This longitudinal randomized controlled trial examined the effects of anti-vaping social media content on e-cigarette attitudes and intentions among U.S. young adults (ages 18-24; n=3,400).

Previous research suggests that individuals who experience panic attacks are more likely to engage in combustible tobacco use and report higher levels of insomnia symptoms. However, no studies to date have examined this association among adolescents. Additionally, no work has examined if adolescent panic attacks may be indirectly associated with insomnia through nicotine dependence among adolescents who use combustible tobacco and experience panic attacks. The current study aims to address these gaps in the literature by examining the following among adolescents: (1) the level of insomnia symptoms with varying combustible tobacco use and panic attack reports; (2) if nicotine dependence partially accounts for the relations between panic attacks and insomnia symptoms among adolescent combustible tobacco users; and (3) and an exploratory post hoc analysis examined if panic attacks partially account for the relations between nicotine dependence and insomnia symptoms among adolescent combustible tobacco users. A total of 10,148 adolescents aged (Mage = 15.18, SD = 1.51; 51.07% female) within the unweighted sample of the National Comorbidity Survey-Adolescent Supplement (NCS-A) were included in analyses. Adolescents who reported combustible tobacco use and panic attacks indicated higher levels of insomnia symptoms than adolescents who do not smoke or experience panic attacks. Also, adolescent panic attacks were indirectly associated with insomnia symptoms through nicotine dependence among adolescent combustible tobacco users, while nicotine dependence was indirectly associated with insomnia symptoms via panic attacks. These findings are the first step towards understanding the complex association between combustible tobacco use, panic attacks, and insomnia symptoms among adolescents.

Ethical decision-making in sensitive research domains significantly influences data integrity and participant representation. Individuals with past trauma, cultural divergence or acute social stigma may feel excluded from studies with common recruitment and data collection methods (Edelman, 2023). Therefore, sexual health research risks yielding an incomplete, heteronormative perspective that fails to capture the experiences of the most marginalized. This is a problem for Chemsex research where sexualised drug use presents a challenge for research recruitment and engagement. We propose a solution: an inclusive research methodology utilizing synchronous avatar-masked online conversations. Providing a virtual mask for both service-user and practitioner via a digital platform can mitigate inhibitory effects of shame and stigma experienced within the Chemsex community and provides benefits for both parties; an avatar 'masked' practitioner will not display emotional cues indicating judgement, while an avatar 'masked' participant may become more immersed as they personalise their avatar and ensure their anonymity. A digital avatar format enhances participant openness, ensures ethical robustness through trauma-informed design, and offers a scalable vehicle for both qualitative inquiry and the delivery of addiction and sexual health interventions. We provide a checklist to help researchers and supporters develop anonymous avatar-masked interactions, and a checklist for reporting research on sensitive subjects (CRoSS) to help compare studies.

According to the most recent report from the European Union Drugs Agency (EUDA), 18.6% of young adults in Europe used cannabis in 2024. In Portugal, cannabis use among young adults remains poorly characterized, with the latest national survey from 2025 reporting a 21% prevalence. Survey-based data are susceptible to bias, underscoring the need for complementary biological monitoring. This study assessed cannabis use among Portuguese university students using hair and oral fluid (OF) testing, which are non-invasive and provide complementary insights: OF reflects recent consumption, while hair reflects mid- to long-term use. Hair and OF samples from 938 participants across nine universities in northern, central, and southern Portugal were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) for THC, THC-OH, THC-COOH, CBN, and CBD. Participants completed questionnaires on cannabis use, demographics, and consumption behaviors. Associations between self-reported use and measured concentrations were examined, and factors influencing cannabinoid levels were analyzed statistically. Cannabinoid detection rates varied across universities, with northern institutions showing the highest concentrations. OF reflected recent use, whereas hair captured longer-term exposure. Concentrations were influenced by geographic region, tobacco use, and social context of consumption, whereas demographics, age at first use, opinions on legalization, and most hair treatments had minimal impact. Discrepancies emerged between self-report and analytical findings. These findings demonstrate that combining self-report with biological monitoring provides a more accurate and comprehensive assessment of drug use. Regional heterogeneity underscores the value of multi-matrix approaches for research, public health surveillance, and evidence-based interventions, and empathizes the need for updated national data.