Addiction Rehab: Early Life Influences on the Risk of Injecting Drug Use: Case Control Study Based on the Edinburgh Addiction Cohort.
Early life influences on the risk of injecting drug use: case control study based on the Edinburgh Addiction Cohort.
Filed under: Addiction Rehab
Addiction. 2012 Nov 16;
Macleod J, Hickman M, Jones HE, Copeland L, McKenzie J, De Angelis D, Kimber J, Robertson JR
AIMS: To investigate childhood influences on onset of injection drug use DESIGN: Matched case-control study SETTING: Edinburgh, Scotland. PARTICIPANTS: 432 individuals presenting at a community health facility with injection drug use and 432 age and sex matched non-injecting controls recruited through the same facility MEASUREMENTS: Main exposures considered were family structure and experience of public care, carer substance use, physical and sexual victimization and conduct problems all measured at personal interview. The outcome was history of adult injection drug use recorded in medical records corroborated at personal interview. FINDINGS: Compared to two parent families all other family structures were associated with increased risk of injection drug use, the greatest increased risk being associated with public care. Violence, criminality and financial problems in the family were also associated with increased risk as were all types of carer substance use. The greatest increased risk was associated with markers of early conduct problems, particularly school exclusion and childhood contact with the criminal justice system. In multivariable analyses the strongest risk factors for later injecting were not always living with a parent, or being in care (odds ratio 2.66, 95%CI 1.02-6.92 and 2.17 95%CI 0.91-5.17 respectively), childhood physical victimization (OR 2.06 (95% CI, 1.26,3.38)) and early evidence of conduct problems, (school exclusion (OR 2.73 (95% CI, 1.68,4.45)); childhood criminality (ever arrested OR 3.05 (95% CI, 1.90,4.89) ever received custodial disposal OR 4.70 (95% CI, 2.02,10.94)). After adjustment for family structure and conduct problems, sexual victimization was weakly associated with injecting onset (OR 1.29 95%CI 0.76-2.19). Over 70% of injection drug use onset appeared attributable to the risk factors identified. CONCLUSIONS: Injection drug use in adults is strongly associated with prior childhood adversity, in particular not living with both parents and early conduct problems. Prevention initiatives should also consider these risk factors.
HubMed – addiction
A systematic review of the relationships between family functioning, pubertal timing and adolescent substance use.
Filed under: Addiction Rehab
Addiction. 2012 Nov 16;
Hummel A, Shelton KH, Heron J, van den Moore L, Bree MB
AIMS: Experiences linked to poor family functioning and pubertal timing have each been associated with increased risk of substance misuse in adolescence. However, it remains unclear to what extent family functioning and pubertal timing combine to put adolescents at particular risk. METHOD: A systematic review was planned, undertaken and reported according to the 27 items of the PRISMA statement. Databases World of Knowledge, PsycINFO and PubMed were searched. Fifty-eight articles were retained and are discussed in this review after screening titles, abstracts and full articles against pre-established exclusion criteria. RESULTS: The combination of off-time pubertal timing and poor parent-adolescent relationship quality has been related to higher levels of substance use. However, this is an under-studied area of research and the evidence is less strong for boys than girls. CONCLUSIONS: Adolescents experiencing both poor parent-adolescent relationship quality and off-time pubertal timing may represent a high-risk group that can benefit from approaches aimed at reducing risk of substance misuse.
HubMed – addiction
Implementation of routine biochemical validation and an ‘opt out’ referral pathway for smoking cessation in pregnancy.
Filed under: Addiction Rehab
Addiction. 2012 Dec; 107 Suppl 2: 53-60
Bauld L, Hackshaw L, Ferguson J, Coleman T, Taylor G, Salway R
To introduce an ‘opt out’ referral pathway for smoking cessation in pregnancy and to compare different methods for identifying pregnant smokers in maternity care.Pilot study that analysed routine data from maternity and smoking cessation services with biochemical validation of smoking status.Dudley and South Birmingham, England.A total of 3712 women who entered the referral pathway-1498 in Dudley and 2214 in South Birmingham.Routine monitoring data on smoking at maternity booking, referral to smoking cessation services, number of women who set quit dates set and short-term (4-week) self-report smoking status. Comparison of self-report, carbon monoxide (CO)-validated and urinary cotinine-validated smoking status for a subsample (n?=?1492) of women at maternity booking.In Dudley 27% of women who entered the opt out referral pathway were identified as smokers following CO testing. Of those referred to the smoking cessation services, 19% reported stopping smoking at 4-week follow-up. In South Birmingham 17% were smokers at booking, with 5% of those referred recorded as non-smokers at 4 weeks. The number of women quitting did not increase during the study when compared with the previous year, despite higher referral rates in both areas. An optimum cut-off CO measurement of 4?parts per million (p.p.m.) was identified for sensitivity and specificity.The introduction of an opt out referral pathway between maternity and stop smoking services resulted in more women being referred for support to quit but not higher numbers of quitters, suggesting that automatic referral may include women who are not motivated to stop and who may not engage with services. Routine carbon monoxide monitoring introduced as part of a referral pathway should involve a cut-off of 4?p.p.m. to identify smoking in pregnancy.
HubMed – addiction
Smokeless tobacco cessation in South Asian communities: a multi-centre prospective cohort study.
Filed under: Addiction Rehab
Addiction. 2012 Dec; 107 Suppl 2: 45-52
Croucher R, Shanbhag S, Dahiya M, Kassim S, Csikar J, Ross L
To evaluate smokeless tobacco cessation in communities of South Asian origin.Multi-centre prospective cohort study.Three tobacco cessation services offering specialist smokeless tobacco cessation outreach clinic support to South Asians (Bangladeshi, Indian and Pakistani) resident in England.A total of 239 South Asian participants seeking to stop smokeless tobacco use between November 2010 and December 2011.Socio-demographics, tobacco use and dependence, self-reported abstinence at 4 weeks and satisfaction measures.Participants’ mean age was 45 [standard deviation (SD)?=?13] years, were predominantly female (76%), of Bangladeshi origin (74%), either home carers (53%) or not working (29%). Sixty-three per cent were recruited from community locations, 21% through a clinical contact and 16% through friends and family. Mean daily number of smokeless tobacco intakes was 10 (SD?=?7) and the mean dependence score was 4.5 (SD?=?1.9). Sixty-three per cent of participants achieved continuous abstinence 4 weeks after quitting. Using nicotine replacement therapy (NRT) versus not using it [OR?=?3.47, 95% confidence interval (CI): 1.25, 9.62] and below median (?8) daily smokeless tobacco intakes (OR?=?1.91, 95% CI: 1.07, 3.40) predicted successful abstinence.South Asian smokeless tobacco users resident in England accessing services to help them stop appear to have short-term success rates comparable with smokers attending stop-smoking services, with higher success rates being reported by those using nicotine replacement therapy.
HubMed – addiction
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