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Governance Studies at Brookings paper

Background Prior research has documented a strong association between cigarette and marijuana use among young adults; it is critical to study patterns and risk factors for co-use. Methods Appended, cross-sectional National Health and Nutrition  Examination Survey (NHANES) data were used to assess prevalence and correlates of cigarette and marijuana co-use among young adults (ages 21–30) over a 10-year period (2005–2014). Respondents (unweighted sample = 4,948) were classified into four categories regarding past-month behavior: neither use, cigarette-only use, marijuana-only use, and co-use of both. Regression models were computed to predict these categories using three waves of NHANES (unweighted sample = 3,073). Results Prevalence of past-month cigarette use decreased from 30.9% in 2005–2006 to 23.7% in 2013–2014 (p = 0.024) while past-month marijuana use (average 18.0%) and past-month co-use (average 9.8%) remained stable during this time. Co-use differed significantly by gender (p < 0.001; average 12.9% men, 6.8% women). Co-users were less likely to be married, more likely to endorse non-Hispanic black racial identity, more likely to have engaged in non-marijuana drug use in their lifetime and more likely to drink alcohol monthly than cigarette-only users. Co-users were more likely to have depressive symptoms, ever use non-marijuana drugs, live with a smoker, and initiate marijuana at a younger age than marijuana-only users. Conclusions Co-use of cigarettes and marijuana remained stable but high over a ten-year period; understanding the unique characteristics, living situations, experiences, and substance use behaviors of co-users can contribute to more effective, tailored prevention and education strategies to reduce the burden of comorbid cigarette and marijuana use.

Maternal smoking quantity seen as vital factor

Increasing number of studies have investigated the impact of maternal exposure to air pollution during pregnancy and adverse birth outcomes, particularly low birth weight (LBW, <2,500 g at birth) and preterm birth (PTB, <37 completed weeks of gestation). We performed a comprehensive review of the peer-reviewed literature and a meta-analysis to quantify the association between maternal exposure to particulate matter with aerodynamic diameter 2.5 and 10 μm (PM 2.5  and PM 10 ) during pregnancy and the risk of LBW and PTB. We identified 20 peer-reviewed articles providing quantitative estimate of exposure and outcome that met our selection criteria. There was significant heterogeneity between studies, particularly for findings related to PM 10  exposure (LBW,  I -squared 54%,  p  = 0.01; PTB,  I -squared = 73%,  p  < 0.01). Results from random-effect meta-analysis suggested a 9% increase in risk of LBW associated with a 10-μg/m 3  increase in PM 2.5  (combined odds ratios (OR), 1.09; 95% confidence interval (CI), 0.90–1.32), but our 95% CI included the null value. We estimated a 15% increase in risk of PTB for each 10-μg/m 3  increase in PM 2.5  (combined OR, 1.15; CI, 1.14–1.16). The magnitude of risk associated with PM 10  exposure was smaller (2% per 10-μg/m 3  increase) and similar in size for both LBW and PTB, neither reaching formal statistical significance. We observed no significant publication bias, with  p  > 0.05 based on both Begg's and Egger's bias tests. Our results suggest that maternal exposure to PM, particularly PM 2.5  may have adverse effect on birth outcomes. Additional mechanistic studies are needed to understand the underlying mechanisms for this association.

  BACKGROUND: There has been mounting interest in the pathophysiological relation between inflammation and psychopathology. In this paper, we examined associations between internalizing and externalizing psychopathology and inflammation in adolescents with a history of severe psychosocial deprivation and children reared in typical family contexts. METHOD: The Bucharest Early Intervention Project is a longitudinal randomized trial of high-quality foster care as an alternative to institutional care. This report is based on 56 institutionalized children randomized to care as usual, 59 institutionalized children randomized to foster care, and 101 never institutionalized children who were recruited as an in-country comparison sample. Externalizing and internalizing behaviors were reported by parents and teachers at ages 8, 12, and 16. At age 16, C-reactive protein (CRP) was derived from blood spots in a subset of participants (n = 127). Multiple-group latent growth curve models were used to examine externalizing and internalizing trajectories and their associations with CRP. RESULTS: Among children assigned to care as usual, higher levels of externalizing behaviors at age 8, as well as smaller decreases in these behaviors from 8 to 16 years predicted higher levels of CRP at age 16. In the same group of children, higher internalizing behaviors at age 8, but not the rate of change in these behaviors, also predicted higher levels of CRP. In contrast, these relations were not observed in the children assigned to foster care and never institutionalized controls. CONCLUSIONS: Early institutional rearing is associated with a coupling of psychopathology and inflammation, whereas early placement into foster care buffers against these risks. These findings have implications for promoting healthy mental and physical development amongst institutionalized children.

Population Development and Review article lauded

Rural coastal areas are highly vulnerable to climate change impacts. In the USA, much energy is devoted to conserving rural coastal ecosystems by promoting their adaptation to climate change. However, these areas are also home to vulnerable and underserved communities who can be challenging to engage in climate adaptation discussions. Churches—as trusted social institutions—may offer a structure through which government decision-makers and rural residents can engage to improve the resilience of these rural coastal regions. We employed collaborative learning to engage government decision-makers and rural church members on the topic of climate impacts on Maryland’s Eastern Shore of the Chesapeake Bay. We analyzed the collaborative learning process and its outcomes using ethnographic methods. In this paper, we present our approach and discuss the benefits and challenges of collaborative learning with rural churches. We found that this approach yielded major benefits including greater understanding of capacities and limitations in addressing environmental challenges, increased trust and social networks, expanded engagement with a greater diversity of stakeholders, increased opportunities for new conversations, new pathways toward interventions, and stakeholder empowerment. Collaborating with churches is not without challenges though; it requires considerable time and effort and presents difficulties in navigating social hierarchies and specialized language, identifying common goals, grappling with the newness of climate change, and overcoming institutional barriers. Despite these challenges, we conclude that collaborative learning with churches is a valuable approach for information exchange and network-building toward more resilient rural coasts.

Laurie DeRose, University of Maryland, et al.; 2014-009

Background Sexual and gender minority (SGM) adolescents are more likely than their heterosexual and cisgender peers to smoke cigarettes. Family rejection has been associated with adverse health outcomes; however, few studies have examined whether SGM-specific family rejection is associated with cigarette smoking among SGM adolescents. Method A non-probability sample of 11,005 SGM adolescents (M = 15.58, SD = 1.27) completed an online cross-sectional survey. Bivariate and multivariable analyses were conducted to examine associations between SGM-specific family rejection, sociodemographic variables, and smoking. Results Approximately 7% of the sample currently smoked cigarettes. Pansexual, asexual, trans boys, and non-binary assigned female at birth adolescents had the highest SGM family rejection scores. In multivariable regression analyses, SGM-specific family rejection was independently associated with smoking after adjusting for covariates (AOR = 1.15, 95% CI 1.04, 1.28). Family support (AOR = 0.80, 95% CI 0.73, 0.88) and experiencing violence (AOR = 1.64, 95% CI 1.49, 1.82) were also associated with smoking in multivariable models. Adolescents who identified as bisexual versus gay/lesbian (AOR = 1.50, 95% CI 1.21, 1.85) and trans boys versus cisgender girls (AOR = 2.05, 95% CI 1.13, 3.71) had an increased odds of smoking. Those who disclosed their sexual orientation identity to most (AOR = 1.95, 95% CI 1.45, 2.63) and all (AOR = 1.60, 95% CI 1.21, 2.11) of their family/parents had increased odds of smoking. Conclusion Our findings underscore the importance of attending to the role of SGM-specific family rejection and distinctions with SGM adolescents in tobacco prevention and smoking cessation efforts.

Newsweek article examines legislative action to develop a plan to increase life expectancy