Background: COVID-19 is a global pandemic and vaccination efforts may be impeded by vaccine hesitancy. The present study examined willingness to receive a COVID-19 vaccine, the associated reasons for willingness/unwillingness, and vaccine safety perceptions in a cross-sectional assessment of community adults in Ontario.Methods: One thousand three hundred sixty seven individuals (60.6% female, mean age = 37.5%) participated in this study between January 15, 2021 and February 15, 2021. Perceptions of vaccine safety and reasons for willingness/unwillingness to receive the COVID-19 vaccine were investigated using an online assessment. Perceptions were investigated in general and by age, sex and education using analysis of variance.Results: Overall, 82.8% of the sample reported they were willing to receive a COVID-19 vaccine and 17.2% reported they were unwilling. The three most common reasons for unwillingness were long-term side effects (65.5%), immediate side effects (60.5%), and lack of trust in the vaccine (55.2%). Vaccine willingness significantly differed by sex and education level, with female participants and those with less than a bachelor's degree being more likely to report unwillingness. Perception of COVID-19 vaccine safety was significantly lower (−10.3%) than vaccines in general and differed by age, sex and education, with females, older adults, and individuals with less than a bachelor's degree reporting lower perceived COVID-19 vaccine safety.Conclusion: In this sample of community adults, the COVID-19 vaccine hesitancy rate was less than one in five individuals, but with higher rates in population subgroups. Targeting public health messaging to females and individuals with less than bachelor's degree, and addressing concerns about long-term and immediate side effects may increase vaccine uptake.

Background There are significant concerns that the COVID‐19 pandemic may have negative effects on substance use and mental health, but most studies to date are cross‐sectional. In a sample of emerging adults, over a two‐week period during the pandemic, the current study examined: (1) changes in drinking‐related outcomes, depression, anxiety, and posttraumatic stress disorder and (2) differences in changes by sex and income loss. The intra‐pandemic measures were compared to pre‐pandemic measures. Methods Participants were 473 emerging adults ( M age = 23.84; 41.7% male) in an existing longitudinal study on alcohol misuse who were assessed from June 17 to July 1, 2020, during acute public health restrictions in Ontario, Canada. These intra‐pandemic data were matched to participant pre‐pandemic reports, collected an average of 5 months earlier. Assessments included validated measures of drinking, alcohol‐related consequences, and mental health indicators. Results Longitudinal analyses revealed significant decreases in heavy drinking and adverse alcohol consequences, with no moderation by sex or income loss, but with substantial heterogeneity in changes. Significant increases in continuous measures of depression and anxiety were present, both of which were moderated by sex. Females reported significantly larger increases in depression and anxiety. Income loss >50% was significantly associated with increases in depression. Conclusions During the initial phase of the pandemic, reductions in heavy drinking and alcohol consequences were present in this sample of emerging adults, perhaps due to restrictions on socializing. In contrast, there was an increase in internalizing symptoms , especially in females, highlighting disparities in the mental health impacts of the pandemic.

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Background There are concerns that the coronavirus disease 2019 (COVID‐19) pandemic may increase drinking, but most accounts to date are cross‐sectional studies of self‐attributions about alcohol‐related impacts and the accuracy of those perceptions has not been investigated. The current study examined the correspondence between self‐attributions of pandemic‐related changes in drinking and longitudinally‐measured changes in drinking and alcohol‐related consequences in a sample of emerging adults. Methods In an existing ongoing longitudinal study on alcohol misuse (≥1 heavy episodic drinking day/month) in emerging adults, 473 individuals ( M age = 23.8; 41.7% male) received a supplemental assessment from June 17th to July 1st, 2020, during public health restrictions in Ontario, Canada. These intrapandemic data were matched to the most recent assessment prior to the pandemic (~8 months earlier). Self‐attributions about changes in drinking were assessed globally (i.e., increases/decreases/no change) and with higher resolution questions clarifying the magnitude of changes. Results Global self‐attributions about changes in drinking substantively paralleled longitudinal changes in weekly drinking days (DD). In the longitudinal data, individuals’ who self‐reported increases in drinking exhibited significant increases; individuals’ who self‐reported decreases exhibited significant decreases; and individuals who self‐reported no change exhibited nonsignificant changes. Higher resolution items likewise revealed longitudinal patterns of weekly drinking that were substantively consistent with self‐attributions. Heavy DD and alcohol‐related consequences exhibited similar patterns, but only individuals who self‐reported large increases in drinking exhibited increases on these outcomes. Individuals who reported large increases in drinking also exhibited significant increases in depression and posttraumatic stress disorder symptoms. Conclusions Self‐attributions about drinking closely corresponded to longitudinal changes in drinking, supporting the validity of self‐attributions in population‐level surveys, particularly in young adults. Notably, a subgroup was identified that exhibited pronounced increases for all alcohol‐related outcomes and concurrent increases in internalizing psychopathology.

Background The coronavirus disease 2019 (COVID-19) pandemic has imposed enormous adversity worldwide. Public health guidelines have been a first line of defense but rely on compliance with evolving recommendations and restrictions. This study sought to characterize adherence to and perceptions of public health guidelines over a one-year timeframe during the pandemic. Methods Participants were 1435 community adults in Ontario who completed assessments at five time points (April 2020, July 2020, October 2020, January 2021, and April 2021; 92% retention). Participants were assessed for self-reported adherence to government protocols and perceptions of government response (importance, compliance, and effectiveness). Analyses used general linear mixed-effects modelling of overall changes by time and examined differences based on age and sex. Findings Over time, participants reported high or increasing behavioural engagement in public health guidelines, including physical distancing, restricting activity, and masking. In contrast, participants exhibited significant reductions in perceived importance and compliance, with evidence of more negative changes in younger participants. The largest changes were a substantial reduction in perceived government effectiveness, from predominantly positive perceptions to predominantly negative perceptions. Interpretation These results illuminate evolving trends in public health compliance and perceptions over the course of the pandemic in Canada, revealing the malleability of public perceptions of public health recommendations and government effectiveness. Funding This research was funded by a grant from the (CIHR). CIHR had no role in study design, data collection, data analysis, interpretation, or writing of the report.

Background and aims The Marijuana Purchase Task (MPT) is increasingly used to measure cannabis reinforcing value and has potential use for cannabis etiological and regulatory research. This meta‐analysis sought to evaluate for the first time the MPT's concurrent validity in relation to cannabis involvement. Methods Electronic databases and pre‐print repositories were searched for MPT studies that examined the cross‐sectional relationship between frequency and quantity of cannabis use, problems, dependence, and five MPT indicators: intensity (i.e. unrestricted consumption), Omax (i.e. maximum consumption), Pmax (i.e. price at which demand becomes elastic), breakpoint (i.e. first price at which consumption ceases), and elasticity (i.e. sensitivity to rising costs). Random effects meta‐analyses of cross‐sectional effect sizes were conducted, with Q tests for examining differences by cannabis variables, meta‐regression to test quantitative moderators, and publication bias assessment. Moderators included sex, number of MPT prices, variable transformations, and year of publication. Populations included community and clinical samples. Results The searches yielded 14 studies (n = 4077, median % females: 44.8%: weighted average age = 29.08 [SD = 6.82]), published between 2015 and 2022. Intensity, Omax, and elasticity showed the most robust concurrent validity (|r's| = 0.147–325, ps < 0.014) with the largest significant effect sizes for quantity (|r| intensity = 0.325) and cannabis dependence (|r| Omax = 0.320, |r| intensity = 0.305, |r| elasticity = 0.303). Higher proportion of males was associated with increased estimates for elasticity‐quantity and Pmax‐problems. Higher number of MPT prices significantly altered magnitude of effects sizes for Pmax and problems, suggesting biased estimations if excessively low prices are considered. Methodological quality was generally good, and minimal evidence of publication bias was observed. Conclusions The marijuana purchase task presents adequate concurrent validity to measure cannabis demand, most robustly for intensity, Omax, and elasticity. Moderating effects by sex suggest potentially meaningful sex differences in the reinforcing value of cannabis.

Objective: Population drinking trends show clear developmental periodicity, with steep increases in harmful alcohol use from ages 18 to 22 followed by a gradual decline across the 20s, albeit with persistent problematic use in a subgroup of individuals. Cross-sectional studies implicate behavioral economic indicators of alcohol overvaluation (high alcohol demand) and lack of alternative substance-free reinforcers (high proportionate alcohol-related reinforcement) as potential predictors of change during this developmental window, but longitudinal evidence is sparse. Method: Using a sample of emerging adults (N = 497, M age = 22.61 years, 62% female, 48.69% White, 40.44% Black), this study examined prospective, bidirectional relations between both past-week heavy drinking days (HDD) and alcohol problems and proportionate alcohol-related reinforcement (reinforcement ratio), alcohol demand intensity (consumption at zero price), alcohol demand O max (maximum expenditure), and change in demand elasticity (rate of change in consumption across escalating price) over five assessments (every 4 months) using random intercept cross-lagged panel models. Results: Alcohol problems and HDD decreased across assessments. Significant between-person effects indicated that each behavioral economic variable was associated with increased drinking risk. Change in reinforcement ratio was positively associated with decreases in alcohol problems. Multigroup invariance modeling revealed distinct risk pathways in that change in demand intensity and O max predicted change in alcohol problems for male participants and change in intensity predicted change in alcohol problems for non-White participants. Conclusion: The study provides consistent support for proportionate alcohol-related reinforcement and mixed support for demand as withinperson predictors of reductions in drinking. Public Health Significance StatementThis study demonstrates that reductions in the value of alcohol relative to alternative alcohol-free activities precede reductions in alcohol-related problems, which provide support for intervention and treatment approaches that increase reinforcement from alternative activities.

BackgroundCOVID-19 is a global pandemic and vaccination efforts may be impeded by vaccine hesitancy. The present study examined willingness to receive COVID-19 vaccine, the associated reasons for willingness/unwillingness, and vaccine safety perceptions in a cross-sectional assessment of community adults in Ontario.Methods1367 individuals (60.3% female, M age = 38.6) completed an online assessment between January 15, 2021 and February 15, 2021. Perceptions were investigated in general and by age, sex and education.ResultsOverall, 82.8% sample reported they were willing to receive a COVID-19 vaccine and 17.2% reported they were unwilling. The three most common reasons for unwillingness were long-term side effects (65.5%), immediate side effects (60.5%), and lack of trust in the vaccine (55.2%). Vaccine willingness significantly differed by sex and education level, with female participants and those with less than a bachelor’s degree being more likely to report unwillingness. Perception of COVID-19 vaccine safety was significantly lower (−10.7%) than vaccines in general and differed by age, sex and education, with females, older adults, and individuals with less than a bachelor’s degree reporting lower perceived COVID-19 vaccine safety.ConclusionIn this sample of community adults, under one in five individuals was unwilling to receive a COVID-19 vaccine, but with higher rates in population subgroups. Targeting public health messaging to females and individuals with less than Bachelor’s degree, and addressing concerns about long-term and immediate side effects may increase vaccine uptake.