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http://dx.doi.org/10.1016/j.jsat.2021.108489DOI Listing
May 2021

Cigarette smoking frequency, quantity, dependence, and quit intentions during adolescence: Comparison of menthol and non-menthol smokers (National Youth Tobacco Survey 2017-2020).

Addict Behav 2021 10 15;121:106986. Epub 2021 May 15.

Department of Psychiatry and Behavioral Neuroscience, Addiction Sciences Division, University of Cincinnati College of Medicine, United States.

Background: Use of menthol cigarettes is linked to sustained cigarette smoking adults. However, the relationship between menthol and smoking profile has not been thoroughly explored in adolescent cigarette smokers. This study examines the relationship between use of menthol cigarette and smoking frequency (i.e., days per month), quantity (i.e., cigarettes per day), quit intentions, and nicotine dependence (i.e., craving tobacco; use within 30 min of waking).

Methods: We pooled four years (2017-2020) of cross-sectional data from the National Youth Tobacco Survey. Participants were 2699 adolescent, past 30-day cigarette smokers. Multinomial logistic regression models examined the relationship between menthol and cigarette smoking frequency and quantity. Logistic regressions examined the relationship between menthol and intentions to quit smoking and nicotine dependence. Models controlled for socio-demographics and other tobacco use.

Results: Menthol cigarette smokers had greater risk of smoking 20-30 days per month relative to 1-5 days per month (RRR: 1.90; 95% CI: 1.41 - 2.54) and greater risk of smoking 11+ cigarettes per day relative to 1 or less cigarettes per day (RRR: 1.35; 95% CI: 1.01 - 1.80), adjusting for covariates. Menthol cigarette smokers had lower odds of intentions to quit smoking (Adj OR: 0.70; 95% CI: 0.58 - 0.84) but great odds of craving tobacco (OR: 1.47; 95% CI: 1.20 - 1.81) and using tobacco within 30 minutes of waking (OR: 1.63; 95% CI: 1.29 - 2.05), adjusting for covariates CONCLUSION: Findings suggest the relationship between menthol and cigarette smoking profile (i.e., frequency, quantity, quit intentions) is different for youth than that of adults. This study adds adolescent-specific evidence to existing research that suggests menthol reinforces sustained cigarette smoking among youth.
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http://dx.doi.org/10.1016/j.addbeh.2021.106986DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8244158PMC
October 2021

Prevalence and correlates of daily blunt use among U.S. African American, Hispanic, and White adults from 2014 to 2018.

Psychol Addict Behav 2021 Apr 29. Epub 2021 Apr 29.

Addiction Sciences Division.

Objective: Blunt smoking presents unique public health concerns relative to other methods of marijuana use, including greater exposure to toxins and carcinogens as well as increased risk for cannabis use disorder. This study examines correlates of self-reported daily blunt use among a nationally representative sample of adult blunt users in the United States.

Method: We pooled and analyzed 5 years of cross-sectional data from = 10,826 adult blunt smokers in the United States using the National Survey on Drug Use and Health (2014-2018). Multiple logistic regression analysis examined correlates of daily blunt use among non-Hispanic White, non-Hispanic African American, and Hispanic/Latino adult blunt users in the United States. Next, multiple logistic regression analyses stratified by race/ethnicity were conducted. This study examined: (a) socio-demographic (age, sex, and income); (b) behavioral (alcohol, tobacco, and illicit drug use); (c) intrapersonal (depression); and (d) regulatory (marijuana laws) factors.

Results: African Americans had the greatest prevalence of daily blunt use (24.2%), relative to Whites (9.1%) and Hispanic/Latinos (13.9%) ( < .001). African Americans aged 26-34 years old (adjusted odds ratio [Adj ]: 1.37) and living in medical marijuana states (Adj : 1.28) were more likely to be daily blunt users; these factors were not associated with daily blunt use in the full sample or in stratified models of Whites or Hispanic/Latinos. Alcohol use was negatively associated with daily blunt use among Whites and Hispanic/Latinos but not African Americans.

Conclusions: Socio-demographic, behavioral, and regulatory factors appear differently associated with daily blunt use across racial/ethnic groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/adb0000702DOI Listing
April 2021

Concurrent E-cigarette and marijuana use and health-risk behaviors among U.S. high school students.

Prev Med 2021 04 19;145:106429. Epub 2021 Jan 19.

School of Human Services, University of Cincinnati, P.O. Box 210068, Cincinnati, OH 45221, USA. Electronic address:

The use of electronic cigarettes (e-cigarettes) and marijuana remain prevalent problems among adolescents nationwide. We assessed current (past 30-day) exclusive e-cigarette use, exclusive marijuana use, and concurrent use with unintentional injury and violent behaviors, alcohol and other drug use behaviors, and sexual behaviors among U.S. high school students. We analyzed 2017 Youth Risk Behavior Survey data including 12,578 high school students nationwide. Multivariable logistic regression models were performed to compare these health-risk behaviors among exclusive e-cigarette users, exclusive marijuana users, and concurrent users with non-users among the overall sample, and then to compare exclusive e-cigarette users and exclusive marijuana users with concurrent users among current users only. All models adjusted for adolescent sex, grade, and race/ethnicity, and other tobacco product use. Approximately 77% of students were non-users, 5.2% were exclusive e-cigarette users, 9.9% were exclusive marijuana users, and 7.8% were concurrent users. Compared to non-users, exclusive e-cigarette users and exclusive marijuana users were more likely to engage in most negative health-risk behaviors associated with unintentional injuries and violence, alcohol and other drug use, and sexual behaviors. Among current users only, exclusive e-cigarette users and exclusive marijuana users were at reduced odds of engaging in most of these health-risk behaviors when compared to concurrent users of both substances. The relationship between exclusive and concurrent e-cigarette and marijuana use and health-risk behaviors highlights the importance of comprehensive educational efforts during high school. Findings suggest need for more studies on influence of e-cigarette and marijuana use on injury and violence risk among youth.
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http://dx.doi.org/10.1016/j.ypmed.2021.106429DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8194044PMC
April 2021

Editorial: Health equity in substance use disorder treatment.

J Subst Abuse Treat 2020 11 8;118:108101. Epub 2020 Aug 8.

University of Michigan, Center for Clinical Management Research, Ann Arbor VA Healthcare System, Ann Arbor, MI, United States of America.

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http://dx.doi.org/10.1016/j.jsat.2020.108101DOI Listing
November 2020

Editorial: COVID-19 and its impact on SUD treatment.

J Subst Abuse Treat 2020 10 25;117:108091. Epub 2020 Jul 25.

University of Cincinnati College of Medicine, United States of America.

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http://dx.doi.org/10.1016/j.jsat.2020.108091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381909PMC
October 2020

Is it "loud" enough?: A qualitative investigation of blunt use among African American young adults.

J Ethn Subst Abuse 2020 Aug 3:1-15. Epub 2020 Aug 3.

University of Cincinnati College of Medicine, Cincinnati, Ohio.

Heavy blunt use is common among young adult cannabis users, especially African Americans. This exploratory qualitative study aimed to examine how African American young adults understand, talk about and experience their blunt use. Semi-structured interviews were conducted with adults reporting daily or almost daily blunt use in the past month ( = 20; 75% male). Thematic analysis of the audio-recorded interviews revealed aspects of how blunts are described, made and used among heavy blunt users. The three emergent themes have implications for the assessment of cannabis use and intervention development for heavy blunt users.
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http://dx.doi.org/10.1080/15332640.2020.1801548DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176965PMC
August 2020

Hispanic participants in the National Institute on Drug Abuse's Clinical Trials Network: A scoping review of two decades of research.

Addict Behav Rep 2020 Dec 1;12:100287. Epub 2020 Jun 1.

College of Social Work, Florida State University, 296 Champions Way, UCC 3407, Tallahassee, FL 32309, United States.

Introduction: Hispanics significantly underutilize substance abuse treatment and are at greater risk for poor treatment outcomes and dropout. Two decades of research from the National Drug Abuse Treatment Clinical Trials Network (CTN) offers an opportunity to increase our understanding in how to address the disparities experienced by Hispanics in substance abuse treatment.

Methods: A scoping review was utilized to determine what has been learned from the CTN about Hispanic populations with substance use disorder. A systematic search was conducted within the CTN Dissemination Library and nine databases. Potentially relevant studies were independently assessed by two reviewers for inclusion.

Results: Twenty-four studies were included in the review. Results identified issues in measurement, characteristics of Hispanic substance use, effective interventions, and gaps for future research. Characteristics that interfere with treatment participation were also identified including low employment rates, less likelihood of having insurance, lower rates of internet access, and increased travel time to services, as were treatment issues such as high rates of alcohol and tobacco use. Effective interventions were identified; however, the effectiveness of these interventions may be limited to specific factors.

Conclusions: Despite efforts to improve inclusion of minority populations, Hispanics remain underrepresented in clinical trials. Future research including Hispanic populations should examine measurement equivalence and consider how cultural and historical experiences, as well as patient characteristics, influence utilization of services. Finally, more studies are needed that examine the impact of structural factors that act as barriers to treatment access and engagement and result in significant disparities in treatment outcomes.
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http://dx.doi.org/10.1016/j.abrep.2020.100287DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330873PMC
December 2020

Extended-release naltrexone versus buprenorphine-naloxone to treat opioid use disorder among black adults.

Addict Behav 2020 11 18;110:106514. Epub 2020 Jun 18.

Columbia University Irving Medical Center, Department of Psychiatry and New York State Psychiatric Institute, 1051 Riverside Dr., New York, NY 10032, United States.

Few studies examine the effectiveness of treatments for opioid use disorder (OUD) among Black individuals despite recent evidence suggesting opioid overdose death rates are, in some cases, highest and increasing at a faster rate among Black people compared to other racial/ethnic groups. This secondary analysis study investigated treatment preference, retention, and relapse rates amongst a subgroup of 73 Black participants with OUD (81% male, mean age 39.05, SD = 11.80) participating in a 24-week multisite randomized clinical trial ("X:BOT") comparing the effectiveness of extended-release naltrexone (XR-NTX) and sublingual buprenorphine-naloxone (BUP-NX) between 2014 and 2017. Chi-square analyses were used to investigate treatment preference assessed at baseline, and logistic regression analyses were used to investigate differences in the odds of retention and relapse assessed over the 24-week course of treatment between treatment groups. Our findings suggest no differences in preference for XR-NTX versus BUP-NX. However, similar to the parent trial, there was an induction hurdle such that only 59.5% of those randomized to XR-NTX successfully initiated medication compared to 91.6% of those randomized to BUP-NX (OR = 0.13, 95% CI = 0.04, 0.52). No significant differences were found in treatment retention (intention-to-treat: OR = 1.19, 95% CI = 0.43, 3.28; per-protocol [i.e., those who initiated medication]: OR = 0.60, 95% CI = 0.20, 1.82) or relapse rates between treatment groups (intention-to-treat: OR = 1.53, 95% CI = 0.57, 4.13; per-protocol: OR = 0.69, 95% CI = 0.23, 2.06). Although there is a significant initiation hurdle with XR-NTX, once inducted, both medications appear similar in effectiveness, but as in the main study, dropout rates were high. Future research is needed on how to improve adherence.
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http://dx.doi.org/10.1016/j.addbeh.2020.106514DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7433932PMC
November 2020

Gender Differences in the Association between Marijuana and Menthol Cigarette Use among African American Adult Cigarette Smokers.

Subst Use Misuse 2020 7;55(8):1335-1342. Epub 2020 Apr 7.

Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Despite the strong relationship between marijuana and tobacco use, especially among African American individuals and males, very few studies have examined the association between marijuana and menthol cigarette use. This study was designed to identify the prevalence of past month, past year and lifetime marijuana use and marijuana dependence among menthol and non-menthol cigarette smokers, as well as the association between marijuana and menthol cigarette use among African American female and male cigarette smokers. Data were drawn from 1,173 African American adult cigarette smokers in the 2017 National Survey on Drug Use and Health. Overall, 8.8%, 13.9% and 44.7% of African American menthol and non-menthol cigarette smokers reported past month, past year and lifetime marijuana use, respectively. Weighted multivariable logistic regression models revealed a significant interaction between gender and past month marijuana use on menthol cigarette use ( = 1.49, 95% CI: 1.21-2.42, < .05). Past month marijuana use was associated with an odds of past month menthol cigarette use (relative to non-menthol cigarette use) among females, but a odds of past of past month menthol cigarette use among males. When stratified by gender, marijuana use is differentially related to menthol cigarette use among African American adults. Given the prevalence of menthol cigarette use among this population, it is important to examine factors such as marijuana use that could be targeted in prevention and treatment interventions for African Americans, especially females, who are at risk for smoking or are currently smoking menthol cigarettes. This study found that marijuana use was associated with an increased odds of menthol cigarette use among African American females, while marijuana use was associated with a decreased odds of menthol cigarette use among their male counterparts. The impact of marijuana use on menthol cigarette smoking differs among females and males, highlighting the need for gender-tailored interventions that target marijuana use among African American individuals, especially females, who are at risk for smoking or are currently smoking menthol cigarettes.
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http://dx.doi.org/10.1080/10826084.2020.1741633DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7281863PMC
June 2021

Blunt use and menthol cigarette smoking: An examination of adult marijuana users.

Addict Behav 2020 03 19;102:106153. Epub 2019 Oct 19.

Department of Psychiatry and Behavioral Neuroscience, Addiction Sciences Division, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Suite 104, Cincinnati, OH 45229, United States. Electronic address:

Introduction: Use of menthol cigarettes remains highly prevalent among African American smokers and has increased among White and Hispanic/Latino smokers. Research is needed to examine if behavioral factors, such as marijuana use, are differentially associated with menthol cigarette use among racially/ethnically diverse samples of marijuana users.

Methods: Using data from the 2017 National Survey on Drug Use and Health, this study examined the association between past month marijuana (blunt versus non-blunt) and cigarette (non-menthol cigarette versus menthol cigarette versus no cigarette) use, as well as racial/ethnic differences in this relationship.

Results: Among all marijuana users (N = 5,137), 34.1% smoked blunts, 28.7% smoked non-menthol cigarettes and 18.0% smoked menthol cigarettes, with the highest rates of blunt (63.8%) and menthol cigarette (38.9%) use found among African American adults. Multinomial logistic regression analyses revealed a significant association between blunt use and non-menthol cigarette use (versus non-use) and menthol cigarette use (versus non-menthol cigarette and no cigarette use) among the full sample. When stratified by race/ethnicity, this finding was consistent for non-Hispanic White (n = 3,492) and partially consistent for Hispanic/Latino (n = 839) adults. However, among African American adults (n = 806), blunt use was not significantly associated with non-menthol cigarette use or menthol cigarette use.

Discussion: Blunt use is associated with increased odds of non-menthol and menthol cigarette use, but only among Hispanic/Latino and White adults. Examining racial/ethnic differences in the association between marijuana and tobacco use is important to understanding disparities and informing prevention and treatment interventions and drug policies.
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http://dx.doi.org/10.1016/j.addbeh.2019.106153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935044PMC
March 2020

A systematic scoping review of research on Black participants in the National Drug Abuse Treatment Clinical Trials Network.

Psychol Addict Behav 2020 Feb 27;34(1):117-127. Epub 2019 Jun 27.

Department of Psychology.

Black individuals experience a disproportionate burden of substance-related disabilities and premature death relative to other racial/ethnic groups, highlighting the need for additional research. The National Drug Abuse Treatment Clinical Trials Network (CTN), a research platform for multisite behavioral, pharmacological, and integrated trials designed to evaluate the effectiveness of substance use treatments in community settings with diversified patient populations, provides a wealth of research knowledge on substance use. Although CTN trials have enrolled over 5,000 Black individuals since its inception in 2000, there has been no synthesis of the findings, discussion of the implications, or suggestions for future research for Black individuals. Members of the Minority Interest Group of the CTN conducted a scoping review of published research on Black participants in CTN trials. Studies were included if the sample was more than 75% Black and/or specific findings pertaining to Black participants were reported. The review yielded 50 articles, with studies that mostly focused on baseline characteristics, followed by substance use treatment outcomes, HIV/risky sex behaviors, retention, comorbid conditions and measurement issues. This review highlighted the importance of several issues that are critical to understanding and treating substance misuse among Black people, such as the characteristics of Black people entering treatment, measurement equivalence, and engaging/retaining adolescents and young adults in treatment. There is still a continued need to identify the most effective treatments for Black individuals who use substances. The CTN offers several untapped opportunities to further advance research on Black individuals who use substances (e.g., secondary analyses of publicly available data). (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/adb0000483DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933111PMC
February 2020

Erratum to 'Flavored tobacco use is associated with dual and poly tobacco use among adolescents' Addictive Behaviors, 92, 2019, 84-88.

Addict Behav 2019 05 22;92:R1. Epub 2019 Apr 22.

University of Cincinnati College of Medicine, Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, USA.

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http://dx.doi.org/10.1016/j.addbeh.2019.04.013DOI Listing
May 2019

Blunts versus joints: Cannabis use characteristics and consequences among treatment-seeking adults.

Drug Alcohol Depend 2019 05 14;198:105-111. Epub 2019 Mar 14.

Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC861, Charleston, SC, 29425, USA.

Background: Despite the high prevalence of blunt smoking among cannabis users, very few studies examine the clinical profile of blunt smokers relative to those using more common methods of cannabis use, such as joints.

Methods: The current study uses baseline data from the ACCENT (Achieving Cannabis Cessation-Evaluating N-acetylcysteine Treatment) study, a multi-site randomized pharmacotherapy clinical trial within the National Drug Abuse Treatment Clinical Trials Network, to predict the association between blunt and joint use frequency and cannabis use characteristics (e.g., grams of cannabis used) and consequences (e.g., withdrawal) among past-month cannabis users (N = 377) who were screened for study participation.

Results: After controlling for race, age, gender, other forms of cannabis use (including joint use) and nicotine dependence, multivariable linear regression models indicated that the number of days of blunt use in the past month was a significant predictor of the average amount of cannabis per using day (t = 3.04, p <  .01), the estimated average cost of cannabis (t = 2.28, p <  .05) and Cannabis Withdrawal Scale scores (t = 1.94, p <  .05). Frequency of joint use did not significantly predict any of the cannabis use characteristics or consequences.

Conclusions: Blunt smokers may present to treatment with greater amounts of cannabis smoked and more intense withdrawal symptoms, which may adversely impact their likelihood of successful abstinence. Cannabis-dependent blunt smokers may be more likely to benefit from treatment that targets physiological and mood-related withdrawal symptoms.
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http://dx.doi.org/10.1016/j.drugalcdep.2019.01.041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6467739PMC
May 2019

Flavored tobacco use is associated with dual and poly tobacco use among adolescents.

Addict Behav 2019 06 4;93:269-273. Epub 2019 Mar 4.

University of Cincinnati College of Medicine, Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, Cincinnati, OH, USA.

Objectives: This study examines the relationships between flavored tobacco use and single, dual, and poly tobacco product use, among adolescents. Given the increased use of flavored tobacco products, it is vital to understand if flavored products are associated with dual and poly tobacco product use.

Methods: Data were obtained from the 2017 National Youth Tobacco Survey. Participants were 2042 adolescent past 30-day tobacco users. Multivariable multinomial logistic regression models were used to assess the relationship between flavored tobacco use and past 30-day single, dual, and poly (three or more) tobacco product use. Two analyses were conducted using different categories as referent groups to allow for a comprehensive examination of the relationship between all groups. Covariates included sex, grade level, race/ethnicity and exposure to tobacco marketing.

Results: Approximately half of all adolescent tobacco users (45.7%) reported use of more than one product. The majority of adolescent tobacco users reported using flavors (69.4%). Flavored tobacco use was significantly correlated with a greater risk of dual (RRR: 2.09) and poly (RRR: 5.54) tobacco use, relative to single product use, controlling for covariates. Similarly, flavored tobacco use was significantly correlated with a greater risk of poly (RRR: 2.66) tobacco use, relative to dual tobacco use, controlling for covariates.

Conclusions: A positive relationship was observed for flavored tobacco use and multiple tobacco product use. Findings suggest the need to consider stronger regulations of flavored tobacco products. Similarly, as most adolescent tobacco users reported using flavors, findings suggest the need to emphasize flavored tobacco use in prevention and education programs.
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http://dx.doi.org/10.1016/j.addbeh.2019.02.022DOI Listing
June 2019

Puff, puff, drink: The association between blunt and alcohol use among African American adolescents and young adults.

Am J Orthopsychiatry 2019 24;89(5):609-615. Epub 2019 Jan 24.

Psychology Department, Virginia Commonwealth University.

Although African Americans report lower levels of alcohol use relative to their White counterparts, they experience higher rates of alcohol-related problems (e.g., alcohol dependence). One understudied connection between alcohol use and dependence is the dual use of illicit drugs, especially marijuana use. It is speculated that blunt use in combination with alcohol will have more adverse alcohol-related consequences among African Americans than alcohol use alone or alcohol and nonblunt marijuana use. The current study uses pooled data from the 2011-2014 National Survey on Drug Use and Health to examine the odds of alcohol dependence based on alcohol and marijuana typology in comparison to alcohol only users. Among 11,124 African American adolescents (12-17) and young adults (18-25) who consumed alcohol in the past year, 57.5%, 36.8%, and 5.7% reported alcohol use alone and in combination with blunt use and nonblunt marijuana use, respectively. Relative to alcohol users only, youth who used alcohol and blunts had increased odds of having alcohol dependence. This association was not found among youth who reported alcohol and nonblunt marijuana use. The increased rates of alcohol dependence highlight the public health concern of dual alcohol and a specific type of marijuana use (i.e., blunts) among African American youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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http://dx.doi.org/10.1037/ort0000400DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6656631PMC
January 2020

The Association Between Marijuana Use and HIV Continuum of Care Outcomes: a Systematic Review.

Curr HIV/AIDS Rep 2019 02;16(1):17-28

Division of Prevention and Community Research, Yale School of Medicine, The Consultation Center, 389 Whitney Avenue, New Haven, CT, 06511, USA.

Purpose Of Review: Approximately 77% of HIV-infected adults report lifetime marijuana use. Given the high rates and social acceptability of marijuana use among HIV-infected individuals, it is important to gain a stronger understanding of if, and how, marijuana impacts HIV care cascade outcomes. The purpose of this study is to systematically review recent articles that assess the relationship between marijuana use and HIV continuum of care outcomes.

Recent Findings: One hundred and ninety articles from PubMed were considered for inclusion, and 15 were included in the review. The studies focus on marijuana use among HIV-infected individuals aware of their serostatus (k = 4), individuals engaged in treatment (k = 1), marijuana use in association with adherence to antiretroviral medications (k = 6), and marijuana use in relation to multiple stages of the HIV care cascade (k = 4). Preliminary findings from the small number of studies revealed an association between marijuana use, especially current heavy use, and HIV seropositivity. However, results from studies assessing marijuana use and treatment engagement and adherence to antiretroviral medications were inconsistent and inconclusive. Additional research is needed to assess the nuanced relationship between marijuana use and HIV continuum of care outcomes, especially among subgroups of HIV-infected individuals, such as men who have sex with men and young adults.
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http://dx.doi.org/10.1007/s11904-019-00422-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6432787PMC
February 2019

WITHDRAWN: Flavored Tobacco Use is Associated with Dual and Poly Tobacco Use among Adolescents.

Addict Behav 2019 05 27;92:84-88. Epub 2018 Dec 27.

University of Cincinnati College of Medicine, Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience.

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http://dx.doi.org/10.1016/j.addbeh.2018.12.028DOI Listing
May 2019

A content analysis of smartphone apps for adolescent smoking cessation.

Transl Behav Med 2020 02;10(1):302-309

Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.

Adolescent cigarette smokers have an increased risk of sustained smoking into adulthood. Smartphone applications (apps) for smoking cessation are a promising treatment resource. However, research on apps for adolescent smoking cessation is limited. This study compared smoking cessation mobile apps targeting an adolescent audience with popular cessation apps for a general audience. Adolescent and general-audience apps were identified by searching the Google Play and Apple App Stores (November 2016). Two coders assessed each app for adherence to clinical practice guidelines for tobacco and adolescent-specific content (2016-2017) and developed a summary score that summed all adherence and adolescent content criteria. Eight adolescent apps were identified and compared with the top 38 general apps (as ranked by Apple and Google). Both general and adolescent apps commonly had adherence content related to developing a quit plan (general: 73.68 per cent; adolescent: 87.50 per cent) and enhancing motivation by describing the rewards of not smoking (general: 76.32 per cent; adolescent: 62.50 per cent). Adolescent-specific content such as peer influence on smoking was common in adolescent apps but not in general apps (general: 5.26 per cent; adolescent: 62.50 per cent). Adolescent apps had a higher general adherence content summary score [t (44) = 2.55, p = .01] and a higher adolescent content summary score [t (7.81) = 2.47, p = .04] than the general apps. On average, adolescent cessation apps included more adherence content and adolescent-specific content than general apps. Future research is needed to determine the extent to which adolescents engage with the adherence content available in these apps.
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http://dx.doi.org/10.1093/tbm/iby113DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295698PMC
February 2020

Factors Associated With Marijuana Use Among Treatment-seeking Adult Cigarette Smokers in the Criminal Justice Population.

J Addict Med 2019 Mar/Apr;13(2):147-152

Addiction Sciences Division, University of Cincinnati College of Medicine, Cincinnati, OH (LM); Department of Psychiatry and Behavioral Neurobiology, Sparks Center 1008, Birmingham, AL (SS); Department of Psychiatry and Behavioral Neurobiology, Sparks Center 1016, Birmingham, AL (KC).

Objectives: Due to the elevated rates of cigarette use and marijuana use within the criminal justice system, it is critical to develop a stronger understanding of tobacco and marijuana co-use among this population to inform future interventions.

Methods: This study is a secondary analysis of baseline data from a smoking cessation randomized clinical trial of adults (n = 500) in a community correction program. Participants were classified as using cigarettes only or both cigarettes and marijuana through either self-report or positive urine drug screening. Demographics and measures regarding legal, drug use, smoking, mental health, and interpersonal histories were assessed. Logistic regression analyses were conducted to assess factors associated with co-use.

Results: Among adults who smoked cigarettes, 25% reported current marijuana use. Individuals who used both cigarettes and marijuana were more likely than those who only used cigarettes to be African American (80%), male (73.6%), and younger (M = 32.4 [SD = 11.0]). Increasing difficulties with last quit attempt was associated with a reduction in the likelihood of co-use (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.60-0.94, P < 0.05), and benzodiazepine (OR 9.09, 95% CI 1.25-65.94, P < 0.05) and opioid (OR 8.17, 95% CI 2.03-32.93, P < 0.01) use was significantly associated with an increased likelihood of co-use.

Conclusions: This study identified several factors that are associated with an increased risk of cigarette and marijuana co-use among a community correction population. These findings will be valuable for informing targeted prevention and treatment interventions.
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http://dx.doi.org/10.1097/ADM.0000000000000466DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417925PMC
April 2020

Tobacco use during cannabis cessation: Use patterns and impact on abstinence in a National Drug Abuse Treatment Clinical Trials Network study.

Drug Alcohol Depend 2018 11 25;192:59-66. Epub 2018 Aug 25.

Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, United States.

Background: It is common for cannabis users to also use tobacco. While data suggest that tobacco users have more difficulty achieving cannabis cessation, secondary analyses of clinical trial data sets may provide insight into the moderating variables contributing to this relationship, as well as changes in tobacco use during cannabis treatment. Those were the aims of this secondary analysis.

Methods: The parent study was a multi-site trial of N-acetylcysteine for cannabis dependence conducted within the National Drug Abuse Treatment Clinical Trials Network. Participants were treatment-seeking adults (ages 18-50) who met criteria for cannabis dependence (N = 302). For cigarette smokers (n = 117), tobacco use was assessed via timeline follow-back and nicotine dependence was assessed via the Fagerström Test for Nicotine Dependence (FTND). Outcome measures included: 1) changes in tobacco use based on treatment assignment, nicotine dependence, and concurrent cannabis reduction/abstinence, and 2) independent associations between nicotine dependence and cannabis abstinence.

Results: Cigarette smokers accounted for 39% of the sample (117/302), with a median FTND score of 3.0 (10-point scale). Among those with lower baseline nicotine dependence scores, cigarette smoking was reduced in the active treatment group compared to placebo. Those with moderate/high levels of nicotine dependence showed slight increases in smoking following active treatment. Nicotine dependence did not affect cannabis cessation.

Conclusions: Cigarette smoking during cannabis treatment was affected, but depended on baseline nicotine dependence severity, though dependence levels did not impact cannabis abstinence. Interventions that address both tobacco and cannabis are needed, especially due to an increasing prevalence of cannabis use.
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http://dx.doi.org/10.1016/j.drugalcdep.2018.07.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200636PMC
November 2018

Rolling and scrolling: The portrayal of marijuana cigars (blunts) on YouTube.

J Subst Use 2018 2;23(4):436-440. Epub 2018 Mar 2.

Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.

Background: Blunts are partially or fully hollowed-out cigars or cigarillos that are filled with marijuana. Despite the high prevalence of blunt use, very few studies assess this specific method of cannabis administration. YouTube, a popular video-sharing website, has the potential to provide insights into blunt use.

Methods: The purpose of this study was to examine the content of YouTube videos that discuss blunts. A sample of 41 videos was coded for content.

Results: The 41 videos had a total of 27,579,636 views. Most of the individuals in the videos were male (85%) and many appeared to be White (80%) and under the age of 25 (46%). Only 34% of the videos had an age restriction. The majority of messages in the videos promoted blunt use (93%) and showed at least one person rolling (76%) and/or smoking (66%) a blunt. The videos mainly consisted of introductions to blunt use (76%) and tips and personal experiences with blunt use (73%).

Conclusions: YouTube videos on blunt use are readily available and primarily promote the use of blunts. Future research should continue to monitor YouTube content and develop videos on social media platforms that inform consumers of the health effects associated with blunt use.
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http://dx.doi.org/10.1080/14659891.2018.1444108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991612PMC
March 2018

What Did You Expect?: The Interaction Between Cigarette and Blunt vs. Non-Blunt Marijuana Use among African American Young Adults.

J Subst Use 2017 26;22(6):612-616. Epub 2017 Feb 26.

Assistant Professor in Residence, University of California, San Francisco, Department of Psychiatry & Langley Porter Psychiatric Institute, Weill Institute for Neurosciences, Helen Diller Comprehensive Cancer Center, 530 Parnassus Avenue, San Francisco, CA 94143.

Background: Marijuana and tobacco co-use is highly prevalent among African American young adults. In an effort to inform prevention and treatment interventions, the current study examined the expectancies around the co-use of marijuana and cigarettes among African American young adults.

Methods: An anonymous online survey recruited African American adults ( = 111) age 18 to 29 who reported past-month marijuana and cigarette co-use. Participants completed the 14-item Nicotine and Marijuana Interaction Expectancy (NAMIE) Questionnaire, with three scales: (1) marijuana use increases tobacco use and urges, (2) tobacco use increases marijuana use and urges and (3) smoking to cope with marijuana urges. Participants also answered questions about marijuana and tobacco initiation and use. Analyses were conducted separately for blunt co-users (i.e., blunt and cigarette use) and non-blunt co-users (i.e., non-blunt marijuana and cigarette use).

Results: A majority of co-users (66%) used blunts as a form of co-use. Non-blunt co-users had higher expectancy scores on NAMIE scales 2 and 3 than blunt co-users. However, only blunt co-users showed a positive association between severity of marijuana use and NAMIE scales 2 (p <.01) and 3 (p <.01).

Conclusions: Findings provide further evidence for the use of the NAMIE and suggest a need to assess and address expectations regarding marijuana and tobacco co-use in prevention and treatment interventions, especially among young African American adults who co-use blunts and cigarettes.
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http://dx.doi.org/10.1080/14659891.2017.1283452DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5766277PMC
February 2017

Interpersonal Contact and Attitudes Toward Adolescents Who Abuse Substances.

J Drug Educ 2016 Dec;46(3-4):113-130

1 School of Human Services, College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, OH, USA.

Only 7.6% of adolescents in need of substance abuse treatment actually receive it. Many adolescents are hesitant to seek treatment due to public stigma (i.e., negative attitudes and beliefs of the general public toward individuals who abuse substances). However, decades of research indicate that interpersonal contact with stigmatized groups helps reduce stigma. This study used structural equations and data from 638 undergraduate students to test the relationships between students' total interpersonal contact with individuals who abuse substances and their attitudes toward those individuals. We found that total contact did not have significant effects on stigma and was associated with better helping attitudes toward adolescents who abuse alcohol but not marijuana. In addition, African Americans and females endorsed greater stigmatization of adolescents who abuse alcohol but better helping attitudes toward those who had received treatment. Increasing contact with individuals who abuse substances, irrespective of type and valence, may not be widely useful as a way of improving attitudes toward such people.
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http://dx.doi.org/10.1177/0047237917744330DOI Listing
December 2016

Racial/Ethnic Differences in Prevalence and Correlates of Blunt Smoking among Adolescents.

J Psychoactive Drugs 2018 Jul-Aug;50(3):195-205. Epub 2017 Dec 4.

b School of Public Health , University of Texas Health Science Center at Houston , Austin , TX , USA.

Blunt use is pervasive among adolescents. The study uses cross-sectional data from the 2014 National Survey on Drug Use and Health to examine sociodemographic, health, and other substance use correlates of current and lifetime blunt use among 12,036 African American, White, and Hispanic/Latino adolescents. Findings revealed that 5.3% of African American, 4.3% of Hispanic/Latino, and 3.8% of White adolescents reported past-30-day blunt use. Age and substance use other than marijuana were consistent correlates of current and lifetime blunt use across all racial/ethnic groups. However, other illicit drug use and alcohol use were differentially associated with lifetime and past-30-day blunt use by race/ethnicity. Gender, family income, lifetime depression, and overall health status were not associated with lifetime or past-30-day blunt use. The link between other substance use and blunt use varies by race/ethnicity among adolescents. Future blunt use prevention and treatment interventions should consider racial/ethnic differences in the association between other substance use and blunt use among African American, White, and Hispanic/Latino adolescents.
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http://dx.doi.org/10.1080/02791072.2017.1401186DOI Listing
October 2019

A scoping review and meta-analysis of psychosocial and pharmacological treatments for cannabis and tobacco use among African Americans.

Psychol Addict Behav 2017 12;31(8):922-943

Department of Psychological Sciences, University of Missouri.

The rates of co-occurring cannabis and tobacco use are higher among African Americans relative to other racial/ethnic groups. One plausible approach to treating co-use among African Americans is to examine the effectiveness of treatments for the sole use of cannabis and tobacco to identify effective approaches that might be combined to treat the dual use of these substances. The current meta-analysis sought to include studies that reported cannabis and/or tobacco use outcomes from randomized clinical trials (RCTs) with 100% African American samples. A total of 843 articles were considered for inclusion, 29 were reviewed by independent qualitative coders, and 22 were included in the review. There were no articles on cannabis use treatment with a 100% African American sample, resulting in a need to lower the threshold (60%) and conduct a scoping review of cannabis studies. Preliminary evidence from a small number of studies (k = 7) supports the use of Motivational Interviewing and Cognitive-Behavioral Therapy to treat cannabis use among African Americans, but not Contingency Management. Results from a meta-analysis of 15 tobacco studies found higher rates of smoking abstinence in the treatment condition relative to control conditions overall and across short and long-term follow-up periods. Significant differences in smoking abstinence were also found when examining the effects of pharmacological treatments relative to their control conditions. The clinical and research implications of these findings for future psychosocial and pharmacological trials for cannabis and tobacco use and co-use among African Americans are described. (PsycINFO Database Record
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http://dx.doi.org/10.1037/adb0000326DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6148355PMC
December 2017

Characterizing Blunt Use Among Twitter Users: Racial/Ethnic Differences in Use Patterns and Characteristics.

Subst Use Misuse 2018 02 14;53(3):501-507. Epub 2017 Sep 14.

c Cancer Prevention Fellowship Program , National Cancer Institute , Medical Center Drive, Rockville , Maryland , USA.

Background: Young adult Twitter users are exposed to and often participate in tweets that promote risky behaviors, such as blunt use. Blunts are hollowed out cigars or cigarillos that are filled with marijuana.

Objectives: The current study was designed to determine the use patterns and characteristics of African American, Hispanic and White young adult Twitter users who reported past month blunt use.

Methods: Young adults (N = 753, 74% male) who reported past month blunt use were recruited via Twitter to participate in a brief anonymous online survey about their blunt use.

Results: Findings revealed that African American young adults initiated blunt smoking at an earlier age (14.8 years), reported more days of blunt smoking in the past month (23.2 days) and smoked more blunts in the past month (27.2 blunts) than their Hispanic (16.5 years, 19.7 days, and 15.4 blunts) and White (18.1 years, 15.8 days, and 22.2 blunts) counterparts, p <.01. African American young adults were more likely than their White counterparts to report physical craving as an obstacle to quitting blunt smoking. Several racial/ethnic differences were also found on attitudes about blunt use and reasons for initiating and continuing to smoke blunts.

Conclusions: Findings suggest that blunt use patterns and attitudes about blunt use vary by race/ethnicity. Understanding racial/ethnic differences in blunt use patterns and characteristics offers opportunities to tailor future interventions and enhance outcomes among African American, Hispanic and White young adults.
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http://dx.doi.org/10.1080/10826084.2017.1341926DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069517PMC
February 2018

Impact of Perceived Risk and Friend Influence on Alcohol and Marijuana Use Among Students.

J Sch Nurs 2017 Dec 4;33(6):446-455. Epub 2017 Jul 4.

4 Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA, USA.

We performed a secondary analysis of Adolescent Health Risk Behavior Survey data ( N = 937), examining associations between lifetime alcohol and marijuana use with intrapersonal (i.e., risk perceptions) and interpersonal (e.g., peer approval and behavior) factors. Multinomial and binary logistic regression analyses contend students reporting lifetime alcohol use-compared to students who had never used alcohol or marijuana-perceived lower alcohol risk ( p < .001), higher friend drinking approval ( p < .001), and greater friend drinking ( p = .003). Using both alcohol and marijuana in one's life was associated with being in public schools ( p = .010), higher grade levels ( p = .001), lower perceived alcohol ( p = .011) and marijuana use risk ( p = .003), higher friend approval of alcohol ( p < .001) and marijuana use ( p < .001), and believed more friends used alcohol ( p < .001). Compared to lifetime alcohol only, perceived friend academic performance decreased the risk of lifetime alcohol and marijuana use ( p = .043). Findings are beneficial to school nurses with students experiencing effects associated with substance use.
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http://dx.doi.org/10.1177/1059840517717591DOI Listing
December 2017

A Review of Hip Hop-Based Interventions for Health Literacy, Health Behaviors, and Mental Health.

J Racial Ethn Health Disparities 2018 06 1;5(3):468-484. Epub 2017 Jul 1.

Elevating Us, LLC, Decatur, GA, USA.

Objective: African-American children and adolescents experience an undue burden of disease for many health outcomes compared to their White peers. More research needs to be completed for this priority population to improve their health outcomes and ameliorate health disparities. Integrating hip hop music or hip hop dance into interventions may help engage African-American youth in health interventions and improve their health outcomes. We conducted a review of the literature to characterize hip hop interventions and determine their potential to improve health.

Methods: We searched Web of Science, Scopus, PsycINFO, and EMBASE to identify studies that assessed hip hop interventions. To be included, studies had to (1) be focused on a psychosocial or physical health intervention that included hip hop and (2) present quantitative data assessing intervention outcomes. Twenty-three articles were identified as meeting all inclusion criteria and were coded by two reviewers. Articles were assessed with regards to sample characteristics, study design, analysis, intervention components, and results.

Results: Hip hop interventions have been developed to improve health literacy, health behavior, and mental health. The interventions were primarily targeted to African-American and Latino children and adolescents. Many of the health literacy and mental health studies used non-experimental study designs. Among the 12 (of 14) health behavior studies that used experimental designs, the association between hip hop interventions and positive health outcomes was inconsistent.

Conclusions: The number of experimental hip hop intervention studies is limited. Future research is required to determine if hip hop interventions can promote health.
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http://dx.doi.org/10.1007/s40615-017-0389-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319262PMC
June 2018
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