Use of Electronic Cigarettes as a Predictor of Cannabis Experimentation: A Longitudinal Study Among German Youth.

INTRODUCTION: Experimentation with e-cigarettes is rising among youth, and there are concerns that e-cigarettes could be a new risk factor for initiating substance use. This study aimed to investigate whether e-cigarette use longitudinally predicts experimentation with cannabis. AIMS AND METHODS: During 2017-2019, a prospective cohort study with an observation period of 18 months was conducted with 3040 students from Germany who had never used cannabis (mean age = 14.8, range: 13-18 years). A multiple Poisson regression was used to investigate whether e-cigarette use was an independent predictor of future cannabis use. RESULTS: Lifetime e-cigarette use was reported by 29.4% of the survey population (n = 894) at baseline, and 17.4% (n = 529) initiated cannabis use during the observation period. Among e-cigarette ever users, the initiation rate was 34.5% compared with 10.4% of never users. Results were robust to adjustment for age, sex, migrant status, type of school, sensation seeking, peer cannabis use, the use of alcohol and conventional cigarettes (ARR = 1.83; 95% CI: 1.48-2.25). Further analyses revealed that the association between e-cigarette use and cannabis experimentation was stronger among youth with low sensation-seeking scores (ARR = .77, CI: .61-.97) and no conventional cigarette use (ARR = .48, CI: .37-.64) at baseline. CONCLUSIONS: E-cigarette use is associated with a subsequent initiation of cannabis use. This association seems to be stronger for youth who have a lower risk for substance use in general. Future studies need to investigate whether this is only true for experimental or also more frequent cannabis use. IMPLICATIONS: The study indicates a prospective association between e-cigarette use and initiation of cannabis experimentation independent of other risk factors. It suggests that e-cigarette use is more strongly associated with cannabis initiation for youth with a lower propensity to use substances (low sensation-seekers and non-smokers).

[Predictors and Effects of Cannabis-Related Legal Investigations]. / Prädiktoren und Auswirkungen von Ermittlungsverfahren wegen Cannabis.

BACKGROUND AND OBJECTIVE: In 2018, 218,660 cases of cannabis-related legal investigations were registered by the German police. In the present study, predictors and effects of cannabis-related legal investigations are investigated. METHODS: Retrospective cohort study with 10,432 subjects between 15 and 46 years of age (M=22.2 years, SD=4.8) of which 54.6% were male. The sample recruitment took place in 2018 over social media. The online questionnaire included potential predictors and as outcome measures mental health, social status, unemployment, income, and problematic cannabis and alcohol use. RESULTS: A total of 9,246 subjects (88.6%) had consumed cannabis in their lifetime. A cannabis-related legal investigation had been initiated against 1,736 subjects (18.8%). These individuals were more likely to be male, older, less likely to achieve A-levels, scored higher on sensation seeking, were more likely to report ADHD, started cannabis use earlier, and had higher levels of all cannabis use variables. No significant associations were found between cannabis-related legal investigations and the level of income, unemployment, mental health or subjective social status. Of the never or former consumers, 63.4 and 44.8%, respectively, reported that fear to get into trouble with the law was a reason for non-use. CONCLUSION: There was no evidence that cannabis-related legal investigations had any impact on the current life or health situation. Fears of getting into trouble with the law were particularly relevant for people who had never used, or were currently not using cannabis.

The Effect of Hunger and Satiety on Mood-Related Food Craving.

In addition to hunger, which results from food deprivation, fasting, or restrained eating, food craving is thought to be one of the major factors influencing eating behavior. Although food craving occurs in healthy humans with normal eating behavior, research suggests pronounced food craving to be a risk factor for binging food, which in turn might cause weight gain and obesity. In addition, negative mood seems to induce binge eating, although the underlying processes are not clearly understood. To examine these effects on momentary food craving more closely, we implemented a food cue-reactivity paradigm in 33 normal-weight females (mean age = 25.1 years, mean BMI = 21.6). Mood (negative vs. neutral) and state of food deprivation (hunger vs. satiety) were varied systematically. Self-rated craving was significantly higher in hungry compared to sated states. Moreover, in neutral mood, high-caloric foods modulated craving, i.e., hungry and sated participants preferred savory food and sweet food, respectively. In negative mood, this differential effect of savory and sweet items was absent. In summary, the state of hunger has a huge impact on food craving, which is further modulated by emotional state. Future research should consider hunger to be of high relevance for effects investigated in food-related paradigms. Our findings in healthy women of normal weight support etiological models of disturbed eating behavior and are in line with common interventions targeting eating schedules and mood regulation.

[Risk factors for risky cannabis use : A retrospective cohort study of 7671 cannabis users]. / Risikofaktoren für einen riskanten Cannabiskonsum : Eine retrospektive Kohortenstudie mit 7671 Cannabisnutzern.

BACKGROUND: Cannabis use is widespread in Germany. So far little is known about which factors are predictive for the development of risky cannabis use. METHODS: A retrospective cohort study was conducted. Via social networks 7671 cannabis users (mean age = 21.8 years, standard deviation (SD) = 4.5 years) were recruited (59.3% male). The end point of the online study was risky cannabis use, which was assumed with a cut-off >3 of the Severity of Dependence Scale (SDS). Predictors were gender, age, migration status, sensation seeking, a diagnosis of attention deficit hyperactivity disorder (ADHD), the age of first use and the prevalence of cannabis use in school time. In addition, characteristics of the parental home were surveyed, such as socioeconomic status, parenting style, the relationship with the parents, and mental health of the parents. RESULTS: Risky cannabis use was reported by 29.7% of the sample. The following risk factors predicted risky cannabis use: male gender (adjusted risk ratio, ARR: 1.25), higher age (ARR: 1.01), migration status (ARR: 1.13), higher sensation seeking (ARR: 1.08), earlier onset of cannabis use (ARR: 0.94), more frequent cannabis use among peers during school time (ARR: 1.21), unstable relationship with parents (ARR: 0.97), and lower parental mental health (father: ARR: 0.98; mother: ARR: 0.96). No associations could be found for a diagnosis of ADHD, parental socioeconomic status and parenting style. CONCLUSION: Potentially influenceable risk factors for risky cannabis use are relationship quality in the parental home and early onset of cannabis use.

Cessation of cannabis use: A retrospective cohort study.

Given recent findings of a worldwide increase in cannabis use, a better understanding of the factors associated with cannabis use is needed. Most previous studies have focused on factors that predict the initiation of cannabis use, but less is known about factors associated with cessation. The present study is a retrospective cohort study of 6467 current or former cannabis users aged 15 to 46 years (mean age 22.5, SD = 4.8). Data were collected via an online survey advertised in social media. All analyzed participants had used cannabis for at least three years. Approximately 16.3% (n = 1055) of the sample population had not used cannabis in the previous 12 months and were classified as quitters; all others (83.7%, n = 5412) reported at least monthly use. Cessation was predicted by older current age, being female, nonmigrant status, less sensation seeking, using psychological treatment, more peer cannabis use during youth and more negative first experience with cannabis. An additional predictor was a nonincrease in the frequency of cannabis use in the first three years of use, indicating that trajectories of cannabis use are set early on and might be used to identify risk groups for early preventive measures.

The endocrine phenotype in silver-russell syndrome is defined by the underlying epigenetic alteration.

CONTEXT: Around 50% of children with Silver-Russell syndrome (SRS) carry a hypomethylation of the imprinting control region 1 at the IGF2/H19 locus on 11p15, the functional significance of which is unknown. OBJECTIVE: We aimed to compare the genotype in SRS with the endocrine phenotype. DESIGN: The retrospective study included all SRS children who were treated during the last 18 yr at our hospital and for comparison a cohort of GH treated nonsyndromic short children born small for gestational age (SGA). PATIENTS: The 61 patients with SRS included were defined by the presence of intrauterine growth retardation, lack of catch-up growth, and at least two of the criteria: typical face, relative macrocephaly, and skeletal asymmetry. Routine karyotype and GH secretion was normal in all children studied. A subgroup of 53 patients was treated with GH. MATERIALS AND METHODS: Genomic DNA was available from 44 children. Multiplex ligation probe-dependent amplification analysis was performed to detect hypomethylation at the imprinting control region 1 on 11p15. Uniparental disomy of chromosome 7 (UPD7) was analyzed by short tandem repeats typing. Serum levels of GH, IGF-I, and IGF-binding protein (IGFBP)-3 were measured by RIA. RESULTS: Epimutations at 11p15 were found in 19 of 44, UPD7 in five of 44, and small structural aberrations of the short arm of chromosome 11 in two of 44 children. Of 44 cases, 18 were negative for any genetic defect known (41%). The most severe phenotype was found in children with 11p15-SRS. Children with UPD7-SRS had a significantly higher birth length (P < 0.004) but lost height sd score (SDS) postpartum, whereas children with 11p15-SRS showed no change in height SDS. IGF-I and IGFBP-3 serum levels were inadequately high in 11p15-SRS at -0.02 SDS (1.07, sd) and +1.38 SDS (1.01), compared with the low levels in UPD7-SRS and in the cohort of 58 nonsyndromic SGA children (P < 0.0009). During GH therapy, IGFBP-3 serum levels increased above normal values in 11p15-SRS (P < 10(-4)), whereas IGF-I increase was moderate. There was a trend toward more height gain in children with UPD7 than in those with 11p15 epimutation under GH therapy (+2.5 vs. +1.9 height SDS after 3 yr) (P = 0.08). CONCLUSIONS: Children with SRS and an 11p15 epimutation have IGFBP-3 excess and show endocrine characteristics suggesting IGF-I insensitivity, whereas children with SRS and UPD7 were not different from nonsyndromic short children born SGA. This phenotype-genotype correlation implicates divergent endocrine mechanisms of growth failure in SRS.