Tobacco use remains the leading preventable cause of death worldwide. In particular, people with mental illness are disproportionately affected with high smoking prevalence; they account for more than 200,000 of the 520,000 tobacco-attributable deaths in the United States annually and die on average 25 years prematurely. Our review aims to provide an update on smoking in the mentally ill. We review the determinants of tobacco use among smokers with mental illness, presented with regard to the public health HAVE framework of “the host” (e.g., tobacco user characteristics), the “agent” (e.g., nicotine product characteristics), the “vector” (e.g., tobacco industry), and the “environment” (e.g., smoking policies). Furthermore, we identify the significant health harms incurred and opportunities for prevention and intervention within a health care systems and larger health policy perspective. A comprehensive effort is warranted to achieve equity toward the 2025 Healthy People goal of reducing US adult tobacco use to 12%, with attention to all subgroups, including smokers with mental illness.

Marijuana is the most commonly used illicit drug during pregnancy, and its use is increasing. From 2002 to 2014, the prevalence of self-reported, past-month marijuana use among US adult pregnant women increased from 2.4% to 3.9%. 1 In aggregated 2002-2012 data, 14.6% of US pregnant adolescents reported past-month use. 2 However, studies are limited to self-reported surveys and likely underestimate use due to social desirability bias and underreporting, leaving the scope of the problem unclear. We investigated trends of prenatal marijuana use from 2009-2016 using data from a large California health care system with universal screening via self-report and urine toxicology.

ACEs screening as part of standard prenatal care is feasible and generally acceptable to patients. Women's health clinicians are willing to screen patients for ACEs when appropriately trained and adequate behavioral health referral resources are available.

Since 2005, a rapidly expanding literature has evaluated whether environmental factors such as socio-cultural context and environmental adversity interact with genetic influences on drinking behaviors. This article critically reviews empirical research on alcohol-related genotype-environment interactions (GxE) and provides a contextual framework for understanding how genetic factors combine with (or are shaped by) environmental influences to influence the development of drinking behaviors and alcohol use disorders. Collectively, evidence from twin, adoption, and molecular genetic studies indicates that the degree of importance of genetic influences on risk for drinking outcomes can vary in different populations and under different environmental circumstances. However, methodological limitations and lack of consistent replications in this literature make it difficult to draw firm conclusions regarding the nature and effect size of alcohol-related GxE. On the basis of this review, we describe several methodological challenges as they relate to current research on GxE in drinking behaviors and provide recommendations to aid future research.

Key Points Question Has the frequency of cannabis use among pregnant women in the year before and during pregnancy increased in recent years? Findings In this serial cross-sectional study of 367 403 pregnancies among women in Kaiser Permanente Northern California who were universally screened for self-reported cannabis use as part of standard prenatal care, annual relative rates of daily, weekly, and monthly cannabis use in the year before pregnancy and during pregnancy increased from 2009 to 2017. Relative rates of self-reported daily cannabis use in the year before and during pregnancy increased fastest. Meaning Results of this study demonstrate that frequency of cannabis use in the year before pregnancy and during pregnancy has increased among women in Northern California in recent years, with relative rates of daily cannabis use increasing most rapidly.

Background We aimed to examine prevalence and correlates of past-month electronic cigarette (“e-cigarette”) use and use of e-cigarettes to aid a cessation attempt in three samples of young adult smokers recruited online in 2009–2010 (Study 1), 2010–2011 (Study 2), and 2013 (Study 3). Methods Participants were young adults aged 18 to 25 who smoked at least one cigarette in the previous month (Study 1, N=1987 and Study 2, N=570) or smoked 3 or more days each week and used Facebook 4 or more days per week (Study 3, N=79). We examined both past-month e-cigarette use and ever use of e-cigarettes to quit conventional cigarettes. Results Prevalence of past-month use of e-cigarettes was higher in each subsequent study: Study 1 (6%), Study 2 (19%), Study 3 (41%). In multivariate analyses, significant correlates of past-month e-cigarette use were identified for Study 1 (male sex OR=2.1, p=.03; past-year quit attempt OR=1.6, p=.03) and Study 2 (male sex, OR=1.7, p=.03; younger age OR=0.88, p=.05), but not Study 3. In multivariate analyses, significant correlates of ever use of e-cigarette to quit conventional cigarettes were identified for Study 1 (education, OR=1.2, p=.02; smoking within 30 minutes of waking, OR=2.8, p=.02; past year quit attempt OR=4.1, p=.02), and Study 3 (desire to quit smoking, OR=1.3, p=.02), but not Study 2. Conclusions E-cigarette use is increasingly common among young adults, particularly men. E-cigarette use for quitting conventional cigarettes appears more common among those more nicotine dependent and interested in quitting.

The study investigated the genetic and environmental etiology of schizotypal personality traits in a non-selected sample of adolescent twins, measured on two occasions between the ages of 11 and 16 years old. The 22-item Schizotypal Personality Questionnaire-Child version (SPQ-C) was found to be factorially similar to the adult version of this instrument, with three underlying factors (Cognitive-Perceptual, Interpersonal-Affective, and Disorganization). Each factor was heritable at age 11–13 years (h2 = 42–53%) and 14–16 years old (h2 = 38–57%). Additive genetic and unique environmental influences for these three dimensions of schizotypal personality acted in part through a single common latent factor, with additional genetic effects specific to both Interpersonal-Affective and Disorganization subscales at each occasion. The longitudinal correlation between the latent schizotypy factor was r = 0.58, and genetic influences explained most of the stability in this latent factor over time (81%). These longitudinal data demonstrate significant genetic variance in schizotypal traits, with moderate stability between early to middle adolescence. In addition to common influences between the two assessments, there were new genetic and non-shared environmental effects that played a role at the later assessment, indicating significant change in schizotypal traits and their etiologies throughout adolescence.

ABSTRACT. Objective: Childhood maltreatment is associated with early alcohol use initiation, alcohol-related problem behaviors, and alcohol use disorders in adulthood. Heavy drinking risk among individuals exposed to childhood maltreatment could be partly attributable to stress sensitization, whereby early adversity leads to psychobiological changes that heighten sensitivity to subsequent stressors and increase risk for stress-related drinking. We addressed this issue by examining whether the association between past-year stressful life events and past-year drinking density, a weighted quantity-frequency measure of alcohol consumption, was stronger among adults exposed to childhood maltreatment. Method: Drinking density, stressful life events, and childhood maltreatment were assessed using structured clinical interviews in a sample of 4,038 male and female participants ages 20-58 years from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. Stress sensitization was examined using hierarchical multiple regression analyses to test whether stressful events moderated the association between maltreatment and drinking density. Analyses were stratifi ed by sex and whether the impact was different for independent stressful events or dependent stressful events as related to a participant's actions. Results: Independent stressful events were associated with heavier drinking density among women exposed to maltreatment. In contrast, drinking density was roughly the same across independent stressful life events exposure among women not exposed to maltreatment. There was little evidence for Maltreatment × Independent Stressor interactions in men or Maltreatment × Dependent Stressor interactions in either gender. Conclusions: Early maltreatment may have direct effects on vulnerability to stress-related drinking among women, particularly in association with stressors that are out of one's control. (J. Stud. Alcohol Drugs, 73, 559-569, 2012)