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    Assessing causal relationships using genetic proxies for exposures: An introduction to Mendelian randomisation.
    Addiction 2017 Sep 18. Epub 2017 Sep 18.
    MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
    Background And Aims: Studying the consequences of addictive behaviours is challenging, with understanding causal relationships from observational data being particularly difficult. For example, people who smoke or drink excessively are often systematically different from those who do not, are less likely to participate in research, and may misreport their behaviours when they do. Furthermore, the direction of causation between an addictive behaviour and outcome may be unclear. Read More

    Alcohol e-Help: Study protocol for a Web-based self-help program to reduce alcohol use in adults with drinking patterns considered harmful, hazardous, or suggestive of dependence in middle-income countries.
    Addiction 2017 Sep 17. Epub 2017 Sep 17.
    Departamento de Psicobiologia, Escola Paulista de Medicina, Universidad Federal de São Paulo, São Paulo, Brazil.
    Background And Aims: Given the scarcity of alcohol prevention and alcohol use disorder treatments in many low and middle-income countries, the World Health Organization launched an e-health portal on alcohol and health that includes a Web-based self-help program. This paper presents the protocol for a multicenter randomised controlled trial (RCT) to test the efficacy of the Internet-based self-help intervention to reduce alcohol use.

    Design: Two-arm RCT with follow-up 6 months after randomisation. Read More

    Genome-wide association study of a nicotine metabolism biomarker in African American smokers: impact of chromosome 19 genetic influences.
    Addiction 2017 Sep 16. Epub 2017 Sep 16.
    Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada.
    Background And Aims: The activity of CYP2A6, the major nicotine-inactivating enzyme, is measurable in smokers using the nicotine metabolite ratio (NMR; 3'hydroxycotinine/cotinine). Due to its role in nicotine clearance, the NMR is associated with smoking behaviours and response to pharmacotherapies. The NMR is highly heritable (~80%), and on average lower in African Americans (AA) versus Whites. Read More

    Needle syringe programmes and opioid substitution therapy for preventing HCV transmission among people who inject drugs: findings from a Cochrane Review and meta-analysis.
    Addiction 2017 Sep 11. Epub 2017 Sep 11.
    School of Social and Community Medicine, University of Bristol, Bristol, UK.
    Aims: To estimate the effects of needle syringe programmes (NSP) and opioid substitution therapy (OST), alone or in combination, for preventing acquisition of Hepatitis C virus (HCV) in people who inject drugs (PWID).

    Methods: Systematic review and meta-analysis. Bibliographic databases were searched for studies measuring concurrent exposure to current OST (within last 6 months) and/or NSP and HCV incidence among PWID. Read More

    Measuring treatment outcomes in gambling disorders: a systematic review.
    Addiction 2017 Aug 5. Epub 2017 Aug 5.
    School of Psychology, University of Sydney, Sydney, Australia.
    Background And Aims: Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery.

    Methods: A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Read More

    The future of the international drug control system and national drug prohibitions.
    Addiction 2017 Sep 8. Epub 2017 Sep 8.
    National Addiction Centre, Institute of Psychiatry, Psychiatry and Neuroscience, King's College, London, London, UK.
    A major impediment to any nation abandoning the policy of drug prohibition has been the fact that international drug treaties to which the majority of United Nations (UN) member states are signatory prohibit the non-medical use of amphetamines, cannabis, cocaine and heroin. The future of these treaties is now uncertain because of decisions by Uruguay, eight US states and Canada to legalize cannabis use. This paper: (1) provides a brief account of the international drug control treaties; (2) outlines the major criticisms of the treaties; (3) analyses critically proposals for treaty reform; and (4) provides a personal view on policies that nation states could adopt to minimize the harms from the use of cannabis, party drugs and hallucinogens, opioids, stimulants and new psychoactive substances. Read More

    Setting research priorities in tobacco control: a stakeholder engagement project.
    Addiction 2017 Sep 6. Epub 2017 Sep 6.
    Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK.
    Background And Aims: The Cochrane Tobacco Addiction Group (TAG) conducts systematic reviews of the evidence for tobacco cessation and prevention interventions. In 2016 TAG conducted a priority-setting, stakeholder engagement project to identify where further research is needed in the areas of tobacco control and smoking cessation.

    Design: The project comprised two surveys and a workshop. Read More

    The short term impact of the Alcohol Act on alcohol-related deaths and hospital admissions in Scotland: a natural experiment.
    Addiction 2017 Sep 6. Epub 2017 Sep 6.
    Public Health Science Directorate, NHS Health Scotland, Meridian Court, Cadogan Street, Glasgow, G2 6QE.
    Background And Aim: The introduction of the Alcohol Act in Scotland on 1 October 2011, which included a ban on multi-buy promotions, was likely associated with a fall in off-trade alcohol sales in the year after its implementation. The aim of this study was to test if the same legislation was associated with reduced levels of alcohol-related deaths and hospital admissions in the 3-year period after its introduction.

    Design: A natural experiment design using time series data to assess the impact of the Alcohol Act legislation in Scotland. Read More

    A Developmental-based Motivational Intervention to Reduce Alcohol and Marijuana Use Among Non-Treatment-Seeking Young Adults: A Randomized Controlled Trial.
    Addiction 2017 Sep 2. Epub 2017 Sep 2.
    Behavioral Medicine and Addictions Research Department, Butler Hospital, Providence, RI, 02906.
    Aims: To test the hypothesis that among non-treatment-seeking emerging adults (EA) who both use marijuana and have alcohol binges, a brief, longitudinally-delivered, developmentally-based motivational intervention would show greater reductions in the use of these two substances compared with a health education control condition.

    Design: Parallel, two group, randomized controlled trial with follow-up interventions conducted at 1, 3, 6, and 9 months and final assessments at 12 and 15 months.

    Setting: Hospital-based research unit in the United States. Read More

    Non-medical use of psychoactive prescription drugs is associated with fatal poisoning.
    Addiction 2017 Aug 25. Epub 2017 Aug 25.
    Forensic Toxicology Unit, National Institute for Health and Welfare, Finland.
    Aims: The aims of this study were to estimate the prevalence and predictors of non-medical substance use, and to assess the association between non-medical substance use and fatal poisoning or history of drug abuse in Finland.

    Design And Setting: Retrospective cohort study of all medico-legally investigated death cases in Finland. The post-mortem toxicology database was linked together with the register on reimbursed prescription medicines. Read More

    Evaluating the Mutual Pathways among Electronic Cigarette Use, Conventional Smoking, and Nicotine Dependence.
    Addiction 2017 Aug 25. Epub 2017 Aug 25.
    Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.
    Background And Aims: The implications of the rapid rise in electronic cigarette (e-cigarette) use remain unknown. We examined mutual associations between e-cigarette use, conventional cigarette use, and nicotine dependence over time to 1) test the association between e-cigarette use and later conventional smoking (both direct and via nicotine dependence), 2) test the converse associations, and 3) determine the strongest pathways predicting each product's use.

    Design: Data from 4 annual waves of a prospective cohort study were analyzed. Read More

    Accuracy of self-reported smoking abstinence in clinical trials of hospital-initiated smoking interventions.
    Addiction 2017 Aug 23. Epub 2017 Aug 23.
    Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA.
    Aims: To estimate the prevalence and predictors of failed biochemical verification of self-reported abstinence among participants enrolled in trials of hospital-initiated smoking cessation interventions.

    Design: Comparison of characteristics between participants who verified and those who failed to verify self-reported abstinence.

    Settings: Multi-site randomized clinical trials conducted between 2010 and 2014 in hospitals throughout the United States. Read More

    Estimates of effectiveness and reach for 'return on investment' modelling of smoking cessation interventions using data from England.
    Addiction 2017 Aug 18. Epub 2017 Aug 18.
    Health Economics Research Group (HERG), Institute of Environment, Health and Society, Brunel University London, Uxbridge, UK.
    Background And Aims: Estimating 'return on investment' (ROI) from smoking cessation interventions requires reach and effectiveness parameters for interventions for use in economic models such as the EQUIPT ROI tool (http://roi.equipt.eu). Read More

    Development and application of an economic model (EQUIPTMOD) to assess the impact of smoking cessation.
    Addiction 2017 Aug 18. Epub 2017 Aug 18.
    Health Economics Research Group, Institute of Environment, Health and Societies, Brunel University London, London, UK.
    Background And Aims: Although clear benefits are associated with reducing smoking, there is increasing pressure on public health providers to justify investment in tobacco control measures. Decision-makers need tools to assess the Return on Investment (ROI)/cost-effectiveness of programmes. The EQUIPT project adapted an ROI tool for England to four European countries (Germany, the Netherlands, Spain and Hungary). Read More

    Socio-economic differentials in cannabis use trends in Australia.
    Addiction 2017 Aug 22. Epub 2017 Aug 22.
    Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia.
    Aim: To test if the degree of change in cannabis use between 2001 and 2013 differed according to socio-economic status.

    Design: Repeated cross-sectional household surveys that were nationally representative.

    Setting: Australia. Read More

    New cancer cases in France in 2015 attributable to different levels of alcohol consumption.
    Addiction 2017 Aug 22. Epub 2017 Aug 22.
    Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
    Background And Aims: Alcohol consumption increases the risk of cancer. Thus, to inform policy decisions, this study estimated the number of new cancer cases in France in 2015 attributable to alcohol consumption generally and to light (<20 grams per day (g/day) among women; <40 g/day among men), moderate (20 to <40 g/day among women; 40 to <60 g/day among men) and heavy drinking (≥40 g/day among women; ≥60 g/day among men), and the number of cancer cases that would have been prevented assuming a previous 10% decrease in alcohol consumption.

    Design: New cancer cases attributable to alcohol were estimated using a Population-Attributable Fraction methodology, assuming a 10-year latency period between exposure and diagnosis. Read More

    Effects of high alcohol intake, alcohol-related symptoms and smoking on mortality.
    Addiction 2017 Aug 22. Epub 2017 Aug 22.
    QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
    Background And Aims: Both high alcohol intake and alcohol dependence increase mortality, and both are associated with smoking. We aimed to compare the associations of quantity of alcohol, number of alcohol-related symptoms and smoking history with all-cause mortality, and to assess symptom count and smoking history as confounders or mediators of the effects of high alcohol intake.

    Design: Survival was analysed by Cox regression with sex, body mass index, alcohol intake (overall and by beverage), maximum drinks on any day, alcohol symptom count and smoking status as potential predictors of age at death. Read More

    Cost-effectiveness of emergency department-initiated treatment for opioid dependence.
    Addiction 2017 Aug 16. Epub 2017 Aug 16.
    Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA.
    Background And Aims: In a recent randomized trial, patients with opioid dependence receiving brief intervention, emergency department (ED)-initiated buprenorphine and ongoing follow-up in primary care with buprenorphine (buprenorphine) were twice as likely to be engaged in addiction treatment compared with referral to community-based treatment (referral) or brief intervention and referral (brief intervention). Our aim was to evaluate the relative cost-effectiveness of these three methods of intervening on opioid dependence in the ED.

    Design: Measured health-care use was converted to dollar values. Read More

    Using Bayes factors to evaluate evidence for no effect: examples from the SIPS project.
    Addiction 2017 Aug 13. Epub 2017 Aug 13.
    Department of Psychology, Northumbria University, Newcastle upon Tyne, UK.
    Aims: To illustrate how Bayes factors are important for determining the effectiveness of interventions.

    Method: We consider a case where inappropriate conclusions were drawn publicly based on significance testing, namely the SIPS project (Screening and Intervention Programme for Sensible drinking), a pragmatic, cluster-randomized controlled trial in each of two health-care settings and in the criminal justice system. We show how Bayes factors can disambiguate the non-significant findings from the SIPS project and thus determine whether the findings represent evidence of absence or absence of evidence. Read More

    Associations of parental alcohol use disorders and parental separation with offspring initiation of alcohol, cigarette and cannabis use and sexual debut in high-risk families.
    Addiction 2017 Aug 13. Epub 2017 Aug 13.
    Washington University School of Medicine, Department of Psychiatry, St Louis, MO, USA.
    Background And Aims: Parental alcohol use disorders (AUDs) and parental separation are associated with increased risk for early use of alcohol in offspring, but whether they increase risks for early use of other substances and for early sexual debut is under-studied. We focused on associations of parental AUDs and parental separation with substance initiation and sexual debut to (1) test the strength of the associations of parental AUDs and parental separation with time to initiation (age in years) of alcohol, tobacco and cannabis use and sexual debut and (2) compare the strength of association of parental AUD and parental separation with initiation.

    Design: Prospective adolescent and young adult cohort of a high-risk family study, the Collaborative Study on the Genetics of Alcoholism (COGA). Read More

    Factors moderating the relative effectiveness of varenicline and nicotine replacement therapy in clients using smoking cessation services.
    Addiction 2017 Aug 13. Epub 2017 Aug 13.
    IRIS, UCL, 1-19 Torrington Place, London, WC1E 6BT, UK.
    Aims: To assess how far the greater effectiveness of varenicline over nicotine replacement therapy (NRT) is moderated by characteristics of the smokers or setting in clinical practice.

    Design: We used observational data from 22,472 treatment episodes between 2013 and 2016 from smoking cessation services in England to assess whether differences between varenicline and NRT were moderated by a set of smoker and setting characteristics: these included level of social deprivation, age, gender, ethnic group, nicotine dependence, and treatment context. From the above, 15,640 episodes were analysed in relation to 4-week quit and 14,273 episodes at 12 weeks. Read More

    Does paying service providers by results improve recovery outcomes for drug misusers in treatment in England?
    Addiction 2017 Aug 10. Epub 2017 Aug 10.
    Centre for Mental Health and Safety, University of Manchester, Manchester, UK.
    Aim: To compare drug recovery outcomes in commissioning areas included in a 'payment by results' scheme with all other areas.

    Design: Observational and data linkage study of the National Drug Treatment Monitoring System, Office for National Statistics mortality database and Police National Computer criminal records, for 2 years before and after introduction of the scheme. Pre-post controlled comparison compared outcomes in participating versus non-participating areas following adjustment for drug use, functioning and drug treatment status. Read More

    Associations of coffee genetic risk scores with consumption of coffee, tea and other beverages in the UK Biobank.
    Addiction 2017 Aug 9. Epub 2017 Aug 9.
    MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, UK.
    Aims: To evaluate the utility of coffee-related genetic variants as proxies for coffee consumption in Mendelian randomisation studies, by examining their association with non-alcoholic beverage consumption (including subtypes of coffee and tea) and a range of sociodemographic and lifestyle factors.

    Design: Observational study of the association of genetic risk scores for coffee consumption with different types of non-alcoholic beverage consumption.

    Setting: UK general population PARTICIPANTS: Individuals of European ancestry aged 40-70 years from the UK Biobank between 2006 and 2010 (N = 114,316). Read More

    Qualitative research.
    Addiction 2017 Aug 7. Epub 2017 Aug 7.
    Kirby Institute for Infection and Immunity, University of New South Wales Sydney, Sydney, Australia.
    Background And Aims: This narrative review aims to highlight key insights from qualitative research on drug use and drug users by profiling a selection of classic works.

    Methods: Consensus methods were used to identify and select four papers published in 1938, 1969, 1973 and 1984 considered to be classics.

    Results: These landmark qualitative studies included the first account of addiction as a social process, demonstrating that people have meaningful responses to drug use that cannot be reduced to their pharmacological effects; the portrayal of inner-city heroin users as exacting, energetic and engaged social agents; identification of the interactive social learning processes involved in becoming a drug user; the application of the 'career' concept to understanding transitions and trajectories of drug use over time; and the articulation of a framework for understanding drug use that incorporates the interaction between pharmacology, psychology and social environments. Read More

    Gateway effects and electronic cigarettes.
    Addiction 2017 Aug 7. Epub 2017 Aug 7.
    Institute of Global Health, Faculty of Medicine, University of Geneva, Switzerland.
    Background: E-cigarettes are alleged to be a gateway to cigarette smoking in non-smokers. This study examines whether the gateway theory has value, whether the criteria to establish causality have been met and what type of evidence is required to test this theory.

    Analysis: Experiments are impractical, and we may not be able to test properly the gateway effects via observational studies that simply adjust for confounders. Read More

    Ecological momentary analysis of the relations among stressful events, affective reactivity, and smoking among smokers with high vs. low depressive symptoms during a quit attempt.
    Addiction 2017 Aug 5. Epub 2017 Aug 5.
    Rutgers, The State University of New Jersey, Department of Psychology, 152 Frelinghuysen Road Piscataway, NJ, 08854-8020.
    Aims: To assess whether individuals trying to quit smoking who have high depressive symptoms (HD), compared with low-depressive-symptom (LD) symptoms: 1) report more frequent stressful events (SEs), 2) are more likely to smoke after SEs, 3) experience greater acute or persistent changes in affect after a SE, and 4) are at greater risk of smoking following affective changes.

    Design: Smoking cessation data were analyzed using multilevel path modeling to examine the moderating effects of depressive symptoms on relations among SEs, subsequent affect, and smoking.

    Setting: An academic research center in Central New Jersey, USA. Read More

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