Prevalence of Tobacco Use Among Rural-Dwelling Individuals Who Inject Drugs

Akhtar, Wajiha Z.; Mundt, Marlon; Koepke, Ruth; Krechel, Sarah; Fiore, Michael C.; Seal, David W.; Westergaard, Ryan P.

doi:10.1001/jamanetworkopen.2020.0493

Cited by 6 publications

(11 citation statements)

References 5 publications

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“…People who use drugs (PWUD) may be at increased risk of morbidity from both COVID-19 and substance use disorders (SUD) during the pandemic [2][3][4][5][6][7][8]. PWUD are more likely to have chronic diseases like chronic obstructive pulmonary disease, pulmonary hypertension, and heart failure that are known to increase the risk of COVID-19 complications [9][10][11][12][13]. PWUD also experience social and economic vulnerabilities such as housing instability and lack of transportation [11], which are independently associated with an increased risk of contracting COVID-19 and worse outcomes in those infected [9,11,14].…”

Section: Introductionmentioning

confidence: 99%

Harm Reduction and Adaptations Among PWUD in Rural Oregon During COVID-19

Seaman

Leichtling²,

Stack³

et al. 2021

AIDS Behav

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Coronavirus Disease 2019 (COVID-19) may influence HIV/HCV transmission risk behaviors in rural communities. We conducted semi-structured qualitative interviews with people who use drugs (PWUD) in five rural Oregon counties and asked about COVID-19 impact on substance use and harm reduction practices and their advice for improving public health responses. Participants (n = 36) reported using only methamphetamine (52.8%), only heroin (16.7%), or both (30.6%); 75% of participants reported recent injection. Three thematic categories emerged: SSP adaptations and accessibility, PWUD harm reduction practices, and policy suggestions. Participants noted the importance of SSPs to COVID-19 prevention and wellbeing, though some experienced increased barriers, leading to increased risky injection practices. Participants suggested need-based rather than one-for-one exchange, increasing syringe delivery services, encouraging secondary exchange by PWUD, and peers as trusted voices for information exchange. Rapid implementation of policy and practice changes are urgently required to improve SSP access, reinforce safer use, and prevent HIV/HCV and COVID-19 transmission.

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Section: Introductionmentioning

confidence: 99%

Harm Reduction and Adaptations Among PWUD in Rural Oregon During COVID-19

Seaman

Leichtling²,

Stack³

et al. 2021

AIDS Behav

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“…Second, the findings are limited to self-reported data and could be subject to respondent bias. Third, students were recruited through purposive sampling using friend networks which can reduce variability amongst the sample 37 and, thus, we do not know whether the findings generalize to all students, or to other universities. Furthermore, New Zealand Universities tend to be W.E.I.R.D, for instance, predominantly European (Ministry of Education 45 ), thus the extent to which findings from student samples generalize to the general population is limited.…”

Section: Discussionmentioning

confidence: 99%

“…Social network recruitment strategies have been effectively employed in previous research on health and sensitive research areas. 37,38 Furthermore, other researchers have recommended using peer interviewees to reduce social desirability responding 39 and this technique has been found to facilitate open and frank responses. 21 The only criterion for eligibility was that participants had to be 18 years or older, in line with the ethical requirements for the study.…”

Section: Methodsmentioning

confidence: 99%

Control of Recreational Cannabis in a New Zealand University Sample: Perceptions of Informal and Formal Controls

Robertson

Tustin

2020

Subst�Abuse

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An increasing number of countries have, or are moving towards, reforming cannabis policies. New Zealand is also moving in this direction and the government will hold a referendum on the legalization of recreational cannabis in September 2020. To inform imminent public and political discussions it is important to understand how current cannabis use is controlled. Research suggests that cannabis law has been ineffective in NZ. Internationally, informal controls, rather than the law, have been found to shape cannabis use by creating a threshold for normalization, but the attitudes shaping this threshold are unknown. This study aimed to examine drug acceptability attitudes, specifically students’ attitudes towards the illegal use of cannabis and their attitudes towards peers who abstain, sometimes use, or are heavy users of cannabis, to identify the factors that control cannabis use. Using a mixed methods approach, university students recruited their peers (N = 535) to complete a pen and paper survey investigating perceptions towards 3 cannabis user prototypes (abstainers, moderate users, heavy users), concern for legality of cannabis use, and the integration of cannabis into the student culture (perceptions of peers’ use, ease of acquisition, and availability). Perceptions of peers’ lifetime and regular use were 82% and 38.5%, respectively. Participants rated cannabis as easy to acquire and likely to be available at a typical student social occasion. The majority stated that the law does not deter use (92.7%); participants perceived the law to be soft and that they are unlikely to get caught. Participants’ descriptions of the 3 cannabis user prototypes revealed a threshold for normalization. For instance, abstaining was perceived to be associated with positive attributes (such as being studious), linked to being less sociable, and linked to being less likely to be judged. Moderate use of cannabis was perceived to be normal and sociable. Heavy use was perceived to be associated with having negative attributes, such as being addicted, unhealthy, and an underachiever, and negative drug labels. Our findings revealed that cannabis use is not controlled by the law, but by informal thresholds of control. Moderate cannabis use is accepted whereas heavy cannabis use is not. We extended research by identifying the attitudes shaping these thresholds, in particular that negative outcomes associated with heavy use deters the normalization of this behavior. We argue that policy must be informed by, and build on, these informal controls. The negative perceptions associated with heavy use also raise concerns regarding the well-being of heavy users, and coupled with the ineffectiveness of cannabis law, lend support towards a health model for regulating cannabis. Furthermore, insights into the negative perceptions associated with heavy use could inform health interventions on the types of concerns that will resonate with users.

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“…Purposive sampling was employed to ensure the student researchers and participants were embedded in the same culture. Social network recruitment strategies facilitate open and frank responses ( Lewis et al, 2018 ) and have been effectively employed in previous research on health and sensitive research areas ( Akhtar et al, 2020 , Brown et al, 2013 ). Participation took approximately 10 min.…”

Section: Methodsmentioning

confidence: 99%