Search results

Nicotine is consumed by one in five of the global adult population, mostly by smoking tobacco cigarettes. Modern electronic cigarettes came onto the market from around 2007 and have considerable potential to improve population health by displacing tobacco smoking. The purpose of this study is to map the use of e-cigarettes, but this is difficult due to absence of data sources for many countries.

The global number of vapers was estimated to be 68 million in 2020. New data in 2021 offered an opportunity to update that estimate. The method of assumed similarity was used for countries with missing data. The average prevalence of vaping was calculated for each World Health Organization region, World Bank income classification group and the legal status of e-cigarettes in each country. The number of vapers was calculated for the adult population. The estimate was refined by adjusting for changes in market value size and the actual year of surveys.

Population prevalence data on e-cigarette used were available for 48 countries. We estimate that there were 82 million vapers worldwide in 2021: 9.2 million in the Eastern Mediterranean region; 5.6 million in the African region; 20.1 million in the European region; 16.8 million in the Americas; 16.0 million in the Western Pacific region; and 14.3 million in South-East Asia.

Global, regional and national estimates of the numbers of vapers are important indicators of trends in nicotine use, and monitoring the uptake of vaping is important to inform international and national policy.

Rates of self-harm are elevated in prison, and there is limited evidence to support the efficacy of brief risk screening at reception to predict and prevent self-harm. This study aims to examine the predictive validity of the self-harm/suicide screening items embedded in a prison mental health screening tool from two key domains strongly associated with risk: previous suicidal/self-harm behaviour, and recent ideation.

A sample of men and women were screened on entry to prison, with eight screening items covering the two key domains of risk. Follow-up data on self-harm incidents were collected for 12 months post-screening. The predictive validity of individual screening items, item combinations and cumulative screening score was examined for the overall sample and for men and women separately.

Individual screening items across the two domains were all strongly associated with self-harm in the follow-up period, with odds ratios varying from 2.34 to 9.24. The predictive validity of both individual items, item scores and item combinations demonstrated high specificity but low to moderate sensitivity, and modest area under the curves (AUCs). Predictive validity was generally better for men than women; however, differences were not statistically significant.

Identifying those at risk of self-harm in prisons remains challenging and brief universal screening at prison entry should be only one component of a broader prison risk assessment and management strategy.

To the best of the authors’ knowledge, this study is one of very few to prospectively examine self-harm behaviour following risk screening. Predictive validity was examined in a representative sample of individuals in custody, and for men and women separately.

This chapter examines how darknet drug marketplaces operate within platform capitalism. While capitalist power relations remain underexplored in research on digital drug markets, the analysis shows that the basic foundation of cryptomarkets relies on the infrastructure of platform capitalism. The authors use the concept of platform capitalism to explore cryptomarkets in an ideology-critical way. Platforms are infrastructure for the mediation of buyers and vendors; however, they are designed to extract data on the activities of their users. Platform capitalism refers to the process by which the vast collection of user data feeds into the accumulation of capital. The authors use a dialectical method to examine the constellation of digital drug platforms by disclosing a threefold contradiction: state control and self-regulation; visibility and concealment; and legality and illegality. The analysis reveals that darknet drug platforms make a profit not only from the trade of illicit drugs and the collection of user data, but also based on the illegal status of drugs, the associated ideology, and the closed ecology of darknet platforms. Power relations in cryptomarkets thereby mimic those observed in platform capitalism in general. Finally, the authors discuss the implications of platform capitalism for online drug markets.

Despite increasingly persuasive women-focused marketing of gambling products, there has only been limited investigation around women sports betting. Men remain the focus of much of the conversation about sports betting as they have generally been found to be the most active sports bettors and the most at risk of experiencing harms associated with their behaviour. This chapter aims to fill this gap by exploring the characteristics of young women sports bettors in the United Kingdom and the relationship between sports betting and the experience of gambling harms. To do this, we created two models of analysis. Our analysis is based on data from the first wave (2019) of the Emerging Adults Gambling Survey (EAGS) dataset (n = 3,549). The EAGS is a non-probability longitudinal survey that includes individuals between the ages of 16 and 24 who were residents in Britain at the time of data collection. Firstly, we examined the associations between women sports bettors and several factors identified as important predictors of sports betting. Secondly, we sought to understand the relationship between women's sports betting and the harms associated with this activity. From these models, we found that women's sports betting was most reliably predicted according to fandom and peer influence. We also found that women sports bettors were more at risk of experiencing harms associated with difficulties with family and friends than women gamblers using other products.

Cannabis use continues to increase worldwide, and a number of nation states are changing their cannabis policies. Policy changes require research into key populations, namely, people who use cannabis. This study aims to examine sociodemographic differences of young Finns who reported using cannabis mainly for self-medication versus mainly recreationally, as well as their reported effects of cannabis use.

The data come from an anonymous online survey (N = 247, 70.0% males, 25.9% females, 4.1% other) that was analysed using multiple logistic regression. The authors focused on whether various demographic indicators differed between those who reportedly used cannabis mainly for recreational purposes and mainly for self-medicinal purposes. The authors also qualitatively examined the respondents’ experienced effects of cannabis, both desired and undesired.

Being older and female, living in a smaller city and earlier age of initiation of cannabis use were statistically significant in predicting the medicinal use of cannabis. The majority of recreational effects were related to themes such as relaxation and pleasure, but many participants also reported desired medical effects. Similarly, many participants reported several undesired effects.

Understanding especially young people’s motivations to use cannabis, which include using it for various medical effects, can improve the design of harm reduction and treatment programmes as well as enhance the well-being of people who use cannabis.

This study gives a nuanced account of sociodemographic factors and motivations of young people who use cannabis in Finland as well as the reported effects it has on them, which complements data from national drug surveys.

People who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among incarcerated PWUD in Quebec, Canada, during the pandemic.

The authors conducted an observational, cross-sectional study in three Quebec provincial prisons. Participants completed self-administered questionnaires. The primary outcome, “changes in illicit opioid consumption,” was measured using the question “Has your consumption of opioid drugs that were not prescribed to you by a medical professional changed since March 2020?” The association of independent variables and recent changes (past six months) in opioid consumption were examined using mixed-effects Poisson regression models with robust standard errors. Crude and adjusted risk ratios with 95% confidence intervals (95% CIs) were calculated.

A total of 123 participants (median age 37, 76% White) were included from January 19 to September 15, 2021. The majority (72; 59%) reported decreased illicit opioid consumption since March 2020. Individuals over 40 were 11% less likely (95% CI 14–8 vs 18–39) to report a decrease, while those living with others and with a history of opioid overdose were 30% (95% CI 9–55 vs living alone) and 9% (95% CI 0–18 vs not) more likely to report decreased illicit opioid consumption since March 2020, respectively.

The authors identified possible factors associated with changes in illicit opioid consumption among incarcerated PWUD in Quebec. Irrespective of opioid consumption patterns, increased access to opioid agonist therapy and enhanced discharge planning for incarcerated PWUD are recommended to mitigate the harms from opioids and other drugs.

Internationally, rates of suicide and lifetime self-harm are higher in prisoners compared to the general population. This study aims to identify specific characteristics of self-harming behaviour and to establish a profile of prisoners who engage in self-harm.

Data from the Self-Harm Assessment and Data Analysis Project (SADA) on self-harm episodes in prisons in the Republic of Ireland during 2017–2019 was used. Annual rates per 1,000 were calculated by age and gender.

The rate of self-harm between 2017 and 2019 was 31 per 1,000 prisoners for men and six times higher at 184 per 1,000 prisoners for women. The rate of self-harm was twice as high among prisoners on remand than sentenced prisoners (60.5 versus 31.3 per 1,000). The highest rates of self-harm among sentenced prisoners were observed among 18–29-year-old men (45 per 1,000) and women (125 per 1,000). The rate of self-harm was higher among women prisoners in all age groups. Contributory factors associated with self-harm were mainly related to mental health but also linked to a prisoner’s environment and relationships.

There is a need to ensure access to timely and suitable mental health services, including both appropriate referral and provision of evidence-based mental health interventions to address the needs of these cohorts.

To the best of the authors’ knowledge, this is the first national study to systematically examine incidence and patterns of self-harm among the prison population in Ireland. The recording of severity/intent of each episode is novel when assessing self-harm among the prison population.

Domestic abuse (DA) is a major issue with serious psychological, social, societal and economic impacts. Consequently, there has been an increased focus by policymakers and multiple statutory and third-sector agencies on addressing harms associated with DA and fostering healthy intimate and domestic relationships. This paper details the development and implementation of a whole family approach to DA set within a community social services setting.

A detailed description of the development and implementation of a new whole family approach is provided. This includes a focus on the equilibrium programme, an accredited strengths-based, solution-focused group element that has been devised and established for those engaging in harmful behaviours.

The importance of governance, programme support and practitioner supervision are discussed along with the ways these are used by the service. The evaluation framework presented will enable the impact of the programme to be determined over the coming years.

There is clear need to address the significant problem of DA/intimate partner violence. This paper provides a model and accredited treatment approach to implementing a whole family approach to DA set within a community social services setting. This provides an opportunity for early intervention based on a strengths-based, solution focussed approach to addressing harmful behaviours and building skills and resilience.

This paper details a whole system approach to early intervention with families in which there is DA. Providing input via social care child and family support services prior to legal involvement provides an opportunity to avoid an escalation of harms. It also enables solutions to conflict to be found which take account of the relationship between parents and children.