Kevin Lewis

November 21, 2017

Borders Up in Smoke: Marijuana Enforcement in Nebraska After Colorado's Legalization of Medicinal Marijuana
Jared Ellison & Ryan Spohn
Criminal Justice Policy Review, December 2017, Pages 847-865

With the passage of Amendments 20 (2000) and 64 (2012), Colorado legalized the medicinal and recreational use of marijuana. Nebraskan law enforcement in border counties subsequently reported increases in arrests and reductions in jail space. In response, the Nebraska state legislature passed LR-520 to study the potential increased costs incurred by criminal justice agencies in border counties. To investigate this situation, we compare trends in drug arrests and jail occupancy across three areas: border counties, those that contain Interstate 80 (I-80) as a major transportation route, and the remaining counties in the state of Nebraska from 2000 through 2013. We found that border counties, but not necessarily those along the I-80 corridor, experienced significant growth in marijuana-related arrests and jail admissions after the expansion of the medical marijuana program in Colorado. Implications for research and policy are discussed.

Helping Settle the Marijuana and Alcohol Debate: Evidence from Scanner Data
Michele Baggio, Alberto Chong & Sungoh Kwon
University of Connecticut Working Paper, November 2017

We use data on purchases of alcoholic beverages in grocery, convenience, drug, or mass distribution stores in US counties for 2006-2015 to study the link between medical marijuana laws and alcohol consumption and focus on settling the debate between the substitutability or complementarity between marijuana and alcohol. To do this we exploit the differences in the timing of the of marijuana laws among states and find that these two substances are substitutes. Counties located in MML states reduced monthly alcohol sales by 15 percent. Our findings are robust to border counties analysis, a placebo effective dates for MMLs in the treated states, and falsification tests using sales of pens and pencils.

Alcohol Intoxication and Metamemory: Little Evidence that Moderate Intoxication Impairs Metacognitive Monitoring Processes
Jacqueline Evans et al.
Applied Cognitive Psychology, November/December 2017, Pages 573-585

There is minimal research on metacognition in alcohol-intoxicated participants. Study 1 examined metacognition across sober, intoxicated, and placebo groups, with the intoxicated group's breath alcohol concentration reaching 0.074 g/210 L on average immediately prior to the metacognition task. Participants answered cued recall general knowledge questions and provided confidence ratings and feeling-of-knowing judgments. They then completed a recognition (i.e., multiple choice) version of the same task, indicating an answer and a confidence rating for each question. Findings suggest that metacognitive accuracy generally did not vary across intoxication levels, although the control group's retrospective confidence judgments better discriminated between accurate and inaccurate responses than the alcohol groups in the recognition task. Study 2 surveyed academic psychologists about their expectations regarding the relation between alcohol and metacognition. Study 1's results were counter to their expectations, as respondents generally predicted a relation would be present. We discuss the implications for alcohol and memory.

Association Between Marijuana Use and Sexual Frequency in the United States: A Population-Based Study
Andrew Sun & Michael Eisenberg
Journal of Sexual Medicine, November 2017, Pages 1342-1347

Methods: We analyzed data from cycle 6 (2002), cycle 7 (2006-2010), and continuous survey (2011-2015) administrations of the National Survey of Family Growth, a nationally representative cross-sectional survey. We used a multivariable model, controlling for demographic, socioeconomic, and anthropographic characteristics, to evaluate whether a relationship between marijuana use and sexual frequency exists.

Results: The results of 28,176 women (average age = 29.9 years) and 22,943 men (average age = 29.5) were analyzed. More than 60% of men and women were Caucasian, and 76.1% of men and 80.4% of women reported at least a high school education. After adjustment, female monthly (incidence rate ratio [IRR] = 1.34, 95% CI = 1.07-1.68, P = .012), weekly (IRR = 1.36, 95% CI = 1.15-1.60, P < .001), and daily (IRR = 1.16, 95% CI = 1.01-1.32, P = .035) marijuana users had significantly higher sexual frequency compared with never users. Male weekly (IRR = 1.22, 95% CI = 1.06-1.41, P = .006) and daily (IRR = 1.36, 95% CI = 1.21-1.53, P < .001) users had significantly higher sexual frequency compared with never users. An overall trend for men (IRR = 1.08, 95% CI = 1.05-1.11, P < .001) and women (IRR = 1.07, 95% CI = 1.04-1.10, P < .001) was identified showing that higher marijuana use was associated with increased coital frequency.

Conclusion: A positive association between marijuana use and sexual frequency is seen in men and women across all demographic groups. Although reassuring, the effects of marijuana use on sexual function warrant further study.

A Randomized Trial of Incentives for Smoking Treatment in Medicaid Members
David Fraser et al.
American Journal of Preventive Medicine, December 2017, Pages 754-763

Study design: Two-group randomized clinical trial of Incentive (n=948) and Control interventions (n=952) for smoking.

Setting/participants: Medicaid recipients recruited from primary care patients (n=920) and callers to the Wisconsin Tobacco Quit Line (n=980).

Intervention: Participants were offered five quitline cessation calls and were encouraged to obtain cessation medication (covered by Medicaid). All participants received payment for completing a baseline assessment and a 6-month smoking test. Only Incentive condition participants received compensation for taking counseling calls ($30 per call) and for biochemically verified abstinence at the 6-month visit ($40).

Results: Incentive condition participants had significantly higher biochemically determined 7-day point-prevalence smoking abstinence rates 6 months after study induction than did Controls (21.6% vs 13.8%, respectively, p<0.0001). A positive treatment effect of incentives was present across other abstinence indices, but the size of effects and levels of abstinence varied considerably across indices. Incentive condition participants were also significantly more likely than non-incentivized Control participants to accept Wisconsin Tobacco Quit Line treatment calls and their acceptance of calls mediated their attainment of higher abstinence rates at 6-month follow-up. The cost/quit/participant averaged $4,268.26 for the Control participants and $3,601.37 for the Incentive participants.

Conclusions: This study shows that fairly moderate levels of incentive payments for treatment engagement and abstinence (a total possible payment of $190) increased very low-income smokers' engagement and success in smoking cessation treatment.

Testing the Question-Behavior Effect of Self-Administered Surveys Measuring Youth Drug Use
John Briney et al.
Journal of Adolescent Health, December 2017, Pages 743-746

Purpose: Concern that asking about a specific behavior could elicit that behavior is often cited as a reason that communities and schools should not administer surveys about youth drug use. In this study, we investigated if this question-behavior effect exists related to substance use. We examined if simply asking a student about their current drug use leads to an increase in drug use 1 year later.

Method: This study tests the validity of the question-behavior effect on youth drug use in a longitudinal panel of 2,002 elementary school students. The sample of students was drawn from the Community Youth Development Study, a community-randomized test of the Communities That Care prevention system. If the prevalence of self-reported drug use in sixth grade in a sample surveyed in fifth and sixth grades was higher than in an accretion sample surveyed only in sixth grade, the difference could indicate a question-behavior effect.

Results: Results from logistic regression analyses did not provide any evidence of a question-behavior effect on 30-day or lifetime prevalence of alcohol, tobacco, inhalant, or marijuana use reported in sixth grade.

Preventing relapse to smoking with transcranial magnetic stimulation: Feasibility and potential efficacy
Christine Sheffer et al.
Drug and Alcohol Dependence, January 2018, Pages 8-18

Many smokers attempt to quit every year, but 90% relapse within 12 months. Converging evidence suggests relapse is associated with insufficient activation of the prefrontal cortex. Delay discounting rate reflects relative activity in brain regions associated with relapse. High-frequency repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (LDLPFC) increases cortical excitability and reduces delay discounting rates, but little is known about feasibility, tolerability, and potential efficacy for smoking cessation. We hypothesized that 8 sessions of 20 Hz rTMS of the LDLPFC combined with an evidence-based self-help intervention will demonstrate feasibility, tolerability, and potential efficacy in a limited double-blind randomized control trial. Smokers (n = 29), abstinent for 24 hours, motivated to quit, and not using cessation medications, were randomized to active 20 Hz rTMS at 110% of Motor Threshold or sham stimulation that replicated the look and sound of active stimulation. Stimulation site was located using the 6 cm rule and neuro-navigation. Multiple clinical, feasibility, tolerability, and efficacy measures were examined. Active rTMS decreased delay discounting of $100 (F (1, 25.3694) = 4.14, p = .05) and $1000 (F (1, 25.169) = 8.42, p < .01), reduced the relative risk of relapse 3-fold (RR 0.29, CI 0.10-0.76, Likelihood ratio χ2 with 1 df = 6.40, p = .01), increased abstinence rates (active 50% vs. sham 15.4%, Χ2 (df = 1) = 3.80, p = .05), and increased uptake of the self-help intervention. Clinical, feasibility, and tolerability assessments were favorable. Combining 20 Hz rTMS of the LDLPFC with an evidence-based self-help intervention is feasible, well-tolerated, and demonstrates potential efficacy.

Impact of Comprehensive Smoking Bans on the Health of Infants and Children
Kerry Anne McGeary et al.
NBER Working Paper, November 2017

As evidence of the negative effects of environmental tobacco smoke (ETS) has mounted, an increasingly popular public policy response has been to impose restrictions on smoking through 100% smoke-free bans. Yet sparse information exists regarding the impact these smoking bans at the state and local levels have on the health of children and infants. A rationale for expansion of smoke-free laws implicitly presumes that potential public health gains from reducing adult cigarette consumption and declines in adult ETS exposure extend to children. However, if smokers compensate by shifting their consumption of cigarettes from public venues that impose a 100% smoke free ban to smoking at home, then these policies may have a harmful effect on children and infants. This study provides comprehensive estimates of how 100% smoke-free regulations impact the venue of smoking, smoking behaviors, and the health of children and infants. Using models that exploit state- and county-level changes to smoking ban legislation over time, estimates suggest that smoking bans have improved the health of both infants and children, mainly through implementation of more comprehensive bans. Further, we find no evidence of compensatory behaviors among smokers (both smokers with and without children in the household), and actually find that the bans had a positive spillover effect in terms of reducing smoking inside the home - an effect which may further explain the improvement in infant and children's health.

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