Vaping

from BioMed/Substance Abuse Policy unit – 

by Amanda L. Graham, Sarah Cha,  Elizabeth K. Do,  Megan A.  Jacobs,  Giselle Edwards &  George D. Papandonatos 

Substance Abuse Treatment, Prevention, and Policy volume 20, Article number: 48 (2025) Cite this article

[References not included – ignore all reference numbers. To see references, click on the Source link at the foot of this article]

Abstract

Objective

To examine patterns of abstinence from nicotine vaping and cannabis use among adolescent and young adult (YA) e-cigarette users in two text message vaping cessation trials.

Methods

Among adolescents with complete 7-month data (n = 1,016) at baseline, 25.4% were Exclusive E-cigarette Users (no past 30-day cannabis use) and 74.6% were Dual Users (past 30-day cannabis use). Among YAs with complete 7-month data (n = 1,829), 40.8% were Exclusive E-cigarette Users and 59.2% were Dual Users at baseline. Primary analyses examined the proportion of participants who were Dual Abstinent at 7-months by treatment arm differences. We also examined for interaction effects between baseline product use and vaping status at 7 months on cannabis use outcomes.

Results

At 7-months, adolescent categories of use were: Dual Abstinent, 31.7% (95% CI: 28.8, 34.6); Exclusive E-cigarette Users, 18.2% (95% CI: 15.9, 20.7); Exclusive Cannabis Users, 15.1% (95% CI: 12.9, 17.4); Dual Users, 35.0% (95% CI: 32.1, 38.1). Among YAs: Dual Abstinent, 15.6% (95% CI: 13.9, 17.3); Exclusive E-cigarette Users, 29.4% (95% CI: 27.3, 31.6); Exclusive Cannabis Users, 12.8% (95% CI: 11.3, 14.5); Dual Users, 42.2% (95% CI: 39.9, 44.5). Intervention outperformed Control in promoting rates of Dual Abstinence among adolescents (38.5% vs. 25.0%, p < 0.0001) and YAs (17.9% vs. 13.3%, p = 0.007). A higher proportion of Exclusive E-cigarette Users compared to Dual Users were Dual Abstinent at follow-up (adolescents: 37.6% vs. 29.7%, p = 0.019; YAs: 25.8% vs. 8.5%, p < 0.001).

Conclusion

A text message nicotine vaping cessation intervention promoted dual abstinence from e-cigarettes and cannabis among adolescents and YAs. Dual abstinence rates were higher among exclusive vapers than dual users, signaling the need to optimize cessation programs for dual users.

Trial Registration

Studies included were registered on ClinicalTrials.gov (NCT04251273, registered on January 31, 2020; NCT04919590, registered on June 9, 2021)

Background

E-cigarettes have been the most used tobacco product among young people for a decade [1]. More recently, co-use of cannabis alongside nicotine e-cigarettes (“co-use”) has become more common among adolescents and young adults (YA) [2, 3]. Estimates for the prevalence of nicotine vaping and cannabis co-use range from 16 to 50% among adolescent e-cigarette users [4, 5] and 34–60% among YA e-cigarette users [6,7,8].

Despite the high prevalence of co-use, few studies have addressed concurrent nicotine and cannabis use or cessation [9,10,11] and there are no clinical practice guidelines regarding cessation treatment approaches for co-use. In the limited number of nicotine vaping cessation trials that have been conducted among young people [12,13,14,15], high rates of co-use were documented (72–75% among adolescents, 59% among YA) but treatment effects on cannabis use or co-use were not examined [16].

This research gap is particularly concerning given the compounded health risks associated with co-use. Nicotine vaping carries serious consequences including respiratory problems [17], mental health issues [18], and addiction [19]. Cannabis use during adolescence is associated with structural brain changes affecting cognitive function [20, 21], increased depression and suicidality risk [22], and heightened addiction liability [23]. Cannabis vaping, in particular, introduces additional risks including respiratory symptoms [24], EVALI [25], and acute psychological effects [26, 27]. Co-use of nicotine and cannabis compounds these risks, leading to increased frequency and dependence for both products, poorer cessation outcomes [28, 29], and worse overall health functioning compared to single-substance use [30]. Research is needed to inform the development of cessation treatment approaches for nicotine and cannabis co-use [11].

The nicotine vaping cessation intervention tested in two trials among young people demonstrated a significant treatment effect in promoting dual abstinence from nicotine e-cigarettes and combustible tobacco products [14, 31], suggesting that targeting one form of substance use may have broader impacts on related substance use behaviors through shared mechanisms of behavior change. This study builds on these earlier findings to examine the following research questions about the co-use of nicotine e-cigarettes and cannabis: 1) What were the overall patterns of abstinence from nicotine e-cigarettes and cannabis at the primary 7-month study endpoint? 2) Were there treatment group differences in promoting abstinence from nicotine e-cigarettes and cannabis at follow-up? and 3) Did treatment effects vary by baseline product use? We also explored interactions between nicotine vaping status at 7 months and baseline tobacco product use on cannabis use outcomes. Addressing these questions is crucial for understanding the interplay between nicotine vaping and cannabis use in the context of cessation interventions, with important implications for the development of efficient and effective cessation programs for young people.

Methods

Trial design

This manuscript presents secondary analyses of data from two separate parallel, two-group, double-blind individually randomized controlled trials (RCT) that compared a tailored, interactive vaping cessation text message intervention to a text message assessment-only control. Study methods in the two trials were nearly identical. The RCT among n = 1,503 adolescent (13–17 years old) e-cigarette users was conducted from October 2021 to October 2023 and randomized participants to intervention (n = 759) or assessment-only control (n = 744); a third waitlist control group was included in the parent study [14] but is not included in these analyses. The RCT among n = 2,588 young adult (YA; 18–24 years old) e-cigarette users was conducted from December 2019 to November 2020 and randomized participants to intervention (n = 1304) or assessment-only control (n = 1284) [13].

Interventions

This is Quitting: This is Quitting (TIQ, now part of EX® Program), is an automated, tailored, interactive text message program for nicotine vaping cessation designed for adolescents (13–17 years old) and young adults (18–24 years old) [32]. It is grounded in best practices [33] and our experience delivering digital tobacco cessation interventions to people of all ages and informed by formative research with young people. The program is anchored around social cognitive theory [34] and positioned as a nonjudgmental friend. To reinforce perceived social norms and social support for quitting, messages written by other users (with appropriate editorial review) are incorporated throughout the program. The program is tailored to a user’s age, enrollment date or quit date, and vape brand. Those who do not set a quit date receive 4 weeks of messages focused on building skills and confidence. Those who set a quit date receive messages 6 weeks before and 8 weeks after their quit date that focus on the risks of vaping and benefits of quitting, exercises to build coping skills and self-efficacy, encouragement and support. Mental health support (e.g., mindfulness training, self-care), breathing training, and information about Crisis Text Line are delivered to all users. For adolescents, messages about nicotine replacement therapy describe its utility but note that consultation with a healthcare provider is required. Keywords such as TIPS, FEELS, and STRESS deliver cognitive and behavioral strategies for quitting and on-demand support for managing mood and stress, respectively. Support for quitting cannabis was not explicitly provided in the intervention.

From 2020 through December 2024, TIQ was promoted nationally through the truth® campaign, earned media, and local/national outreach. To isolate treatment effects and ensure participant blinding, all branding was removed from the intervention.

Assessment-Only Control: After a text message confirming enrollment, participants received only the retention messages described below. After completing the 7-month assessment, participants were instructed how to enroll in TIQ, if interested.

Recruitment, enrollment, and randomization

Eligibility criteria for both parent trials included: age (adolescents: 13–17 years; YAs: 18–24 years), past 30-day nicotine e-cigarette use, interest in quitting vaping in the next 30 days, mobile phone ownership with active text message plan, and US residence. Advertisements on Facebook/Instagram, Twitter, and Snapchat promoted a quit vaping study. Interested individuals were asked to complete online eligibility screening. A link to online informed assent/consent was emailed, requiring a valid email for study enrollment. Assent/consent information indicated that participants would be randomly assigned to a text message intervention; specific details about the nature of each study group were not provided, ensuring double blinding.

Assent/consent differed in the two trials. In the adolescent trial, a waiver of parental consent was approved by the review board. Eligible adolescents were required to provide assent and correctly answer a series of questions indicating decisional capacity to enroll. Providing assent and answering all decisional capacity questions correctly launched the baseline assessment. In the YA trial, acceptance of informed consent launched the baseline assessment. For both trials, those who completed the baseline assessment were randomly assigned to intervention or control via the survey platform and instructed to text the study number to complete enrollment. Those who responded to the confirmation text message within 24 hours were fully enrolled.

Detailed descriptions of the study samples have been published elsewhere [13, 14]. Briefly, the adolescent sample (n = 1,503) had an average age of 16.4 years (SD = 0.8), was 50.6% female, 42.5% sexual minority, 16.2% Hispanic ethnicity, and 62.6% White race. Participants were primarily daily e-cigarette users (median vaping days in the past month: 30) with moderate-high scores on multiple measures of nicotine dependence. The young adult sample (n = 2,588) had an average age of 20.4 years (SD = 1.7), was 50.3% female, 19.0% sexual minority, 10.6% Hispanic ethnicity, and 83.4% White race. A majority reported vaping nicotine daily (93.1%) and 82.3% reported vaping within 30 minutes of waking. Study groups in both samples were balanced on baseline characteristics.

Retention

To minimize differential attrition and optimize follow-up rates in both trials, incentivized text message assessments ($5 each) regarding e-cigarette use were sent to all participants 14 days post-randomization (Checking in: Have you cut down how much you vape nicotine in the past 2 weeks? Respond w/letter: A = I still use the same amount, B = I use less, C = I don’t use at all anymore) and monthly thereafter through the 6-month follow-up (How’s the quit going? When was the last time you vaped nicotine, even a puff of someone else’s? Respond w/letter: A = In the past 7 days, B = 8–30 days ago, C = More than 30 days ago). Data from these assessments were not used in outcome analyses.

Measures

The baseline survey in both trials was conducted online, hosted on a secure server. The 7-month assessment was conducted via mixed-mode follow-up: online non-responders were contacted by phone by research staff blind to treatment assignment; text messages and emails were final means of gathering data on vaping abstinence from non-responders. Participants earned $20 for completing the follow-up, with a $10 incentive for responding within 24 hours of initial invitation.

The full battery of measures administered at baseline and 7 months have been previously described [13, 14]. These secondary analyses focus on self-reported past 30-day use of nicotine e-cigarettes and cannabis at baseline and 7 months post-randomization. For e-cigarette use, participants were instructed at both timepoints “For these questions, please think of your use of vape product(s) that contain nicotine in your responses” and responded to the question “In the past 30 days, did you vape at all, even a puff of someone else’s?” Similarly, participants reported past 30-day use of other substances, including cannabis; the mode of cannabis use was not specified.

Statistical analyses

At baseline, participants were categorized as 1) Exclusive E-cigarette Users if they reported no past 30-day cannabis use, or 2) Dual Users if they also reported past 30-day cannabis use. At 7 months post-randomization, four groups of interest were defined: 1) Dual Abstinent, no past 30-day nicotine e-cigarette or cannabis use, 2) Exclusive E-cigarette Users: no past 30-day cannabis use, but any past 30-day nicotine e-cigarette use, 3) Exclusive Cannabis Users: no past 30-day nicotine e-cigarette use, but any past 30-day cannabis use, and 4) Dual Users: any past 30-day use of nicotine e-cigarettes and cannabis.

Primary analyses focused on the proportion of participants who were Dual Abstinent as the outcome of interest. We employed 2-sample Z-tests based on a normal approximation to the binomial distribution to examine between-arm differences in Dual Abstinence rates, both in the overall sample and by baseline substance use pattern (Exclusive E-cigarette vs. Dual Use).

Within-subject comparisons of cannabis use at baseline and 7-month follow-up were based on McNemar’s test [35]. Additional analyses of 7-month follow-up data explored whether cannabis use at follow-up was associated with nicotine vaping cessation.

All statistical analyses were conducted in R (v 4.5) [36].

Results

Among 1,503 adolescents randomized, the 7-month follow-up rate was 70.8% (n = 1,064). Data on cannabis use was missing for 48 participants, who provided data only on 7-month nicotine vaping status. Thus, the adolescent analytic sample comprised n = 1,016 participants with follow-up data on both e-cigarette and cannabis use. There was no differential attrition by treatment assignment (p = 0.20), with 66.0% (501 of 759) of Intervention participants retained at 7 months versus 69.2% (515 of 744) of Control. Likewise, there was no differential attrition by baseline cannabis use (p = 0.74), with 68.4% (258 of 377) of Exclusive E-cigarette Users retained at 7 months versus 67.3% (758 of 1126) of Dual Users. At baseline, 74.6% (95% CI = 71.8, 77.3) of adolescents reported past 30-day cannabis use, which decreased to 50.1% (47.0, 53.2) at 7 months, a 24.5% point change (95% CI = 20.8, 28.0; McNemar’s test p < 0.001).

Among 2,588 YAs randomized, the 7-month follow-up rate was 76.0% (n = 1,967). Data on cannabis use was missing for 138 participants, who provided data only on 7-month nicotine vaping status. Thus, the YA analytic sample comprised n = 1,829 participants with follow-up data on both e-cigarette and cannabis use. There was no differential attrition by treatment assignment (p = 0.14), with 69.3% (904 of 1304) of Intervention participants retained at 7 months versus 72.0% (925 of 1284) of Control. Likewise, there was no differential attrition by baseline cannabis use (p = 0.86), with 70.9% (747 of 1053) of Exclusive E-cigarette Users retained at 7 months versus 70.5% (1,082 of 1534) of Dual Users. At baseline, 59.2% (95% CI = 56.9, 61.4) of YAs reported past 30-day cannabis use, which decreased to 55.0% (95% CI = 52.7, 57.3) at 7 months, a 4.2% point change (95% CI = 1.9, 6.4; McNemar’s test p < 0.001).

What were the overall patterns of abstinence from e-cigarettes and cannabis at 7-months?

As shown in Table 1, 31.7% (95% CI = 28.8, 34.6) of adolescents were Dual Abstinent, 18.2% (95% CI = 15.9, 20.7) were Exclusive E-cigarette Users, 15.1% (95% CI = 12.9, 17.4) were Exclusive Cannabis Users, and 35.0% (95% CI = 32.1, 38.1) were Dual Users.

Table 1 Dual use of nicotine e-cigarettes and cannabis at 7 months by treatment assignment and baseline product use among adolescents (13–17 years) enrolled in a randomized trial of vaping cessation, n (%)

As shown in Table 2, 15.6% (95% CI = 13.9, 17.3) of YAs were Dual Abstinent, 29.4% (95% CI = 27.3, 31.6) were Exclusive E-cigarette Users, 12.8% (95% CI = 11.3, 14.5) were Exclusive Cannabis Users, and 42.2% (95% CI = 39.9, 44.5) were Dual Users.

Table 2 Dual use of nicotine e-cigarettes and cannabis at 7 months by treatment assignment and baseline product use among young adults (18–24 years) enrolled in a randomized trial of vaping cessation, n (%)

Was there a treatment effect in promoting dual abstinence at follow-up?

Yes. As shown in Table 1, among adolescents, the rate of Dual Abstinence was 13.5% points higher (95% CI = 7.8, 19.1; p < 0.0001) among those randomized to Intervention (38.5%; 95% CI = 34.4, 42.9) vs. Control (25.0%; 95% CI = 21.5, 29.0). As shown in Table 2, among YAs, the rate of Dual Abstinence was 4.6% points higher (95% CI = 1.3, 7.9; p = 0.007) among those randomized to Intervention (17.9%; 95% CI = 15.5, 20.6) vs. Control (13.3%; 95% CI = 11.2, 15.7).

Did treatment effects in promoting dual abstinence vary by baseline product use?

No. In the adolescent sample, the treatment advantage of Intervention over Control was comparable for Exclusive E-cigarette Users (12.4 points; 95% CI = 0.6, 23.8) and Dual Users (13.9 points; 95% CI = 7.4, 20.3), interaction p = 0.82 (Table 1). Among Exclusive E-cigarette Users, 44.0% of adolescents randomized to Intervention were Dual Abstinent (95% CI = 35.1, 53.1) compared to 31.6% of Control (95% CI = 23.8, 40.2). Among Dual Users, 36.7% of Intervention participants were Dual Abstinent (95% CI = 31.8, 41.8) compared to 22.8% of Control (95% CI = 18.7, 27.3).

Likewise, in the YA sample, the treatment advantage of Intervention over Control was comparable for Exclusive E-cigarette Users (7.4 points; 95% CI = 1.1, 13.7; p = 0.02) and Dual Users (3.7 points; 95% CI = 0.0, 7.1, p = 0.03), interaction p = 0.28 (Table 2). Among Exclusive E-cigarette Users, 29.7% of YAs randomized to Intervention were Dual Abstinent (95% CI = 25.0, 34.8) compared to 22.3% of Control (95% CI = 18.3, 26.8). Among Dual Users, 10.3% of Intervention participants were Dual Abstinent (95% CI = 7.9, 13.2) compared to 6.6% of Control (95% CI = 4.6, 9.0).

Was there an interaction effect between vaping status at 7 months and baseline tobacco product use on cannabis use outcomes?

Among adolescents, the difference in cannabis use at follow-up between continuing vapers and vaping abstainers was significantly weaker among baseline Exclusive E-cigarette Users than among baseline Dual Users (interaction p < 0.001). As shown in Supplemental Table 1, among 258 adolescent baseline Exclusive E-cigarette Users, cannabis use at 7 months was reported by 31.1% (95% CI = 23.4, 39.6) of those who were still nicotine vaping versus 21.1% (95% CI = 14.8, 29.2) of those who were vaping abstinent, a 10% point difference (95% CI = −0.8, 20.3). Among 758 baseline Dual Users, cannabis use at 7 months was reported by 77.3% (95% CI = 72.9, 81.3) of those who were still nicotine vaping versus 36.1% (95% CI = 31.1, 41.3) of those who were vaping abstinent, a 41.3% point difference (95% CI = 34.5, 47.4). In total, 97 out of 258 baseline Exclusive E-cigarette Users were dual abstinent (37.6%) compared to 225 out of 758 baseline Dual Users (29.7%), a significant difference at p = 0.019.

Among YAs, the difference in cannabis use at follow-up between continuing vapers and vaping abstainers was comparable (interaction p = 0.81) for baseline Exclusive E-cigarette Users and baseline Dual Users. As shown in Supplemental Table 2, among 747 YA baseline Exclusive E-cigarette Users, cannabis use at 7 months was reported by 27.2% (95% CI = 23.4, 31.2) of continuing nicotine vapers versus 16.8% (95% CI = 12.2, 22.3) of vaping abstainers, a 10.4% point difference (95% CI = 3.9, 16.2, p < 0.001). Among 1,082 baseline Dual Users, cannabis use at 7 months was reported by 79.5% (95% CI = 76.5, 82.2) of continuing nicotine vapers versus 68.1% (95% CI = 62.3, 73.4) of vaping abstainers, an 11.4% point difference (95% CI = 5.5, 17.6). In total, 193 out of 747 baseline Exclusive E-cigarette Users were dual abstinent (25.8%) compared to 92 out of 1082 baseline Dual Users (8.5%), a significant difference at p < 0.001.

Discussion

This study provides the first evidence that a text message intervention designed to promote nicotine vaping cessation also promoted dual abstinence from both nicotine e-cigarettes and cannabis among adolescents and young adults. The observed treatment effect is particularly noteworthy given that the intervention contained no explicit cannabis-specific content, highlighting the potential for spillover effects across substances that share common use patterns, contexts, and delivery mechanisms. The magnitude of the treatment effect was substantial, with the intervention demonstrating a 13.5% point advantage over control in promoting dual abstinence among adolescents (38.5% vs. 25.0%) and a 4.6% point advantage among young adults (17.9% vs. 13.3%). Importantly, these treatment effects were observed regardless of baseline cannabis use status, indicating the intervention’s broad efficacy across different patterns of substance use. The stronger effect observed in adolescents compared to young adults suggests potentially greater malleability of substance use behaviors during earlier developmental stages.

Several mechanisms may explain this beneficial spillover effect on cannabis use. First, it may reflect the increasingly common practice of cannabis vaping [37] the use of electronic delivery systems similar or identical to those used for nicotine to aerosolize liquid tetrahydrocannabinol (THC). When young people successfully quit using their vaping devices for nicotine, this behavior change would naturally extend to decreased cannabis consumption via the same delivery method, creating an incidental cessation effect for both substances simultaneously. Additionally, as young people stopped using e-cigarettes, they may have experienced decreased exposure to the people, places, and cues associated with cannabis use. The fact that baseline dual users who successfully quit vaping were significantly less likely to continue cannabis use compared to those who continued vaping aligns with this hypothesis. Second, participation in a cessation study may have triggered broader self-reflection about substance use patterns, prompting young people to reconsider their cannabis use independently. Third, the cognitive and behavioral skills taught for nicotine vaping cessation (e.g., identifying triggers, developing coping strategies, building self-efficacy) may have generalized to cannabis use behaviors through shared psychological mechanisms of behavior change. Fourth, the text message intervention may have resonated with dual users’ motivations to reduce multiple substances. Finally, young people’s perceptions of health risks associated with vaping may have extended to cannabis due to shared delivery mechanisms and overlapping health concerns. While some observed changes in cannabis use may reflect experimentation, the significant treatment group differences and interaction effects with vaping cessation status suggest intervention-specific mechanisms beyond spontaneous cessation patterns. These potential mechanisms represent a critical area for future research that could inform more efficient interventions addressing polysubstance use.

While these findings demonstrate promising spillover effects, they also reveal important heterogeneity in treatment response that has implications for future intervention development. The lower dual abstinence rates among baseline dual users compared to exclusive e-cigarette users suggest that while some young people may benefit from shared behavioral strategies that address both nicotine vaping and cannabis use simultaneously, individuals with established patterns of polysubstance use may require additional or enhanced intervention components beyond those targeting nicotine vaping alone. The nature of this additional support – whether it involves cannabis-specific content, modified behavioral strategies, increased intervention intensity, or entirely different therapeutic approaches – represents a critical area for future research. Developing and testing interventions that systematically address both substances while identifying which young people are most likely to benefit from integrated versus sequential treatment approaches are critical next steps.

The remarkably high rates of cannabis use observed in both trials (74.6% among adolescents and 59.2% among young adults) far exceeded national prevalence estimates from population-based surveys (approximately 25% for adolescents and 23% for young adults [38]). This disparity suggests that young people who vape nicotine represent a distinct high-risk population for polysubstance use. Notably, similarly high rates of cannabis use (71%) were reported in another recent vaping cessation trial targeting 16- to 25-year-olds [12], confirming that this pattern is not unique to our sample but rather characteristic of young people seeking nicotine vaping cessation support.

A notable age-related pattern emerged in our data: while adolescents reported higher baseline rates of cannabis use compared to young adults (74.6% vs. 59.2%), they also demonstrated substantially greater reductions in cannabis use at follow-up (24.5% points vs. 4.2% points). Adolescents also achieved higher rates of dual abstinence compared to young adults (31.7% vs. 15.6%), suggesting that younger populations may be more responsive to cessation interventions, potentially due to shorter duration of use, less entrenched habits, or greater neuroplasticity during this developmental period [39].

This study has several notable strengths. To our knowledge, it is the first to document treatment effects on cannabis use from a nicotine vaping cessation intervention that did not explicitly target cannabis. This finding is significant as it provides evidence that substance-specific interventions may yield beneficial effects on other substances, potentially reducing implementation burden for addressing multiple substance use. The large sample sizes across two distinct age groups enhance the generalizability of our findings and allow for meaningful age comparisons, which are particularly important given developmental differences in substance use patterns and cessation outcomes. Additionally, the randomized controlled trial design with high follow-up rates and no differential attrition provides robust evidence of intervention effects while mitigating selection bias.

An important limitation of our study is that assessment of cannabis use did not distinguish between different modes of administration (e.g., smoking, vaping, dabbing, edible). This limitation prevents us from determining whether reported reductions were specific to certain modes of administration, particularly vaping. We also cannot examine whether the intervention might have had stronger effects on cannabis vaping specifically, given similarities with nicotine vaping in terms of behavior patterns, devices, and contexts of use. Future research should assess mode of administration to enable more nuanced analyses of cessation patterns and intervention effects across different cannabis products. A second limitation is that abstinence from vaping and cannabis were not biochemically verified. Biochemical verification of substance use has shown to be challenging in other digital cessation studies [40]. Despite reliance on self-reported data that may be susceptible to social desirability bias, this low-intensity, fully automated intervention trial with low-demand characteristics that did not explicitly intend to address cannabis use, rates of misreporting are anticipated to be minimal. Two aspects of our measurement approach warrant comment: examination of interim timepoints beyond baseline and 7-month endpoints could provide important insights into the temporal dynamics of behavior change, and our use of a 30-day assessment window for cannabis use may not have captured infrequent or experimental use patterns, potentially underestimating baseline prevalence of cannabis use or overestimating cessation rates among less-than-monthly users. Another limitation is that both trials were conducted during the COVID-19 pandemic, which introduced unique stressors [41] and altered substance use patterns among young people [42, 43]. This context may have influenced both baseline substance use rates and cessation outcomes in ways that limit generalizability to non-pandemic conditions.

Conclusions

A text message nicotine vaping cessation intervention was effective in promoting abstinence from nicotine e-cigarettes and cannabis among adolescents and young adults, with stronger effects observed in adolescents. Treatment efficacy was comparable across exclusive e-cigarette users and dual users, though baseline exclusive e-cigarette users achieved higher dual abstinence rates. These findings demonstrate that substance-specific interventions can yield broader health benefits across multiple substances simultaneously, while also highlighting the need for enhanced approaches specifically targeting young people who use multiple substances.

Continued monitoring of substance use patterns among youth is needed given the evolving e-cigarette and cannabis landscape. The increasing prevalence of co-use highlights the growing need for concurrent treatment approaches [11]. This study demonstrates a promising, efficient pathway to address polysubstance use by leveraging existing intervention frameworks, potentially reducing implementation burden while maximizing public health impact.

Source: https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-025-00679-1

Filed under: Cannabis/Marijuana,Culture,Drug use-various effects,Prevention and Intervention,Tobacco, smoking,USA,Vaping,Youth :

Red Ribbon Week and Cobb County School District, Georgia – Oct. 30, 2025

Every October, schools across the nation celebrate Red Ribbon Week, a time dedicated to promoting healthy, drug-free lifestyles for students of all ages. This year, the Cobb County School District and our school resource officers are joining forces to remind families that staying drug-free isn’t just a one-week message, but a lifelong commitment that begins with open and honest communication.

While traditional drugs are a concern, School Resource Officer Edwin Ainsworth says vaping has become one of the most visible and dangerous trends among students. 

Ainsworth explained that a distinct fruity scent is a telltale sign that students have been vaping. The smell of THC also doesn’t get past him. 

Officer Ainsworth estimates that as many as eight in ten high school students have tried vaping at least once.

“These kids like them because they’re easy. They can pull them out and smoke them quickly. Some of them are odourless, some don’t even have smoke coming out of them, and kids can hide them,” he said.

Beyond the discreet design and flavours, the health risks are real and long-lasting. “It can cause them to have a hole in their lung, and if they get really addicted, their attitude changes. They start being a little more defensive when you talk to them,” Ainsworth added, “If your lung capacity gets full with popcorn lung, you could end up on a ventilator.”

Best Practices from Cobb Schools Police

Cobb School Resource Officers emphasize that parents play the most powerful role in prevention. The best protection is to get involved. 

Here are some strategies to help keep students drug-free! 

  • Know the Signs. Watch for changes in friends, social groups, mood, and sleep patterns.
  • Stay Involved. Get to know your students’ teachers, coaches, and friends. Encourage participation in sports, clubs, and community activities. 
  • Set Clear Expectations. Be explicit about rules and consequences. Discuss them calmly and consistently. 
  • Teach the Facts. Talk about how drugs and vaping can affect decision-making, athletic performance, and future goals.
  • Start Early. Begin age-appropriate conversations in elementary school about making healthy choices.
  • Model Healthy Behaviour. Avoid using substances in front of students. 
  • Be Proactive. Conduct regular checks of bedrooms, backpacks, and vehicles.

When students make safe, healthy choices, classrooms become stronger, and communities thrive. Red Ribbon Week serves as a reminder that prevention begins at home through honest conversations, clear expectations, and supportive environments. 

Together, we can help every Cobb student stay drug-free for life.

Source: https://www.cobbk12.org/osborne/_ci/p/120665

Filed under: Age-related,Drug use-various effects,Education,Prevention and Intervention,USA,Vaping :

by Herschel Baker, International Liaison Director/Queensland Director, Drug Free Australia – 8 November 2025

Now the Australian drug cartels are using nitazenes (strong opioids) in refillable vape liquids see attached warning (click link at the foot of this article) it is now very important for the community to support strong legislation to stop illegal vapes. Drug Free Australia urgently request the West Australian Premier to please fast-track strong legislation to help stop vapes in W.A. and protect his community.

Main points of the warnings in the linked article are:

  1. Safety Notice is current at the issue date. Printed copies are uncontrolled.

NSW Health UPDATED: Further cases of dependence linked to use of nitazenes (strong opioids) in refillable vape liquids

  1. A New Type of Opioid Is Killing People in the US, Europe, and Australia

Nitazenes, a class of synthetic drugs 40 times more potent than fentanyl, are steadily becoming more common

 

  1. Clinical Experiences With the Nitazene Class of Synthetic Opioids: A Cohort Study https://www.sciencedirect.com/science/article/pii/S0196064425010406

 

This case series highlights that standard parenteral naloxone doses are typically effective, but ongoing monitoring is necessary to detect renarcotization. Nitazene opioids display novel consumption patterns, including exposure by vaping and unintentional use in products sold as containing another drug. The risk of opioid withdrawal from regular nitazene opioid use is a novel observation. Monitoring trends through active drug surveillance, public education, and community access to naloxone are crucial to mitigate the harm posed by nitazene opioid opioids.

  1. Nitazenes: review of comparative pharmacology and antagonist action.

Nitazenes represent an emerging public health challenge due to their high potency, unknown pharmacokinetics, and increasing presence in illicit drug supplies. While naloxone is effective in reversing nitazene poisoning, cases of prolonged toxicity suggest the need for extended monitoring and repeated naloxone dosing. The findings of this review highlight the importance of enhanced drug surveillance, improved clinical awareness, and the development of targeted harm reduction strategies, including the potential for novel opioid antagonists with prolonged efficacy. Future research should focus on defining nitazene receptor kinetics, post-mortem redistribution effects, and optimizing naloxone administration protocols for these emerging synthetic opioids. https://pubmed.ncbi.nlm.nih.gov/40422647/

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Risks of nitazenes (strong opioids) in refillable vapes – from DFA

Filed under: Addiction,Australia,Drug use-various effects,Nitazenes,Opioids,Vaping :

 

The UK government has launched a new campaign to alert young people to the dangers of ketamine, counterfeit medicines and adulterated THC vapes.
by Department of Health and Social Care and Ashley Dalton MP – Published 16 October 2025
  • New campaign to alert young people to the dangers of ketamine, counterfeit medicines and adulterated THC vapes
  • Ketamine use and drug poisonings highest on record with 8 times more people seeking treatment since 2015
  • Government investing £310 million into drug treatment services alongside awareness campaign

Young people are being warned that they risk irreparable bladder damage, poisoning and even death if they take ketamine, synthetic opioids or deliberately contaminated THC vapes, as part of a new anti-drugs campaign.

Launching today (16 October 2025), the campaign, which includes online films, will target 16 to 24 years olds and social media users, following a worrying rise in the number of young people being harmed by drugs. There has been an eight-fold increase in the number of people requiring treatment for ketamine since 2015.

Supported by £310 million investment in drug treatment services, this initiative directly supports the government’s Plan for Change mission to create safer streets by reducing serious harm and protecting communities from emerging drug threats.

Health Minister Ashley Dalton said:

Young people don’t always realise the decision to take drugs such as ketamine can have profound effects. It can destroy your bladder and even end your life.

We’ve seen a worrying rise in people coming to harm from ketamine as well as deliberately contaminated THC vapes and synthetic opioids hidden in fake medicines bought online.

Prevention is at the heart of this government’s approach to tackling drugs and this campaign will ensure young people have the facts they need to make informed decisions about their health and safety, so they think twice about putting themselves in danger.

As part of the campaign, experts will highlight particular risks, including the:

  • potentially irreparable damage ketamine can cause to your bladder
  • dangers of counterfeit medicines containing deadly synthetic opioids purchased online
  • risks from so-called ‘THC vapes’ that often contain dangerous synthetic cannabinoids like spice rather than THC

Resources will be available for schools, universities and local public health teams with content available on FRANK, the drug information website.

There are growing concerns about novel synthetic opioids, particularly nitazenes, which are increasingly appearing in counterfeit medicines sold through illegitimate online sources. Users purchasing these products are typically younger and more drug-naïve.

Reports of harms from THC vapes have also increased, with many products containing synthetic cannabinoids (commonly known as ‘spice’) that have higher potency and unpredictable effects.

Katy Porter, CEO, The Loop, said:

The Loop welcomes the further investment in evidence-based approaches and support to reduce drug-related harm.

Providing accurate, non-judgemental information equips and empowers people to make safer choices and can help reduce preventable harms.

Drug poisoning deaths reached 5,448 in England and Wales in 2023, the highest number since records began in 1993. The campaign emphasises that while complete safety requires avoiding drug use altogether, those who may still use substances should be aware of the risks and know how to access help and support.

The campaign underlines that ketamine’s medical applications do not make illicit use safe, with urologists increasingly concerned about young people presenting with severe bladder problems from recreational ketamine use.

Resources will be distributed to local public health teams, drug and alcohol treatment services, youth services, schools and universities. The campaign provides clear information on accessing help and support for those experiencing drug-related problems or mental health issues.

This year the Department of Health and Social Care is also providing £310 million in additional targeted grants to improve drug and alcohol treatment services and recovery support in England, including specialist services for children and young people.

For information and support on drug-related issues, visit www.talktofrank.com or call the FRANK helpline on 0300 123 6600.

Background information

How to watch this YouTube videoThere’s a YouTube video on this page. You can’t access it because of your cookie settings.You can change your cookie settings or watch the video on YouTube instead:Ket: while each high lasts minutes, for some the damage to their bladder could last forever

How to watch this YouTube videoThere’s a YouTube video on this page. You can’t access it because of your cookie settings.You can change your cookie settings or watch the video on YouTube instead:Synthetic opioids: what are they and why are they so dangerous?

Additional resources for professionals and educators will be available through local public health networks.

The £310 million additional funding for drug treatment services is separate from the public health grant.

Source: https://www.gov.uk/government/news/young-people-given-stark-warning-on-deadly-risks-of-taking-drugs

 

Filed under: Brain and Behaviour,Cannabis/Marijuana,Culture,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Ketamine,Prevention and Intervention,Treatment and Addiction,UK,Vaping,Youth :

by Herschel Baker – Director Queensland Director, Drug Free Australia – 03 August 2025 

Story by Kat Lay, Global health correspondent

Avatars smoke in an image shared on social media of a gathering in the metaverse. A packet of Djarum LA cigarettes, an Indonesian brand, sit on the table. Photograph: iceperience.id Instagram via Canary© Photograph: iceperience.id Instagram via Canary

In the image, a group of friends is standing in a bar, smoke winding upwards from the cigarettes in their hands. More lie in an open packet on the table between them. This is not a photograph taken before smoking bans, but a picture shared on social media of a gathering in the metaverse.

Virtual online spaces are becoming a new marketing battleground as tobacco and alcohol promoters target young people without any legislative consequences.

A report shared at the World Conference on Tobacco Control last month in Dublin set out multiple examples of new technologies being adopted to promote smoking and vaping, including tobacco companies launching digital tokens and vape companies sponsoring online games.

It comes from a monitoring project known as Canary – because it seeks to act as the canary in a coalmine – run by the global public health organisation Vital Strategies.

“Tobacco companies are no longer waiting for regulations to catch them up. They are way ahead of us. We are still trying to understand what we’re seeing in social media, but they’re already operating in unregulated spaces like the metaverse,” says Dr Melina Magsumbol, of Vital Strategies India. “They’re using NFTs [non-fungible tokens]. They’re using immersive events to get our kids to come and see what they’re offering.”

In India, one tobacco company made and promoted an NFT, which represents ownership of digital assets, to celebrate its 93rd anniversary.

Canary scans for and analyses tobacco marketing on social media platforms and news sites in India, Indonesia and Mexico. It is expanding to more countries, including Brazil and China, and to cover alcohol and ultra-processed food marketing.

Digital platforms are being used to bypass traditional advertising restrictions and target young audiences

Melina Magsumbol, Vital Strategies India

It is not set up to scan the metaverse – a three-dimensional, immersive version of the internet that uses technology such as virtual reality headsets to enable people to interact in a digital space. But it has picked up references to what is going on there via links and information shared on older social media sites.

Researchers say that children are likely to be exposed to any tobacco marketing in the new digital spaces given the age profile of users – more than half of the metaverse’s active users are aged 13 and below.

Social media companies have deep knowledge of how to drive engagement and keep people coming back for more views, says Dr Mary-Ann Etiebet, chief executive of Vital Strategies.

“When you combine that with the experience and the knowledge of the tobacco industry on how to hook and keep people hooked … those two things together in a space that is unknown and opaque – that scares me.”

Mark Zuckerberg, metaverse’s prominent backer, says in future “you’ll be able to do almost anything you can imagine” there. Already, that includes shopping and attending virtual concerts.

But Magsumbol describes it as “a new battleground for all of us” that is “being taken over by corporate entities that actually push health-harming products”.

“My daughter is very quiet, she’s an introvert. But online, on [gaming platform] Roblox, when she is killing zombies and ghosts, she morphs into a different avatar – she’s like Alexander the Great mixed with Bruce Lee and John Wick. She is so bloodthirsty,” she says.

“Online we behave differently. Social norms change … the tobacco industry knows that very well. And it’s so easy to subtly sell the idea that you can be anything, anyone you want.”

The metaverse art the team saw in Indonesia was shared on an Instagram account for electronic music lovers linked to Djarum, one of Indonesia’s largest cigarette companies. Another example showed a group having coffee, and looking for a lighter.

It all amounts to efforts to “normalise” smoking and vaping, says Magsumbol. “This kind of behaviour is happening and being done by your avatars, but is it seeping into your real life?

“Digital platforms are being used to bypass traditional advertising restrictions and target young audiences,” she says. “What we’re seeing here is not just a shift in marketing, it’s a shift in how influence works.”

Other researchers have set out examples of alcohol being promoted and even sold in virtual stores.

Online marketing is a global issue. At the same conference, Irish researchers shared findings that 53% of teenagers saw e-cigarette posts daily on social media.

A World Health Organization official (WHO) says a rise in youth smoking in Ukraine is due, in part, to Covid and the war pushing children “too much online” and exposing them to marketing.

Related: Vapes threaten to undo gains in tackling dangers of tobacco, health leaders warn

In India, Agamroop Kaur, a youth ambassador at the Campaign for Tobacco-Free Kids, includes social media marketing when speaking to schoolchildren about the dangers of tobacco and vaping. She has seen vapes suggested as a “wellness” item.

“I think educating youth on what an advertisement looks like, why it’s false, how you might not even see that it’s from the tobacco industry and it’s [content posted by an] influencer is really powerful because then that builds a skill – so that when they’re on social media, because they are digital natives, they’re able to see all of that and know that it’s fake and it’s not something they should be attracted by. I think building those skills early from high school to middle school, and even younger, is really important.”

The WHO Framework Convention on Tobacco Control requires countries to implement bans on tobacco advertising, promotion and sponsorship. Last year, signatories agreed that action was needed to tackle the increasing focus on “digital marketing channels such as social media, which increases adolescent and young people’s exposure to tobacco marketing”.

But there is no easy answer, says Andrew Black at the framework’s secretariat.

“The challenge of regulating the internet is not a problem that’s unique to tobacco. It’s a real challenge for governments to think about how they can provide the protections that society is used to in a world where borders are broken down because of these technologies.”

Nandita Murukutla, who oversees Canary, says regulators should take note: “What starts out small and you ignore, rises up to a certain point when you’ve got critical mass, and after that, it just explodes, and dialing something back is virtually impossible.”

Herschel Baker

International Liaison, Director Queensland Director, Drug Free Australia – Web https://drugfree.org.au/

Source:  https://www.msn.com/en-au/news/other/smoking-avatars-and-online-games-how-big-tobacco-targets-young-people-in-the-metaverse/ar-AA1J2WHU?

Filed under: Australia,Drug use-various effects,Nicotine,Tobacco, smoking,Vaping,Youth :

OPENING COMMENT by NDPA:

This file comes in three parts:

A. Post from Minister Mark Butler

B. Response to Minister Butler by Herschel Baker

C. Press Interview by Minister Butler

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

A. Post from Minister Mark Butler

Sent: 16 July 2025 10:16

Subject: Good news from Australia Regarding both Vaping and Border Control success stopping illegal drugs importance.

Please find attached Vaping Update from MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS; Chris Picton, the Minister for Health in South Australia, and Andrea Michaels who has responsibility for enforcement in South Australia. Also joined by Assistant Commissioner. Tony Smith from the ABF and Professor Becky Freeman from the University of Sydney.

 

  1. First of all, we put in import control to ban the import of

disposable vapes. And the work that Border Force and the TGA have done in

particular has been exemplary. Today, we can say that more than 10 million

vapes have been seized by those two Commonwealth agencies, and I want to

thank the officials at Border Force and TGA for their hard work. We have

resourced them to do that job, and they have provided a great return to

the community on that investment and I thank them for it.

  1. More broadly though, and most importantly perhaps, the research

that Professor Freeman and some others have done is showing that this is making

a difference for young Australians. As I said, vaping rates were exploding

year on year when we were coming to Government. We can now say that the

peak of vaping is behind us, and most research is showing that fewer young

people are vaping and fewer young people are smoking as well. Professor Freeman

will talk about the latest wave of the research she leads out of the

University of Sydney, research that’s supported by the Commonwealth

Government as well as the New South Wales Government and the Cancer

Council.

3.Big Tobacco on the one hand and serious organised crime that is

determined to continue to make money from these very dangerous products, vaping but

also illicit tobacco as well. We know it’s going to be a tough fight. We

know there’s a lot more to do, and we have to do that in close concert

between the Commonwealth and the state governments and territory

governments. But I’m really pleased to say that it looks like we have

turned the corner and at least stopped the explosion in vaping among young

Australians that was emerging as one of the most significant public health

challenges for our community.

  1. BECKY FREEMAN, PROFESSOR UNIVERSITY OF SYDNEY: Thanks so much for

having me here today. Young people were sold a lie. They were told that

vapes were harmless, they were fun, they were part of a young person’s

lifestyle, and they didn’t need to worry about any impacts on their

health.

That was a lie.  We know that young people now, when they look at vaping,

their attitudes have changed. Just a few short years ago when we started

the Gen Vapes study, young people thought, you know, everyone vapes. “It’s

something just young people do. It’s for us, it’s not like your

grandfather’s stinky cigarette.” When we talk to young people now, those

attitudes have shifted. They’re almost ashamed of the fact that they’re

addicted. They can’t believe that something that they were just using at

parties for fun on the weekends, that they were told if they took to music

festivals or used with their friends at parties would be a great way to

enhance their good time.  Now their wellbeing is being impacted. They’re

waking up with a vape under their pillow. They can’t believe they can’t go

all day at their lectures or at school without having a vape. I think it’s

really important to remember those public health impacts.

BUTLER: The Gen Vape research? The really pleasing thing about the latest

wave of research from Gen Vape is it shows fewer young people are vaping

and fewer young people are smoking. When we introduced this package of

measures in concert with Ministers like Chris Picton, there was a concern that if

we stopped young people vaping that they might turn to smoking cigarettes.

And I think the really pleasing thing we’re seeing from a number of different

pieces of research is that twin achievement of fewer young people vaping

and fewer young people smoking.

Now, again, I say and I stress this fight is far from over. We still have

a long way to go. The explosion in illicit tobacco around the country,

cheap, illegal cigarettes, is probably now, I think, the biggest threat we have

to our most important public health objective, which is to stop people

smoking.

It’s still the biggest preventable killer of Australians, 60 or 70

Australians will die today and tomorrow and the day after because of

cigarettes. We’ve got a lot more to do to get to those very, very low

rates of smoking that are set out as targets in the National Tobacco Strategy

across all age cohorts, including young Australians. But the fact we

haven’t seen smoking rates increase markedly as we’ve started to clamp down on

vaping rates among young people, I think is one of the really heartening

things that comes out of Gen Vape. I’m not sure whether Professor Freeman

wants to add to that.

FREEMAN: I fully agree. The only thing I would add is let’s remember that

vaping is actually a risk factor for future smoking as well. We know from

the Gen Vape study that young people who vape are at five times the risk

of going on to smoke. So if you can prevent vaping, you’re also going to

prevent future smoking. And this is why you can’t really consider them as

separate behaviours, really, as well. Let’s remember, it’s the same industry

often behind these products as well. There’s a great quote from the study

from a young person. She said: “you know, when I was a young teen, I

absolutely hated smoking. I could not believe anyone would smoke. I’d had

it drilled into me from a very young age, those gross packets. And then I

tried vaping, and it sort of loosened me up. And I thought, oh, well, if I’m

going to vape, maybe I could smoke too.” So I think that prevention of vaping

and prevention of smoking together is super important.

Kind Regards  – Minister Mark Butler

 

B. Response to Minister Butler by Herschel Baker

Herschel Baker

International Liaison Director

Queensland Director

Drug Free Australia

M: 0412988835Prevent.

Don’t Promote Drug

mailto:drugfreeaust@drugfree.org.au

mailto:drugfree@org.au

Web https://drugfree.org.au/

 

C. Press Interview by Minister Butler

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Source:  Good news from Australia Regarding both Vaping and Border Control

 

 

 

Filed under: Australia,Political Sector,Vaping :

by WRD News Team –  July 17, 2025

Australia has achieved a remarkable milestone in youth substance abuse prevention, with border authorities seizing over 10 million vapes since implementing world-leading import controls in January 2024. The comprehensive crackdown has successfully turned the corner on what was described as “one of the most significant public health challenges” facing Australian communities.

Vaping Rates Plummet as Enforcement Delivers Results

Health Minister Mark Butler confirmed that “the peak of vaping is behind us,” with research showing fewer young people are now vaping and fewer young people are smoking. When the current government took office three years ago, vaping was “exploding as a public health menace,” with year-on-year increases at “alarming rates”.

School communities had reported vaping as their “number one behavioural concern,” with suspensions climbing and schools implementing extraordinary measures including “rostering teachers to stand inside school toilets during recess and lunchtimes” to combat the crisis.

Young Australians Recognise They Were “Sold a Lie”

Professor Becky Freeman from the University of Sydney, who leads the landmark Gen Vapes research study, revealed the dramatic shift in youth attitudes: “Young people were sold a lie. They were told that vapes were harmless, they were fun, they were part of a young person’s lifestyle”.

The research shows young people’s attitudes have fundamentally changed. Freeman noted: “They’re almost ashamed of the fact that they’re addicted. They can’t believe that something that they were just using at parties for fun on the weekends… Now their wellbeing is being impacted. They’re waking up with a vape under their pillow”.

Coordinated Government Response Targets Criminal Networks

The comprehensive strategy included banning imports of disposable vapes and outlawing retail sales outside therapeutic settings. Previously, “nine out of 10” vape stores were located “in walking distance of schools because they knew that was their target market”.

Assistant Commissioner Tony Smith from the Australian Border Force emphasised the criminal elements involved: “Every vape and every cigarette that is illegally purchased fuels the black market… and sends profits into the hands of organised crime”.

Border Force officers now make “on average 120 detections a day,” contributing to the 10 million vapes seized alongside “2.5 billion cigarette sticks and 435 tonnes of illicit tobacco”.

South Australia Leads Enforcement Excellence

South Australia has emerged as the national leader in enforcement, receiving top marks in an independent assessment. The state has seized over 100,000 vapes worth $4.5 million in just 12 months.

Minister Andrea Michaels revealed the state now has “the ability to shut stores for 28 days” and has already “closed almost 20 stores for 28 days” since the enhanced powers took effect in June 2025. Penalties for violations can reach up to $6.6 million for repeat offences.

Research Confirms Gateway Effect Prevention

Critical research findings demonstrate that vaping serves as a gateway to smoking, with “young people who vape are at five times the risk of going on to smoke”. As one young participant in the study explained: “when I was a young teen, I absolutely hated smoking… And then I tried vaping, and it sort of loosened me up. And I thought, oh, well, if I’m going to vape, maybe I could smoke too”.

The success in reducing both vaping and smoking rates simultaneously addresses earlier concerns that restricting vapes might drive young people toward cigarettes instead.

International Partnerships Disrupt Supply Chains

Australia has deployed Border Force officers internationally, including to “the UK, to Thailand and also through to Hong Kong” to work with international partners to stem the flow of vape products. Recent referrals contributed to the seizure of “over 630,000 vapes from reaching our borders”.

The products are arriving from multiple countries including “China, from the UAE, Singapore” and “other locations such as the UK as well”, often using “mis-declaration or mis-description of goods” to evade detection.

Ongoing Challenges Acknowledged

Despite the remarkable progress, officials stressed the fight continues. Minister Butler acknowledged: “We know it’s going to be a tough fight. We know there’s a lot more to do… We’re up against two very strong opponents, Big Tobacco on the one hand and serious organised crime”.

Professor Freeman emphasised the need for sustained action: “We always have to be mindful of the tobacco industry tactics and what product they’re going to bring in next. We know that they are not going to give up on this market”.

Global Implications for Youth Protection

Australia’s comprehensive approach demonstrates that decisive government action can successfully combat youth substance abuse epidemics. The combination of import controls, retail restrictions, enforcement measures, and international cooperation provides a blueprint for other nations grappling with similar challenges.

The transformation from a crisis where vaping was “exploding year on year” to confirmed evidence that “the peak of vaping is behind us” offers hope for communities worldwide seeking effective prevention strategies.

Source:  https://wrdnews.org/australia-seizes-10-million-vapes-world-leading-crackdown-shows-dramatic-results-in-youth-prevention/

Filed under: Addiction,Australia,Prevalence,Prevention and Intervention,Vaping,Youth :

Two large-scale surveys of California high school students found that teens who saw cannabis and e-cigarette content were more likely to start using those substances or to have used them in the past month

Teens who see social media posts showing cannabis or e-cigarettes, including from friends and influencers, are more likely to later start using those substances or to report using them in the past month, according to surveys done by researchers at the Keck School of Medicine of USC. Viewing such posts was linked to cannabis use, as well as dual use of cannabis and e-cigarettes (vapes). Dual use refers to youth who have used both cannabis and e-cigarettes at some point. The results were just published in JAMA Network Open.

The findings come amid a decline in youth e-cigarette use, reported in 2024 by the U.S. Food and Drug Administration (FDA) and U.S. Centers for Disease Control and Prevention. However, teen vaping, cannabis use and the dual use of e-cigarettes and cannabis remain a problem. 

“While the rate of e-cigarette use is declining, our study shows that exposure to e-cigarette content on social media still contributes to the risk of using e-cigarettes with other substances, like cannabis,” said Julia Vassey, PhD, a health behavior researcher in the Department of Population and Public Health Sciences at the Keck School of Medicine.

The study, funded by the National Institutes of Health, also helps clarify how certain types of social media posts relate to teen substance use. Researchers surveyed more than 7,600 teens across two studies: a longitudinal study to understand whether viewing cannabis or e-cigarette posts on TikTok, Instagram and YouTube relates to a teen’s later choice to start using either substance or both, and a second survey looking at whether an association exists between the source of the content— friends, influencers, celebrities or brands—and substance use.  

“Answering these questions can help federal regulators and social media platforms create guidelines geared toward preventing youth substance use,” Vassey said.

Links across substances

Data for the study came from California high school students, with an average age of 17, who completed questionnaires on classroom computers between 2021 and 2023. Researchers conducted two surveys, one focused on teens who used cannabis, e-cigarettes or both for the first time, the other focused on use during the past month.

In the first survey, which included 4,232 students, 22.9% reported frequently seeing e-cigarette posts on TikTok, Instagram or YouTube, meaning they saw at least one post per week. A smaller portion—12%—frequently saw cannabis posts.

One year later, researchers followed up with the students. Teens who had frequently seen cannabis posts—but had never tried cannabis or e-cigarettes—were more likely to have started using e-cigarettes, cannabis or both. Teens who had frequently seen e-cigarette posts on TikTok were more likely to have started using cannabis or started dual use of both cannabis and e-cigarettes. No such pattern was found for Instagram or YouTube. The data collected allowed researchers to look at platform-specific results for e-cigarettes posts, but not for cannabis posts.

“This is consistent with previous research showing that, of the three platforms, TikTok is probably the strongest risk factor for substance use,” Vassey said. That may be because TikTok’s algorithm pushes popular content broadly, including posts that feature e-cigarettes, even to users who don’t follow the accounts.

In the second survey, researchers asked 3,380 students whether they saw cannabis or e-cigarette posts from brands, friends, celebrities, or influencers with 10,000 to 100,000 followers. Teens who saw e-cigarette or cannabis posts from influencers were more likely than their peers to have used cannabis in the past month. Those who saw e-cigarette posts from friends were more likely to have been dual users of cannabis and e-cigarettes in the past month. Those who saw cannabis posts from friends were more likely to have used cannabis in the past month or to have been dual users of cannabis and e-cigarettes.

The link between e-cigarette posts and cannabis use is what researchers call a “cross-substance association” and may be explained by the similar appearance of nicotine and cannabis vaping devices, Vassey said. 

The risks of influencer content

Influencer posts deserve special attention because they often slip through loopholes in federal rules and platform guidelines. For example, the FDA can only regulate content when brand partnerships are disclosed, but influencers—consciously or not—may skip disclosures in some posts.

Studies show that these seemingly unsponsored posts are seen as more authentic, Vassey said, making them particularly influential.

Most social media platforms already ban paid promotion of cannabis and tobacco products, including e-cigarettes. Some researchers say those bans should be extended to cover additional influencer content. Others want platforms to partner with regulators to find a comprehensive solution.

“So far, it’s a grey area, and nobody has provided a clear answer on how we should act and when,” Vassey said.

In future studies, Vassey plans to further explore cannabis influencer marketing, including whether changes to social media guidelines impact what teens see and how they respond.

About this research

In addition to Vassey, the study’s other authors are Junhan Cho, Trisha Iyer and Jennifer B. Unger from the Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California; Erin A. Vogel from the TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City; and Julia Chen-Sankey from the Institute for Nicotine and Tobacco Studies and the School of Public Health, Rutgers University, New Brunswick, New Jersey.

This work was supported by National Institutes of Health [R01CA260459]and the National Institute on Drug Abuse [K01DA055073].

Source:  https://keck.usc.edu/news/e-cigarette-and-cannabis-social-media-posts-pose-risks-for-teens-study-finds/

Filed under: Cannabis/Marijuana,Culture,Drug use-various effects,Marijuana and Medicine,Prevention and Intervention,Treatment and Addiction,USA,Vaping,Youth :

by Shane Varcoe, Dalgarno Institute, based on https://nobrainer.org.au
Teen vaping is on the rise. Around the world, 16.8% of young people have already tried e-cigarettes, often starting as early as 14 years old. The risks? Nicotine addiction, lung damage, harmful chemicals, and even mental health concerns. Schools are on the frontline to tackle this issue, and now, a new programme called ‘Our Futures Vaping’ is aiming to revolutionise teen vaping prevention in schools.
Why Teen Vaping Prevention is Essential: Reports indicate that one in four teenagers in Australia has experimented with vaping. With the average age of initiation being just 14, the potential harm cannot be ignored. The effects of vaping include:
• Lung injuries caused by chemical exposure
• Higher risk of transitioning to smoking cigarettes
• Possible long-term mental health difficulties
Despite regulatory reforms aiming to restrict vaping to medicinal use, illegal access remains widespread. To address this challenge, schools need prevention tools that are credible, age-appropriate, and accessible.
A New Approach to Teen Vaping Prevention with Digital Lessons: A team of researchers has co-designed an innovative school-based programme called ‘Our Futures Vaping’. This cutting-edge project takes the fight against teen vaping to the classroom, with an engaging digital platform tailored to Year 7 and 8 students. It’s more than just a teaching tool; it’s a way to empower students with knowledge, critical thinking skills, and the confidence to say no to vaping. 
Source:  https://nobrainer.org.au/index.php/student-teacher/get-a-clue-partae/1456-new-digital-lessons-to-combat-teen-vaping-in-schools?
Filed under: Australia,Drug use-various effects,Prevention and Intervention,Vaping,Youth :

by Barbara A. Preston | www.themontynews.org – June 6, 2025

Montgomery Police and Health Department officials are partnering to raise awareness about the dangers of vaping and substance abuse. They sponsored a program at Montgomery High School on Friday, June 6, aimed at educating teens about the risks.

Experts say vaping weed, and nicotine, are very popular with teens across the country — however, users are often uninformed about the risks and harm associated with the trend.

According to the CDC and the Food and Drug Administration (FDA), Tobacco companies and e-cigarette companies are targeting youth. The problem goes beyond nicotine. The delivery device, commonly referred to Electronic Nicotine Delivery Systems (ENDS) is a major part of the problem. Also called electronic cigarettes, e-cigarettes, vaping devices, or vape pens, ENDS are battery-powered devices used to smoke or “vape” a flavored or unflavored solution which usually contains nicotine or marijuana, or both. The American Academy of Family Physicians (AAFP) recognizes the increased use of ENDS, especially among youth and young adults.

Montgomery Township Police Chief Silvio Bet said the Vaping Program at the high school is one of many important initiatives the police and health department plan to roll out.
“Our continued initiatives symbolize our commitment to fostering a culture of awareness that benefits all community members,” Chief Bet said. The programs also build a stronger relationship between the police department, the health department, and the community, he said.

ThinkFast Interactive, an educational consultant company based in Kent County, Michigan, led the assembly portion of the program. They gave a lively, loud, and fun interactive presentation to the MHS freshman and sophomores in the school auditorium.

The ThinkFast MCs and DJs raised student awareness on everything from the harmful chemicals found in e-cigarettes to the potency of today’s marijuana.

Chemicals Found in Vapes

According to ThinkFast and Prevention Resources Inc data, the following chemicals are commonly found in vape devices:
       – Diacetyl (The chemical associated with the disease “popcorn lung.”)
       – Heavy Metals ( Lead and nickel can build-up in the body to fatal levels.)
       – Formaldehyde (A toxic chemical component used in the embalming process.)

Potency of Today’s THC (Marijuana)

Teens are overdosing from vaping THC in our community, according to Prevention Resources. They have ended up in local hospitals for emergency care because of the very high concentration of THC in today’s weed.
Some studies show the percentage of THC in cannabis has more than quadrupled since 1995. Samples seized by the Drug Enforcement Administration in 1995 contained 3.96% of THC. By 2022, the percent of TCH increased to 16.14%, according to The National Institute on Drug Abuse.
– Addictive Drugs such as nicotine and THC (marijuana), are known to cause brain changes, which are most harmful to adolescents. Research shows that about one in six teens who repeatedly use cannabis can become addicted, as compared to one in nine adults
Marcantuono summed up the program, telling The Montgomery News, “Our goal is to educate, raise awareness, and change the trajectory to prevent ENDS device initiation and ultimately, to end tobacco and marijuana use.”

Source:  https://www.themontynews.org/single-post/teens-learn-about-the-many-risks-of-vaping-nicotine-and-thc-more-potent-addictive-and-dangerous-t

Filed under: Cannabis/Marijuana,Drug use-various effects,Education,Mental Health,Prevention and Intervention,USA,Vaping,Youth :

by Pat Aussem, L.P.C., M.A.C., Vice President, Consumer Clinical Content Development – June 2025

Personalized support for addressing your child’s substance use or addiction

(available in English and Spanish)

 

Fentanyl poisoning & counterfeit pills

According to the CDC, deaths from fentanyl poisoning are fastest growing among 14- to 23-year-olds. The presence of fentanyl both in counterfeit pills and in illicit street drugs poses a grave threat to the safety of teens and adults alike.

Teen substance use trends are always changing, and staying informed can help parents have better conversations with their kids. The good news? Teen substance use is at an all-time low! According to the Monitoring the Future survey, fewer teens are drinking, vaping, or using drugs compared to previous years.1 So, the next time your teen says, “Everyone is doing it,” you can ask how they’re seeing substance use in their world and what their peers are saying. The truth is, most teens are making healthy choices.

That said, it’s still important to keep an eye on emerging trends. New products, shifting laws, and the influence of social media continue to shape how young people perceive and access substances. What was true when we were growing up may no longer apply today. This article breaks down the key trends for 2025—no scare tactics, just real information to help you guide and support your teen. Let’s explore what’s on the horizon together.

Trend #1: VAPING EVOLUTION

Vaping is not new, but it’s evolving. Today’s e-cigarettes are more discreet than ever, often resembling USB drives, pens, or even watches.

The biggest concerns? Flavors that mask the harshness of nicotine make it easier for first-time users. And nicotine concentrations have skyrocketed, as one pod can contain as much nicotine as an entire pack of cigarettes.

Signs of vape use can include increased thirst, sweet smells, unfamiliar tech devices, small cartridges or pods.

You can start a conversation with your child by asking, “Vaping devices keep changing. What are you seeing at school these days?”

Trend #2: NICOTINE POUCHES

Nicotine pouches are one of the fastest-growing nicotine products among young people. These small, tobacco-free pouches are placed between the lip and gum and contain nicotine powder delivered directly into the bloodstream.

Nicotine pouches come in small white pouches the size of Mentos or Chicklets gum. They are packaged in circular containers. In addition to seeing packaging, be aware of white stains on clothing and frequent spitting that are signs of use.

With flavors like mint and fruit, they’re designed to appeal to teens and young adults. In addition, because they’re tobacco-free, they face fewer regulations than traditional tobacco products.

If you see people using nicotine pouches or brands like Zyn on social media or TV shows, you could ask your child, “What have you heard about nicotine pouches?”

Trend #3: CANNABIS LANDSCAPE

With more states legalizing adult use of marijuana (cannabis), many people no longer see it as being risky. But today’s cannabis is not what it was decades ago.

Modern strains can have THC levels more than 3-4 times higher than in the 1990’s. And the ways to use it have expanded beyond smoking with options like edibles, vapes, drinks, salves and concentrates.

Marijuana use during adolescence has been linked to negative impacts on brain development and mental health problems like depression, anxiety, suicidal thinking and psychosis. And at the age when teens are becoming new drivers, remember that driving under the influence of marijuana is illegal, not to mention extremely dangerous.  It can impact a person’s ability to make split-second decisions, even to stay in their lane without weaving.

You can talk about safety with your child by offering options should they be in a situation where the driver is impaired. For example, you can come up with an emoji symbol that they can text you to let you know they need to be picked up with no questions asked until the next day.

Trend #4: ALCOHOL AWARENESS

Even today, alcohol is still the most commonly used substance among teens. While overall use has declined in recent years, the way teens consume alcohol has changed dramatically.

Today’s alcohol landscape is dominated by sweet, flavored options that mask the taste of alcohol, like hard seltzers, alcopops and coolers, and spirit-based ready-to-drink cocktails. Many teens don’t even consider these to be “real alcohol.” And social media-driven drinking games and challenges have made dangerous drinking patterns like binge drinking more normalized.

You may be able to use yourself as a way to open a conversation. Think back to when you first tried alcohol or share a situation you experienced with alcohol. Ask about what types of alcohol kids your age are talking about.

Trend #5: PRESCRIPTION DRUG MISUSE

Prescription medications—particularly ADHD stimulants like Adderall—continue to be misused, often for studying or weight loss.  School pressure can be intense, and some teens see these medications as performance enhancers rather than drugs of misuse.

Parents should secure medications, count pills regularly, and be aware of “study drug” culture. Teens often consider these medications “safe” because doctors prescribe them. But no one should take medication unless it is prescribed to them.

You may consider asking: “I’ve heard about students using medications to help with studying. What’s that like at your school?”

Trend #6: FENTANYL CRISIS

Fentanyl—a lab-made opioid 50 times stronger than heroin—is being found in counterfeit pills and mixed with other drugs like heroin and methamphetamine. These fake pills are flooding the U.S. and can look nearly identical to prescription medications like Xanax and Oxycontin.  Even one counterfeit pill can be fatal.

One way to support your child is by practicing or role playing with them how to manage peer pressure and how to decline a potential offer of any pills.

Trend #7: SOCIAL MEDIA INFLUENCE

Social media has transformed how substances are marketed and normalized. Content providers can push content making substance use look fun and cool, and teens are often exposed to misinformation.

What’s concerning? “Challenges” (like the Benadryl challenge) involving substances can go viral, and influencers may promote alcohol brands or cannabis products.

It’s helpful to stay familiar with your teen’s social platforms. Follow some of the same accounts they do. Create a family social media plan that includes critical thinking about sponsored content.

A conversation starter can be: “I noticed some of those social media videos show people partying with certain drinks or substances. Do you and your friends ever talk about whether that stuff is real or staged?”

Practical Tips:

What can you actually do with this information?

  1. Build trust through ongoing conversations, by finding opportunities to talk about substance misuse and risk – not just one big “drug talk”
  2. Focus on health and safety, not just rules
  3. Always stay curious, not judgmental
  4. Educate yourself on warning signs of substance use and mental health symptoms
  5. Roleplay scenarios involving peer pressure, saying “no” and planning an exit plan
  6. Identify trusted adults that your child can go to if you’re not available

The reality is that young people are going to encounter substances. Your goal isn’t to create fear around substance use, but to build trust and communication. With honest dialogue and good information, you’re giving them the tools to make better decisions.

 

Source:  https://drugfree.org/article/top-7-teen-substance-use-trends-parents-need-to-know-in-2025/

Filed under: Alcohol,Brain and Behaviour,Cannabis/Marijuana,Culture,Drug use-various effects,Fentanyl,Internet,Parents,Prescription Drugs,USA,Vaping,Youth :

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Published by NIH/NIDA 14 May 2025

 

Cannabis vaping is making headlines worldwide, often promoted as a “safer” alternative to smoking. Meanwhile, Drug Trends data from Australia reveal that non-prescribed cannabis use remains high among people who regularly use drugs. But are wider permission models and positive propaganda about cannabis leading to greater engagement, especially among those most at risk? This article dives into Australian data from the Ecstasy and Related Drugs Reporting System (EDRS) and Illicit Drugs Reporting System (IDRS), exploring what’s really happening with cannabis products, vaping, and why honest health education is more critical than ever.

Cannabis Vaping and Drug Trends in Australia (2014–2024): What the Data Tells Us

Cannabis vaping, once an afterthought, now claims a growing share of the global market. Many believe vaping to be less harmful, with marketers highlighting vaping’s lack of smoke and alleged respiratory benefits. However, recent Drug Trends research in Australia challenges some of these assumptions and uncovers troubling patterns.

The Rise of Electronic Vaping Products

Electronic vaping products started as oversized gadgets in the late 1990s. Initially intended to vaporise dried cannabis herb, they eventually shrank, morphing into today’s sleek e-cigarettes. While vaping nicotine products has become mainstream, cannabis vaping is following close behind, spurred in part by changes to medicinal and recreational cannabis laws overseas.

A North American review found a seven-fold increase in monthly cannabis vaping among adolescents, with notable shifts from dried herb to potent cannabis oils. However, the situation in Australia is different, shaped by stricter regulations and unique market conditions.

Drug Trends in Non-Prescribed Cannabis Use

Australia’s EDRS and IDRS surveys collect real-world data on non-prescribed cannabis and cannabinoid-related products. Between 2014 and 2024, most participants in both systems reported using cannabis recently, with rates as high as 90% in the EDRS and 74% in the IDRS.

Hydroponic and Bush Cannabis Still Dominate

  • Hydroponic cannabis was the most popular, with usage rates ranging from 63%–83% among EDRS respondents, and a remarkable 88%–94% for IDRS participants.
  • Bush cannabis also stayed common, with 51%–77% (EDRS) and 37%–54% (IDRS) reporting use.
  • Other cannabis products, such as THC extracts and commercially-prepared edibles, have appeared in recent years, showing increased product diversity—but are far less popular than traditional forms.

Cannabis Vaping Emerges, But Smoking Prevails

Despite media attention around cannabis vaping, the majority of Australians captured in these studies still smoke cannabis. From 2014 to 2024:

  • Smoking remained the dominant route of administration (ROA) in both groups.
  • Cannabis vaping (inhaling/vaporising) trended upward, but stayed a minority choice. Vaporising among EDRS participants increased from 12% to 25%, and from 2% to 9% for IDRS.

Notably, few users chose vaping as their only method. Most combined it with smoking, suggesting the rise in vaping hasn’t replaced traditional habits.

Concerns About Cannabis Vaping and Permission Models

The Problem with Changing Perceptions

There is growing concern that permission models and positive messaging around cannabis use (whether through legislation or social media) may downplay its risks. Vaping, in particular, is surrounded by claims of being a “safer” alternative to smoking. While it’s true that vaping doesn’t involve combustion and may expose users to fewer toxic chemicals, it’s not risk-free.

Key Issues Include:

  • Potency extremes: Some vape oils and extracts reach THC concentrations of 70–90%, far higher than the average 10%–20% in cannabis herb. Highly potent products carry greater risks for dependence, anxiety, and psychosis.
  • Unknown health risks: The long-term effects of inhaling cannabis vapour, especially from unregulated or home-made devices, are not fully understood.
  • Discreet use and normalisation: Portability and subtlety make vaping easier to hide, particularly from parents and teachers. For some users, this can enable more frequent use or uptake at a younger age.
  • Unhealthy dual use: Most vapers continue smoking, increasing overall exposure to both methods. (for complete research WRD News)

Source: https://www.dalgarnoinstitute.org.au/index.php/resources/drug-information-sheets/2672-cannabis-vaping-and-drug-trends-among-youth-in-australia-2014-2024-a-growing-concern?

Filed under: Addiction,Australia,Cannabis/Marijuana,Cocaine,Culture,Drug use-various effects,Drugs and Accidents,Ecstasy,Health,Heroin/Methadone,HIV/Injecting-Drug-Users,Ketamine,Khat,Kratom,Mental Health,Methamphetamine/GHB/Hallucinogens/Oxycodone,Nicotine,Opioids,Prescription Drugs,Prevention and Intervention,Solvent abuse,Synthetics,Tobacco, smoking,Vaping,Youth :

Statement by the Queensland Cabinet and Ministerial Directory

Published Tuesday, 06 May, 2025 at 10:09 AM

The Honourable Tim Nicholls – Minister for Health and Ambulance Services

Record-breaking raids in war on illicit tobacco and dangerous vapes

  • Queensland has seized the nation’s largest ever haul of illegal cigarettes and vapes by a health authority, under Queensland Health-led Operation Appaloosa. 
  • More than 30 locations were raided, with 76,000 vapes, 19 million cigarettes and 3.6 tonnes of loose tobacco seized.
  • The raids come as more than $5 million in fines were issued in the first week of the Government’s nation-leading fines – over $1 million more than in the final four months of Labor. 

Queensland has stepped up the war against illicit tobacco and dangerous vapes, with the nation’s largest ever haul of illegal products by a health authority, in an effort to keep them out of the hands of kids.  

More than 76,000 vapes, 19 million illicit cigarettes and 3.6 tonnes of loose illicit tobacco – with a combined estimated street value of $20.8 million – were seized during the record-breaking Operation Appaloosa in March.

Queensland Health raided more than 30 locations across Central Queensland, Wide Bay, Metro North, Metro South, and West Moreton, supported by the Queensland Police Service and the Therapeutic Goods Administration.

This crackdown came ahead of the 3 April 2025 commencement of the nation’s toughest on-the-spot fines for the sale of illicit tobacco and vapes, which means individuals can be fined $32,260 and businesses up to $161,300 if caught selling illicit tobacco and vapes.

In just the very first week of these new fines, illegal traders were hit with fines totalling $5,094,560. To put that into perspective, Labor averaged less than $250,000 in fines per week in their final months in office. 

Minister for Health Tim Nicholls said the Crisafulli Government was determined to keep dangerous vapes out of the hands of children by stamping out illegal chop shops.

“Labor allowed organised crime gangs to set up illegal chop shops in plain sight across the State, putting our kids at great risk,” Minister Nicholls said.

“We need to do everything possible to keep dangerous illegal vapes away from Queensland’s young people, which is why we’ve boosted enforcement and introduced serious new fines. 

“We’re hitting these illegal traders where it hurts most, by seizing their illicit goods to deprive them of generating a profit and hitting them with the nation’s toughest fines.

“The is the latest in our crackdown on illegal chop shops and we’ll continue to target this organised crime and keep dangerous vapes out of the hands of kids.”

Illicit tobacco or vape sales can be reported via the Queensland Health website or calling 13 QGOV (13 74 68). 

 

Source: https://statements.qld.gov.au/statements/102504#:~:text=Queensland%20has%20s

Filed under: Australia,Crime/Violence/Prison,Tobacco, smoking,Vaping :

Dangerous but common misconceptions can prevent crucial early addiction treatment.

Key points:

  • Misconceptions and the ignoring of research-based evidence prevent crucial early treatment of addiction.
  • Drugs of abuse cause health, life, and relationship problems with many long-lasting effects.
  • Teen and young adult drug prevention is necessary and needs funding.

Research published in high-quality peer-reviewed journals reveals key information on the realities of addiction, exposing pervasive myths and misconceptions, as in these examples.

False Belief 1: Drug experimentation is normal for teens and shouldn’t alarm parents.

Drug use and experimentation among teens often is ignored by many—even parents, who then may be unaware that any use places adolescent brains in jeopardy. For today’s teens, life often feels overwhelming, but avoiding alcohol, tobacco, marijuana, and other drugs is their one best choice to promote continued healthy physical and mental development. Preventing or delaying all teenage substance use not only reduces their current risks for depression, psychosis, and school/learning problems, but it also significantly decreases their probability of addiction as adults.

Harvard’s Sharon Levy, MD, MPH, and founding National Institute of Drug Abuse Director Robert DuPont, MD, strongly advocate a zero-tolerance approach to youth substance use. They emphasize that no amount of drug use is safe for young people. They promote the One Choice initiative encouraging adolescents to avoid substance use: alcohol, tobacco, marijuana, and other drugs.

It’s now known that THC in marijuana interferes with the developing brain circuits responsible for regulating behavior, leading to increased risk-taking and poor decision-making. Even infrequent teen use can impede judgment, increasing the probability of risky behaviors and accidents. Adolescents also are more likely than adults to develop cannabis use disorder (CUD) due to their heightened neuroplasticity during this developmental stage. The resulting impairment may lead to academic underperformance and problematic interpersonal relationships.

False Belief 2: Addiction is a personal weakness.

Addiction is not about people being weak-minded. It’s far more complicated. Becoming addicted depends on the drug used, dose, route, frequency, and risk factors like ages of users. Also, the same drug at the same dose affects people differently because of personal differences, as well as the presence/absence of traumatic past life experiences.

Yale’s Joel Gelernter identified genetic variants associated with vulnerability to addictions. However, genetic characteristics themselves interact with environmental factors in developing substance use disorders (SUDs). As Nora Volkow, director of NIDA, has said, “Addiction is a complex disease of a complex brain; ignoring this fact will only hamper our efforts to find effective solutions …”

False Belief 3: People must hit “rock bottom” to recover from addiction.

No, no, and no! Roadside alcohol testing has prevented thousands of deaths and helped many people with alcohol use disorders (AUD) obtain help, sometimes by coercion of courts. About 50 percent of those arrested for DUI have an AUD. Users often deny they have a problem with drugs or alcohol and believe they are truthful. But they are lying to themselves.

Addiction is a chronic, relapsing condition driven by changes in brain circuitry, particularly in areas controlling reward, stress, and decision-making. While some people seek help after suffering dire consequences, others are compelled into treatment by the courts, based on a past offense. Waiting to hit “rock bottom” increases major risks of harming the person’s relationships, job, and health—and strengthens the hold of the drug over the person.

False Belief 4: Addiction treatment never works.

Researchers from the University of British Columbia and Harvard Medical School recently analyzed survey data from nearly 57,000 participants in 21 countries over 19 years, providing clear data. They discovered that the number-one barrier to treatment was addicted people themselves: Most were in denial and did not recognize they needed treatment.

Alcoholics Anonymous is often successful, non-judgmentally providing new members a roadmap, role models, hope, and social connections. Successful people actively involved in AA complain that their friends kept asking them why they “weren’t cured yet” since they went to so many meetings. But going to meetings is what works.

Even among experts, there’s no consensus on what constitutes successful treatment. To some, success is that the person is still alive and hasn’t been rushed to the emergency room because of an overdose in the past 6 months or year. To others, it is taking treatment medications. And to still others, only abstinence and a full resumption of all family and work obligations counted as success.

Another issue is that most people with SUDs have multiple addictions. Even when they overdosed, most took multiple drugs. It’s also true that many people come to treatment also needing treatment for other medical, addiction, and psychiatric problems. Yet only rarely are patients evaluated and treated for all issues.

False Belief 5: Overdoses of drugs don’t cause brain damage.

Drugs of abuse can harm the brain. Overdose survivors may suffer from undetected brain damage and hypoxic brain injury caused by opioid-induced respiratory depression. As a society, we better understand hypoxia as associated with drowning or choking than its much more common occurrence in drug overdoses with loss of consciousness.

Recent studies estimate that at least half of people using opioids have illicitly experienced a non-fatal overdose or witnessed an overdose. People who regularly use drugs are at elevated risk of brain injury due to accidents, fights, and overdoses. A single fentanyl overdose could cause hypoxia, brain injury, and memory and concentration problems.

Overdoses with counterfeit pills, cocaine, methamphetamine, xylazine, or heroin usually also include fentanyl, making neurologically compromising overdoses more common.

Summary

Myths and misconceptions increase stigma and decrease the likelihood that someone with an addictive illness will receive prompt, effective treatment. We need early intervention and treatment during the preaddiction phase. Bottom line: Preventing teen and young adult use is crucial.

Mark Gold M.D.

Mark S. Gold, M.D., is a pioneering researcher, professor, and chairman of psychiatry at Yale, the University of Florida, and Washington University in St Louis. His theories have changed the field, stimulated additional research, and led to new understanding and treatments for opioid use disorders, cocaine use disorders, overeating, smoking, and depression.

Source: https://www.psychologytoday.com/intl/blog/addiction-outlook/202502/5-common-false-beliefs-about-drug-use-users-and-addiction
Filed under: Addiction,Brain and Behaviour,Crime/Violence/Prison,Culture,Economic,HIV/Injecting-Drug-Users,Marijuana and Medicine,Parents,Prevalence,Prevention and Intervention,Psychiatric drugs,Social Affairs (Papers),USA,Vaping :

(1)    Use of Alternative Payment Models for Substance Use Disorder Prevention in the United States: Development of a Conceptual Framework

Journal: Substance Abuse Treatment, Prevention, and Policy, 2025, doi: 10.1186/ s13011-025-00635-z

Authors: Elian Rosenfeld, Sarah Potter, Jennifer Caputo, Sushmita Shoma Ghose, Nelia Nadal, Christopher M. Jones, … Michael T. French

Abstract:

Background: Alternative payment models (APMs) are methods through which insurers reimburse health care providers and are widely used to improve the quality and value of health care. While there is a growing movement to utilize APMs for substance use disorder (SUD) treatment services, they have rarely included SUD prevention strategies. Challenges to using APMs for SUD prevention include underdeveloped program outcome measures, inadequate SUD prevention funding, and lack of clarity regarding what prevention strategies might fit within the scope of APMs.

Methods: In November 2023, the Substance Abuse and Mental Health Services Administration (SAMHSA), through a contract with Westat, convened an expert panel to refine a preliminary conceptual framework developed for utilizing APMs for SUD prevention and to identify strategies to encourage their adoption.

Results: The conceptual framework agreed upon by the panel provides expert consensus on how APMs could finance a variety of prevention programs across diverse populations and settings. Additional efforts are needed to accelerate the support for and adoption of APMs for SUD prevention, and the principles of health equity and community engagement should underpin these efforts. Opportunities to increase the use of APMs for SUD prevention include educating key groups, expanding and promoting the SUD prevention workforce, establishing funding for pilot studies, identifying evidence-based core components of SUD prevention, analyzing the cost effectiveness of APMs for SUD prevention, and aligning funding across federal agencies.

Conclusion: Given that the use of APMs for SUD prevention is a new practice, additional research, education, and resources are needed. The conceptual framework and strategies generated by the expert panel offer a path for future research. SUD health care stakeholders should consider ways that SUD prevention can be effectively and equitably implemented within APMs.

To read the full text of the article, please visit the publisher’s website.

(2)     Quitline-Based Young Adult Vaping Cessation: A Randomized Clinical Trial Examining NRT and mHealth

Journal: American Journal of Preventive Medicine, 2025, doi: 10.1016/j.amepre.2024 .10.019

Authors: Katrina A. Vickerman, Kelly M. Carpenter, Kristina Mullis, Abigail B. Shoben, Julianna Nemeth, Elizabeth Mayers, & Elizabeth G. Klein

Abstract:

Introduction: Broad-reaching, effective e-cigarette cessation interventions are needed.

Study design: This remote, randomized clinical trial tested a mHealth program and nicotine replacement therapy (NRT) for young adult vaping cessation.

Setting/participants: Social media was used from 2021 to 2022 to recruit 508 young adults (aged 18-24 years) in the U.S. who exclusively and regularly (20+ days of last 30) used e-cigarettes and were interested in quitting.

Intervention: All were offered 2 coaching calls and needed to complete the first call for full study enrollment. Participants were randomized to one of 4 groups in the 2×2 design: mailed NRT (8 weeks versus none) and/or mHealth (yes versus no; stand-alone text program including links to videos and online content).

Main outcome measures: Self-reported 7-day point prevalence vaping abstinence at 3 months.

Results: A total of 981 participants were eligible and randomized; 508 (52%) fully enrolled by completing the first call. Enrolled participants were 71% female, 31% non-White, and 78% vaped daily. Overall, 74% completed the 3-month survey. Overall, 83% in the mailed NRT groups and 24% in the no-mailed NRT groups self-reported NRT use. Intent-to-treat 7-day point prevalence abstinence rates (missing assumed vaping) were 41% for calls only, 43% for Calls+mHealth, 48% for Calls+NRT, and 48% for Calls+NRT+mHealth. There were no statistically significant differences for mailed NRT (versus no-mailed NRT; OR=1.3; 95% CI=0.91, 1.84; p=0.14) or mHealth (versus no mHealth; OR=1.04; 95% CI=0.73, 1.47; p=0.84).

Conclusions: This quitline-delivered intervention was successful at helping young adults quit vaping, with almost half abstinent after 3 months. Higher than anticipated quit rates reduced power to identify significant group differences. Mailed NRT and mHealth did not significantly improve quit rates, in the context of an active control of a 2-call coaching program. Future research is needed to examine the independent effects of coaching calls, NRT, and mHealth in a fully-powered randomized control trial.

To read the full text of the article, please visit the publisher’s website.

(3)     The Alcohol Exposome

Journal: Alcohol, 2025, doi: 10.1016/j.alcohol.2024.12.003

Authors: Nousha H. Sabet, & Todd A. Wyatt

Abstract:
Science is now in a new era of exposome research that strives to build a more all-inclusive, panoramic view in the quest for answers; this is especially true in the field of toxicology. Alcohol exposure researchers have been examining the multivariate co-exposures that may either exacerbate or initiate alcohol-related tissue/organ injuries. This manuscript presents selected key variables that represent the Alcohol Exposome. The primary variables that make up the Alcohol Exposome can include comorbidities such as cigarettes, poor diet, occupational hazards, environmental hazards, infectious agents, and aging. In addition to representing multiple factors, the Alcohol Exposome examines the various types of intercellular communications that are carried from one organ system to another and may greatly impact the types of injuries and metabolites caused by alcohol exposure. The intent of defining the Alcohol Exposome is to bring the newly expanded definition of Exposomics, meaning the study of the exposome, to the field of alcohol research and to emphasize the need for examining research results in a non-isolated environment representing a more relevant manner in which all human physiology exists.

To read the full text of the article, please visit the publisher’s website.

(4)     Neural Variability and Cognitive Control in Individuals with Opioid Use Disorder

Journal: JAMA Network Open, 2025, doi: 10.1001/jamanetworkopen.2024.55165

Authors: Jean Ye, Saloni Mehta, Hannah Peterson, Ahmad Ibrahim, Gul Saeed, Sarah Linsky, … Dustin Scheinost

Abstract:

Importance: Opioid use disorder (OUD) impacts millions of people worldwide. Prior studies investigating its underpinning neural mechanisms have not often considered how brain signals evolve over time, so it remains unclear whether brain dynamics are altered in OUD and have subsequent behavioral implications.

Objective: To characterize brain dynamic alterations and their association with cognitive control in individuals with OUD.

Design, setting, and participants: This case-control study collected functional magnetic resonance imaging (fMRI) data from individuals with OUD and healthy control (HC) participants. The study was performed at an academic research center and an outpatient clinic from August 2019 to May 2024.

Exposure: Individuals with OUD were all recently stabilized on medications for OUD (<24 weeks). Main outcomes and measures: Recurring brain states supporting different cognitive processes were first identified in an independent sample with 390 participants. A multivariate computational framework extended these brain states to the current dataset to assess their moment-to-moment engagement within each individual. Resting-state and naturalistic fMRI investigated whether brain dynamic alterations were consistently observed in OUD. Using a drug cue paradigm in participants with OUD, the association between cognitive control and brain dynamics during exposure to opioid-related information was studied. Variations in continuous brain state engagement (ie, state engagement variability [SEV]) were extracted during resting-state, naturalistic, and drug-cue paradigms. Stroop assessed cognitive control.

Results: Overall, 99 HC participants (54 [54.5%] female; mean [SD] age, 31.71 [12.16] years) and 76 individuals with OUD (31 [40.8%] female; mean [SD] age, 39.37 [10.47] years) were included. Compared with HC participants, individuals with OUD demonstrated consistent SEV alterations during resting-state (99 HC participants; 71 individuals with OUD; F4,161 = 6.83; P < .001) and naturalistic (96 HC participants; 76 individuals with OUD; F4,163 = 9.93; P < .001) fMRI. Decreased cognitive control was associated with lower SEV during the rest period of a drug cue paradigm among 70 participants with OUD. For example, lower incongruent accuracy scores were associated with decreased transition SEV (ρ58 = 0.34; P = .008). Conclusions and relevance: In this case-control study of brain dynamics in OUD, individuals with OUD experienced greater difficulty in effectively engaging various brain states to meet changing demands. Decreased cognitive control during the rest period of a drug cue paradigm suggests that these individuals had an impaired ability to disengage from opioid-related information. The current study introduces novel information that may serve as groundwork to strengthen cognitive control and reduce opioid-related preoccupation in OUD.

To read the full text of the article, please visit the publisher’s website.

Source: https://drugfree.org/drug-and-alcohol-news/research-news-roundup-february-13-2025/

Filed under: Addiction,Brain and Behaviour,Culture,Health,Marijuana and Medicine,Mental Health,Treatment and Addiction,USA,Vaping,Youth :

Author(s):  Hannah Elmore, PharmD,John Handshaw, PharmD, BCACP  –  December 23, 2024

Pharmacists can help address nicotine addiction by recommending FDA-approved smoking cessation methods and educating on the risks associated with electronic cigarette use.

Electronic cigarettes (E-cigarettes) have emerged as a popular alternative to traditional smoking. This method, known as vaping, involves inhaling an aerosol that contains nicotine, flavorings, and harmful chemicals including carcinogens, toxic substances, and metals. Nicotine is a highly addictive compound that activates the brain’s reward center by increasing dopamine levels, which creates sensations of pleasure and satisfaction. These euphoric feelings are often what leads to nicotine addiction.1

Although vaping is often perceived as a safer option, it actually carries significant health risks similar to those of traditional cigarettes. Pharmacists can play a vital role in educating patients on the dangers of vaping and providing guidance on safe and effective smoking cessation methods.

E-cigarettes trace back to the 1960s when British American Tobacco created a smoking device under the codename Ariel. At that time, researchers were already aware of nicotine’s addictive properties, but new evidence linking smoking to lung cancer prompted cigarette companies to try and explore alternative products with less risks. They aimed to create an inhalation device with filters to reduce carcinogens and tar. However, it was discovered that filtered cigarettes were not a healthier alternative because all components of cigarette smoke have proven to be harmful. Additionally, if the device only contained pure nicotine, it would warrant classification as a drug-delivery system, subjecting it to stricter regulations. The company wanted to avoid this in order to bypass the stringent safety evaluations and extensive clinical trials required by drug delivery systems, which would allow the company to reduce their manufacturing costs, speed up production, and take this device to the market quicker. They were able to produce a product with 24% nicotine, which is 6 times the concentration found in traditional cigarettes. Despite this innovation, Ariel was discontinued to protect the company’s profitable traditional cigarette market. This marked the first instance of companies exploring the manipulative potential of nicotine.2

E-cigarettes were officially authorized for sale by the FDA in 2007 with over 460 brands. The most popular brand is Juul, accounting for nearly 75% of the e-cigarettes on the market.3,4 In 2022, the FDA banned the sale of Juul products due to conflicting evidence regarding its associated risks, including the potential to cause strokes, respiratory failure, seizures, and cases of e-cigarette or vaping-use-associated lung injury (EVALI).4 EVALI is a condition in which the lungs become severely damaged and often results in admission to the intensive care unit (ICU) on mechanical ventilation.3,4

Additionally, there is also a lack of long-term safety data for these products.5 Although originally marketed as a healthier alternative to cigarettes, e-cigarettes have not demonstrated efficacy as a smoking cessation aid and rather, have led to a rise in the youth vaping epidemic.1

There has been a lack of data correlating successful smoking cessation rates among those who use e-cigarettes. There have been a few studies that suggest that vaping may aid in quitting tobacco but is not effective for quitting nicotine use altogether.6 One study found that those who utilized e-cigarettes in combination with nicotine replacement therapy (NRT) and counseling were 24.3% less likely to quit smoking compared to those who used only NRT and counseling. Additionally, those who used e-cigarettes were 15.1% more likely to become dual users utilizing both tobacco and vaping products. Those who are considered dual users are at an even higher risk for health complications including myocardial infarction and a 4-fold increase in developing lung cancer.6

In another survey of 800 people who utilized vaping as a smoking cessation agent, it was reported that only 9% successfully quit when asked 1 year later, compared to 19.8% who utilized NRT.1,7 These findings help highlight that vaping is not a reliable method for eliminating nicotine use entirely and can even lead to utilizing both traditional and electronic cigarette products.8

Vaping is now the most commonly used form of nicotine among adolescents. A study was conducted that showed high schoolers who had used e-cigarettes were 16.7% more likely to start smoking cigarettes within the next year.9 Nicotine’s impact on the developing brain can cause mood disorders, affect attention and learning, and amplify the desire for other mood-enhancing drugs such as cocaine or methamphetamine.1 In 2018, e-cigarette use among high school students increased by 78%, which led the FDA to enforce stricter regulations on the sale of nicotine products. Despite their efforts, vaping remains a leading challenge that teens face today as they have already fallen victim to nicotine addiction.4

The FDA currently lists 7 approved quit aids that are safe and effective for smoking cessation. These include several forms of NRT as well as pharmacologic therapy with bupropion and varenicline. Some of the agents, including the NRT gum, patch, and lozenge, are even available OTC. Pharmacists can play a vital role in smoking cessation, especially in patients who lack access to a primary care provider to obtain prescription medications. Therefore, it is crucial for pharmacists to stay up to date on the current smoking cessation guidelines, dosing recommendations, and counseling points for these agents.

The primary goal of pharmacist-driven smoking cessation should always be to support the patient’s desire to quit smoking. Pharmacists should guide patients toward the FDA-approved agents, either prescription medications through a provider, or OTC therapies in the pharmacy, rather than electronic cigarettes due to lack of supportive data and increased risk for adverse health events. The appropriate selection of FDA-approved agent should be individualized based on the patient’s specific factors, contraindications, and goals of therapy. Pharmacists should educate the patient extensively on the appropriate options for smoking cessation and should not recommend the use of e-cigarettes. However, if a patient decides to use e-cigarettes, pharmacists should still serve as a support system for the patient by being the primary educator and providing extensive counseling on the associated risks of vaping. Patients should be made aware of both the known and unknown adverse reactions associated with electronic cigarettes as well as highlighting that the goal of vaping should be to achieve complete smoking cessation.10

Vaping e-cigarettes has become a popular alternative to traditional cigarettes, with unknown efficacy and safety surrounding these products.10 Pharmacists should continue to stay up to date on new literature published on e-cigarettes and should follow the FDA’s suggestions on smoking cessation methods. Pharmacists are the most widely accessible health care professionals available to patients. Therefore, pharmacists have the power and knowledge to be the most influential providers available to advise patients on the correct paths to smoking cessation. By offering education and support, pharmacists can help patients live healthier lives and take steps towards reversing the youth smoking epidemic one education at a time.

Source: https://www.pharmacytimes.com/view/clearing-the-air-the-influence-of-vaping-on-smoking-cessation

Filed under: Prevalence,Tobacco, smoking,USA,Vaping :

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