Purpose.-To examine adolescents' self-reported exposure to cannabis marketing in states with legalized cannabis and its association with past-year cannabis use.Methods.-We conducted a cross-sectional, online panel survey of 469 adolescents age 15-19 years residing in four states with legal retail cannabis for adult use. Adolescents self-reported exposure to cannabis marketing on social or traditional media (i.e. outdoor or print) and past-year cannabis use. Logistic regression generated estimated odds of youths' past-year cannabis use by marketing exposure after adjusting for demographic factors and cannabis-related social norms.Results.-Exposure to cannabis marketing on Facebook, Twitter, and Instagram was associated with increased odds of past-year cannabis use of 96% (95% CI: 15%−234%), 88% (95% CI: 11% −219%), and 129% (95% CI: 32%−287%), respectively. Odds of past-year cannabis use increased by 48% (95% CI:16%−87%) with each additional social media platform where adolescents reported exposure.Conclusion.-Despite restrictions that prohibit cannabis advertising on social media, adolescents are exposed to cannabis marketing via social media, and this exposure is associated with recent cannabis use. States should consider further regulation of cannabis marketing on social media.

BackgroundThere is limited information about the potential individual-level and contextual drivers of heavy drinking in South Africa. This study aimed to identify risk factors for heavy drinking in Tshwane, South Africa.MethodsA household survey using a multi-stage stratified cluster random sampling design. Complete consumption and income data were available on 713 adults. Heavy drinking was defined as consuming ≥120 ml (96 g) of absolute alcohol (AA) for men and ≥ 90 ml (72 g) AA for women at any location at least monthly.Results53% of the sample were heavy drinkers. Bivariate analyses revealed that heavy drinking differed by marital status, primary drinking location, and container size. Using simple logistic regression, only cider consumption was found to lower the odds of heavy drinking. Persons who primarily drank in someone else’s home, nightclubs, and sports clubs had increased odds of heavy drinking. Using multiple logistic regression and adjusting for marital status and primary container size, single persons were found to have substantially higher odds of heavy drinking. Persons who drank their primary beverage from above average-sized containers at their primary location had 7.9 times the odds of heavy drinking as compared to persons who drank from average-sized containers. Some significant associations between heavy drinking and age, race, and income were found for certain beverages.ConclusionRates of heavy drinking were higher than expected giving impetus to various alcohol policy reforms under consideration in South Africa. Better labeling of the alcohol content of different containers is needed together with limiting production, marketing and serving of alcohol in large containers.

Background: While there is overwhelming data supporting the association between alcohol outlet density and violent crime, there remain conflicting findings about whether on- or off-premise outlets have a stronger association. This inconsistency may be in part a result of the methods used to calculate alcohol outlet density and violent crime. This analysis uses routine activity theory and spatial access methods to study the association between access to alcohol outlets and violent crime, including type of outlet and type of crime in Baltimore, Maryland. Methods: The data in this analysis include alcohol outlets from 2016 (n=1,204), violent crimes from 2012–2016 (n=51,006), and markers of social disorganization, including owner-occupied housing, median annual household income, drug arrests, and population density. The analysis used linear regression to determine the association between access to alcohol outlets and violent crime exposure. Results: Each 10% increase in alcohol outlet access was associated with a 4.2% increase in violent crime exposure (β=0.43, 95% CI 0.33, 0.52, p<0.001). A 10% increase in access to off-premise outlets (4.4%, β=0.45, 95% CI 0.33, 0.57, p<0.001) and LBD-7 outlets (combined off- and on-premise outlets) (4.2%, β=0.43, 95% CI 0.33, 0.52, p<0.001) had a greater association with violent crime than on-premise outlets (3.0%, β=0.31, 95% CI 0.20, 0.41, p<0.001). Conclusions: Access to outlets that allow for off-site consumption had a greater association with violent crime than outlets that only permit on-site consumption. The lack of effective measures to keep order in and around off-premise outlets could attract or multiply violent crime.