Disentangling between- and within-person alcohol and expectancy effects on acute alcohol craving

Do Subjective Effects from Alcohol and Cannabis Predict Simultaneous Use During a Decision-Making Task?

Background: Simultaneous alcohol and cannabis use is associated with negative outcomes, yet little is known about what motivates the decision of simultaneous use. One possibility is that early-episode subjective effects motivate simultaneous use to complement or replace the first substance's effects. The current study used a hypothetical decision-making task to test this hypothesis. Objectives: College students (N = 486) were presented eight scenarios characterized by alcohol/cannabis subjective effects (i.e., high/low arousal positive [e.g., excited, relaxed], high/low arousal negative [e.g., aggressive, dizzy]) and asked their likelihood of simultaneously using the other substance per scenario. Multilevel modeling tested whether subjective effect scenarios predicted a higher likelihood of simultaneous use and whether ordering moderated this association. Results: Task-based simultaneous use likelihood was associated with self-reported simultaneous use, showing task validity. Scenarios characterized by high/low arousal positive effects were associated with higher likelihood of simultaneous use, whereas high/low arousal negative scenarios were associated with lower likelihood. Alcohol vs. cannabis-first scenarios were associated with higher likelihood of simultaneous use, and significant interactions were observed for high/low arousal positive and high arousal negative effects. High arousal positive scenarios were associated with higher likelihood of simultaneous use when cannabis was used first, low arousal positive scenarios with higher likelihood when alcohol was used first, and high arousal negative scenarios with lower likelihood when cannabis was used first. Conclusions: Beginning-of-episode subjective substance effects may be a promising event-level predictor of simultaneous use, and just-in-time interventions may benefit from targeting the ordering and subjective experiences of alcohol and cannabis use.

The Relation of Social-ecological Factors and Health Literacy to Medical Students' Alcohol Use Behavior in Hubei Province, China

BACKGROUND

Health literacy (HL) plays a crucial role in the adolescent's behavior. Inadequate HL can contribute to engaging in risky alcohol consumption, but little is known about this relationship among medical students. We aimed to investigate the relationship between HL and alcohol use among Chinese medical students. Study Design: A cross-sectional design.

METHODS

This research was conducted on 1146 medical students in Hubei province, China. The data were collected using a web-based online questionnaire. Multiple logistic regression was applied to investigate factors related to alcohol use.

RESULTS

Approximately 45.3% of medical students were drinkers, about 11.5% were hazardous drinkers, and 33.8% were low-risk drinkers; furthermore, about 49.3% of them reported lower levels of HL. In both the low-risk and hazardous drinking groups, the subjects who had low levels of all six dimensions of HL were more likely to use alcohol after adjusting for other covariates, including cognitive skill (adjORfor low-risk=3.50; 95% CI: 2.41, 5.07, adjORhazardous=2.07; 95% CI: 1.22, 3.51), access skill (adjORfor low-risk=2.11; 95% CI: 1.46, 3.05, adjORhazardous=2.40; 95% CI: 1.37, 4.19), communication skill (adjORfor low-risk=1.72; 95% CI: 1.20, 2.47, adjORhazardous=2.21; 95% CI: 1.22, 4.00), self-management skill (adjORfor low-risk=1.73; 95% CI: 1.15, 2.59, adjORhazardous=4.01; 95% CI: 1.91, 8.44), media skill (adjORfor low-risk=1.50; 95% CI: 1.01, 2.23, adjORhazardous=4.68; 95% CI: 2.15, 10.17), and decision skill (adjORfor low-risk=2.12; 95% CI: 1.49, 3.00, adjORhazardous=2.25; 95% CI: 1.35, 3.74).

CONCLUSION

Inadequate HL plays an important role in increasing alcohol use. Thus, prevention and intervention strategies should be based on improving medical students' HL.