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Zvolensky MJ, Bakhshaie J, Redmond BY, Garey L, de Dios M, Cano MÁ, Schmidt NB. Anxiety sensitivity reduction-smoking cessation intervention among individuals who engage in dual cigarette and cannabis use: A secondary analysis. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 156:209211. [PMID: 37931686 PMCID: PMC11200176 DOI: 10.1016/j.josat.2023.209211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/27/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Cannabis use among individuals who smoke is prevalent in the general population and related to adverse health effects, including higher levels of interoceptive perturbation (i.e., a disturbance in internal experiences). An important aspect of smoking cessation among individuals who co-use cannabis is to address behavioral associations between physiological sensations and habitual behaviors via integrated treatments focused on reducing reactivity to internal perturbations such as anxiety sensitivity (i.e., the belief that such symptoms produce personal harm). METHODS The current study involved a secondary analysis of a randomized clinical trial (RCT) of an integrated anxiety sensitivity-smoking cessation intervention compared to standard smoking cessation. The current study sought to extend findings from the initial trial to examine if the integrated intervention produced better smoking cessation outcomes than standard care among individuals who engage in dual cigarette and cannabis use. Participants were 149 adults who engage in dual cigarette and cannabis use (41.6 % female; Mage = 30.89, SD = 13.1). RESULTS Results indicated that the anxiety sensitivity intervention produced statistically significant differences in distal (long-term) smoking abstinence at 3-, 6-, and 12-month follow-up assessments but not proximal (short-term; quit-week to 2-weeks) smoking abstinence. CONCLUSIONS Overall, the potential of an integrated anxiety sensitivity smoking cessation intervention to yield better long-term smoking abstinence rates than standard cessation treatment among individuals who engage in dual cigarette and cannabis use is clinically significant.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA.
| | - Jafar Bakhshaie
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, 1 Bowdoin Square, Suite 100, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Brooke Y Redmond
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Marcel de Dios
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
| | - Miguel Ángel Cano
- Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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Mattingly DT, Mezuk B, Elliott MR, Neighbors HW, Fleischer NL. Racial and Ethnic Disparities in Mental Health Problems and Tobacco and Cannabis Use Among US Emerging Adults. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01822-z. [PMID: 37828404 DOI: 10.1007/s40615-023-01822-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION Mental health problems in emerging adulthood are linked to tobacco and cannabis use, but whether race and ethnicity modifies these associations is unclear. METHODS We used data from wave 4 of the Population Assessment of Tobacco and Health Study (youth n = 6898, young adult n = 10,304) to conduct latent class analysis (LCA) of six past 30-day tobacco and cannabis use indicators (i.e., cigarettes, electronic nicotine delivery systems (ENDS), cigars, blunts, cannabis vaping, other cannabis). We estimated associations between past 30-day internalizing and externalizing (i.e., low (referent), moderate, high) problems and latent classes of tobacco/cannabis use (vs. never/former use) using adjusted multinomial logistic regression. We explored whether associations varied by race and ethnicity through stratification. RESULTS We identified four exclusive use latent classes and two dual/poly use latent classes for both youth and young adult samples. Race/ethnicity-stratified models identified associations between internalizing/externalizing problems and most use classes for Hispanic and non-Hispanic White youth/young adults, with mixed results for non-Hispanic Black youth/young adults. For example, Hispanic (OR: 2.50, 95% CI: 1.09-5.74) and non-Hispanic White (OR: 1.90, 95% CI: 1.18-3.06) youth with high internalizing problems had higher odds of ENDS + cannabis vaping. Externalizing problems were not associated with use among non-Hispanic Black youth while internalizing problems were not associated with use among non-Hispanic Black young adults. CONCLUSION We observed racial/ethnic variation in mental health problems and tobacco and cannabis use. Understanding mental health problem and tobacco product and cannabis use comorbidity may better inform culturally relevant interventions aimed to prevent and reduce use.
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Affiliation(s)
- Delvon T Mattingly
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, 40536, USA.
- Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY, 40536, USA.
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
| | - Michael R Elliott
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, 48104, USA
| | - Harold W Neighbors
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 70112, USA
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
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Jeste DV, Malaspina D, Bagot K, Barch DM, Cole S, Dickerson F, Dilmore A, Ford CL, Karcher NR, Luby J, Rajji T, Pinto-Tomas AA, Young LJ. Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: III. Biology. Schizophr Bull 2023; 49:867-880. [PMID: 37023360 PMCID: PMC10318888 DOI: 10.1093/schbul/sbad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
BACKGROUND Social determinants of health (SDoHs) are nonmedical factors that significantly impact health and longevity. We found no published reviews on the biology of SDoHs in schizophrenia-spectrum psychotic disorders (SSPD). STUDY DESIGN We present an overview of pathophysiological mechanisms and neurobiological processes plausibly involved in the effects of major SDoHs on clinical outcomes in SSPD. STUDY RESULTS This review of the biology of SDoHs focuses on early-life adversities, poverty, social disconnection, discrimination including racism, migration, disadvantaged neighborhoods, and food insecurity. These factors interact with psychological and biological factors to increase the risk and worsen the course and prognosis of schizophrenia. Published studies on the topic are limited by cross-sectional design, variable clinical and biomarker assessments, heterogeneous methods, and a lack of control for confounding variables. Drawing on preclinical and clinical studies, we propose a biological framework to consider the likely pathogenesis. Putative systemic pathophysiological processes include epigenetics, allostatic load, accelerated aging with inflammation (inflammaging), and the microbiome. These processes affect neural structures, brain function, neurochemistry, and neuroplasticity, impacting the development of psychosis, quality of life, cognitive impairment, physical comorbidities, and premature mortality. Our model provides a framework for research that could lead to developing specific strategies for prevention and treatment of the risk factors and biological processes, thereby improving the quality of life and increasing the longevity of people with SSPD. CONCLUSIONS Biology of SDoHs in SSPD is an exciting area of research that points to innovative multidisciplinary team science for improving the course and prognosis of these serious psychiatric disorders.
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Affiliation(s)
- Dilip V Jeste
- Department of Psychiatry, University of California, San Diego (Retired), CA, USA
| | - Dolores Malaspina
- Departments of Psychiatry, Neuroscience and Genetics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kara Bagot
- Department of Psychiatry, Addiction Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deanna M Barch
- Departments of Psychological and Brain Sciences, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Steve Cole
- Departments of Psychiatry and Biobehavioral Sciences, and Medicine, University of California, Los Angeles, CA, USA
| | - Faith Dickerson
- Department of Psychology, Sheppard Pratt, Baltimore, MD, USA
| | - Amanda Dilmore
- Department of Pediatrics, University of California, San Diego, CA, USA
| | - Charles L Ford
- Center for Translational Social Neuroscience, Department of Psychiatry, Emory University, Atlanta, GA, USA
| | - Nicole R Karcher
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Joan Luby
- Department of Psychiatry (Child), Washington University in St. Louis, St. Louis, MO, USA
| | - Tarek Rajji
- Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Adrián A Pinto-Tomas
- Biochemistry Department, School of Medicine, Universidad de Costa Rica, San José, Costa Rica
| | - Larry J Young
- Center for Translational Social Neuroscience, Department of Psychiatry, Emory University, Atlanta, GA, USA
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Han B, Shi Y. Associations of recreational cannabis dispensaries' availability, storefront signage and health benefit signs with cannabis use: findings from a representative adult sample in California, United States. Addiction 2023; 118:1270-1279. [PMID: 36680550 PMCID: PMC10272035 DOI: 10.1111/add.16132] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS There are concerns that availability of recreational cannabis dispensaries (RCDs) and point-of-sale marketing may lead to increased cannabis use in jurisdictions where cannabis retail sale is legal. This paper examined whether the availability RCDs and the presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs were associated with cannabis use and risk perceptions. DESIGN Cross-sectional, secondary data analysis. SETTING California, USA. PARTICIPANTS A representative sample of 3385 adults in California who participated in the 2020 probability-based Marijuana Use and Environment Survey. MEASUREMENTS Binary outcomes included past-month overall cannabis use, perceiving cannabis smoking as harmful and past-month cannabis use by purpose (medical only, recreational only and dual). The objectively assessed predictors included proximity and density of RCDs and presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs. FINDINGS In terms of proximity, thepresence of storefront signage in the nearest RCD was associated with smaller odds of perceiving cannabis smoking as harmful [odds ratio (OR) = 0.63, 95% confidence interval (CI) = 0.39, 0.99] if the RCD was located within 2 miles of home. Presence of health benefit signs in the nearest RCD was associated with greater odds of overall cannabis use (OR = 2.45, 95% CI = 1.17, 5.16) and recreational use (OR = 3.50, 95% CI = 1.027, 11.91) if the RCD was located within 2-4 miles of home. In terms of density, count of RCDs, count of RCDs with storefront signage and count of RCDs with health benefit signs within 2 miles of home were each separately associated with greater odds of overall cannabis use and cannabis use for dual purposes. CONCLUSIONS The availability of recreational cannabis dispensaries within 2 miles of one's home and the presence of storefront signage indicating the availability of cannabis and signs promoting health benefits of cannabis appear to be associated with increased cannabis use and reduced risk perceptions among adults in California, USA.
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Affiliation(s)
- Bing Han
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Yuyan Shi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
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