International Journal of Environmental Research and Public Health

Editorial

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7 pages, 263 KiB

Open AccessEditorial

Missing in Action: Sex and Gender in Substance Use Research

by Lorraine Greaves

Int. J. Environ. Res. Public Health 2020, 17(7), 2352; https://doi.org/10.3390/ijerph17072352 - 31 Mar 2020

Cited by 21 | Viewed by 7848

Abstract

Substance use and misuse is a significant global health issue that requires a sex- and gender-based analysis. Substance use patterns and trends are gendered: that is, women and men, girls and boys, and gender-diverse people often exhibit different rates of use of substances, [...] Read more.

Substance use and misuse is a significant global health issue that requires a sex- and gender-based analysis. Substance use patterns and trends are gendered: that is, women and men, girls and boys, and gender-diverse people often exhibit different rates of use of substances, reasons for use, modes of administration, and effects of use. Sex-specific effects and responses to substances are also important, with various substances affecting females and males differentially. Nevertheless, much research and practice in responding to substance use and misuse remains gender blind, ignoring the impacts of sex and gender on this important health issue. This special issue identifies how various aspects of sex and gender matter in substance use, illustrates the application of sex- and gender-based analyses to a range of substances, populations and settings, and assists in progressing sex and gender science in relation to substance use. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

Research

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15 pages, 333 KiB

Open AccessArticle

Understanding the Relationship between Predictors of Alcohol Consumption in Pregnancy: Towards Effective Prevention of FASD

by Isabel Corrales-Gutierrez, Ramon Mendoza, Diego Gomez-Baya and Fatima Leon-Larios

Int. J. Environ. Res. Public Health 2020, 17(4), 1388; https://doi.org/10.3390/ijerph17041388 - 21 Feb 2020

Cited by 17 | Viewed by 5602

Abstract

Background: Prenatal alcohol exposure can produce serious changes in neurodevelopment that last a lifetime, as well as a wide range of congenital abnormalities, and is the main non-hereditary, avoidable cause of intellectual disability in developed countries. It is therefore crucial to understand the [...] Read more.

Background: Prenatal alcohol exposure can produce serious changes in neurodevelopment that last a lifetime, as well as a wide range of congenital abnormalities, and is the main non-hereditary, avoidable cause of intellectual disability in developed countries. It is therefore crucial to understand the determinants of alcohol consumption during pregnancy. This study is aimed at determining the factors that predict it, as well as the interactions between them. Methods: A cross-sectional study was carried out using a random sample of 426 pregnant women being treated at the outpatient clinic of a public university hospital in Seville (Spain), when they were in their twentieth week of pregnancy. A custom-designed questionnaire was used for data collection and applied in the course of an interview administered by trained health professionals. The data collected were analyzed using hierarchical regression, moderation analysis, and a structural equations model. Results: Alcohol consumption prior to pregnancy proved to be the most powerful predictor of alcohol intake during pregnancy. Other particularly significant predictors were the percentage of professionals who gave correct advice to the expectant mother—not to consume any alcohol during pregnancy—and perception of the risk from drinking wine during pregnancy. The number of pregnancies correlates positively with alcohol intake during pregnancy, while the expectant mother’s level of education correlates negatively. Conclusions: Identifying these predictive factors will allow the design of more effective fetal alcohol spectrum disorder (FASD) prevention strategies. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

14 pages, 731 KiB

Open AccessArticle

Computerized Clinical Decision Support System for Prompting Brief Alcohol Interventions with Treatment Seeking Smokers: A Sex-Based Secondary Analysis of a Cluster Randomized Trial

by Nadia Minian, Anna Ivanova, Sabrina Voci, Scott Veldhuizen, Laurie Zawertailo, Dolly Baliunas, Aliya Noormohamed, Norman Giesbrecht and Peter Selby

Int. J. Environ. Res. Public Health 2020, 17(3), 1024; https://doi.org/10.3390/ijerph17031024 - 6 Feb 2020

Cited by 4 | Viewed by 3923

Abstract

Although brief alcohol intervention can reduce alcohol use for both men and women, health care providers (HCPs) are less likely to discuss alcohol use or deliver brief intervention to women compared to men. This secondary analysis examined whether previously reported outcomes from a [...] Read more.

Although brief alcohol intervention can reduce alcohol use for both men and women, health care providers (HCPs) are less likely to discuss alcohol use or deliver brief intervention to women compared to men. This secondary analysis examined whether previously reported outcomes from a cluster randomized trial of a clinical decision support system (CDSS)—prompting delivery of a brief alcohol intervention (an educational alcohol resource) for patients drinking above cancer guidelines—were moderated by patients’ sex. Patients (n = 5702) enrolled in a smoking cessation program at primary care sites across Ontario, Canada, were randomized to either the intervention (CDSS) or control arm (no CDSS). Logistic generalized estimating equations models were fit for the primary and secondary outcome (HCP offer of resource and patient acceptance of resource, respectively). Previously reported results showed no difference between treatment arms in HCP offers of an educational alcohol resource to eligible patients, but there was increased acceptance of the alcohol resource among patients in the intervention arm. The results of this study showed that these CDSS intervention effects were not moderated by sex, and this can help inform the development of a scalable strategy to overcome gender disparities in alcohol intervention seen in other studies. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

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14 pages, 335 KiB

Open AccessArticle

Sex and Polytobacco Use among Spanish and Turkish University Students

by Sílvia Font-Mayolas, Mark J. M. Sullman and Maria-Eugenia Gras

Int. J. Environ. Res. Public Health 2019, 16(24), 5038; https://doi.org/10.3390/ijerph16245038 - 11 Dec 2019

Cited by 10 | Viewed by 19851

Abstract

Polytobacco use has become increasingly popular among young adults, particularly males, and can be defined as the concurrent use of regular cigarettes and other tobacco products (e.g., e-cigarettes). The present study investigated the use of legal smoking products (cigarettes, waterpipe and electronic cigarettes) [...] Read more.

Polytobacco use has become increasingly popular among young adults, particularly males, and can be defined as the concurrent use of regular cigarettes and other tobacco products (e.g., e-cigarettes). The present study investigated the use of legal smoking products (cigarettes, waterpipe and electronic cigarettes) among young adults (n = 355) in Spain and Turkey. The survey measured demographics, lifetime and past month tobacco use, waterpipe and e-cigarette use, whether waterpipes and e-cigarettes contained nicotine and reasons for using these substances. The majority of the Turkish (men = 80% and women = 63.9%) and Spanish sample (men = 61.4% and women = 69.3%) were polytobacco users. The most common reason for using e-cigarettes was “to experiment, to see what is like” (Turkish sample: men 66.7% and women 57.1; Spanish sample: men 72.7% and women 93.8%). The most common reason to use regular cigarettes was “to relax and relieve tension” (Turkish sample: men 88.9% and women 77.6%; Spanish sample: men 78.1% and women 76%), while for waterpipe users, the most common reason was “to experiment, to see what it is like” (Turkish sample: men 93.3% and women 80%; Spanish sample: men 78.9% and women 93.8%). The implications for prevention and future research are discussed. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

16 pages, 1217 KiB

Open AccessArticle

Gender Equality, Drinking Cultures and Second-Hand Harms from Alcohol in the 50 US States

by Katherine J. Karriker-Jaffe, Christina C. Tam, Won Kim Cook, Thomas K. Greenfield and Sarah C.M. Roberts

Int. J. Environ. Res. Public Health 2019, 16(23), 4619; https://doi.org/10.3390/ijerph16234619 - 21 Nov 2019

Cited by 7 | Viewed by 4412

Abstract

Background: Gender inequality and cultures of binge drinking may increase the risk of second-hand harms from alcohol. Methods: Using the 2014–2015 National Alcohol Survey and 2015 National Alcohol’s Harm to Others Survey (N = 7792), we examine associations of state-level gender equality measures [...] Read more.

Background: Gender inequality and cultures of binge drinking may increase the risk of second-hand harms from alcohol. Methods: Using the 2014–2015 National Alcohol Survey and 2015 National Alcohol’s Harm to Others Survey (N = 7792), we examine associations of state-level gender equality measures (contraceptive access, abortion rights, women’s economic equality) and binge drinking cultures (rates of men’s and women’s binge drinking) with individual-level indicators of second-hand harms by drinking strangers and partners/spouses. Results: In main effects models, only male binge drinking was associated with greater odds of harms from drinking strangers. There were significant interactions of gender equality with male binge drinking: High male binge drinking rates were more strongly associated with stranger-perpetrated harms in states low on contraceptive access or abortion rights compared to states high on these measures. Conversely, male binge drinking was more strongly associated with spouse/partner-perpetrated second-hand harms in states with more economic equality, compared to states lower on this measure. Conclusions: Detrimental effects of high male binge drinking rates may be modified by gender equality. Targeted interventions may reduce alcohol-related harms experienced by women in states with high rates of male binge drinking. Restrictions in access to contraception and abortion may exacerbate harms due to men’s drinking. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

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13 pages, 309 KiB

Open AccessArticle

Multi-Dimensional Factors Associated with Illegal Substance Use Among Gay and Bisexual Men in Taiwan

by Dian-Jeng Li, Shiou-Lan Chen and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2019, 16(22), 4476; https://doi.org/10.3390/ijerph16224476 - 14 Nov 2019

Cited by 12 | Viewed by 2860

Abstract

Illegal substance use in sexual minorities is an important health issue worldwide. The present cross-sectional study aimed to investigate the multi-dimensional factors associated with illegal substance use among gay and bisexual men in Taiwan. This questionnaire-survey study recruited 500 gay or bisexual men [...] Read more.

Illegal substance use in sexual minorities is an important health issue worldwide. The present cross-sectional study aimed to investigate the multi-dimensional factors associated with illegal substance use among gay and bisexual men in Taiwan. This questionnaire-survey study recruited 500 gay or bisexual men aged between 20 and 25 years. Their experiences of using eight kinds of illegal substances in the preceding month were collected. Their previous experiences of homophobic bullying, satisfaction with academic performance, truancy, perceived family and peer support in childhood and adolescence, and social-demographic characteristics, were also collected. Potential factors associated with illegal substance use were identified using univariate logistic regression, and further selected into a forward stepwise logistic regression model to identify the factors most significantly related to illegal substance use. A total of 22 (4.4%) participants reported illegal substance use in the preceding month, and mean age was 22.9 ± 1.6. Forward stepwise logistic regression revealed that being victims of homophobic cyberbullying in childhood and adolescence (odds ratio (OR) = 1.26; p = 0.011), disclosure of sexual orientation at junior high school (OR = 4.67; p = 0.001), and missing classes or truancy in senior high school (OR = 2.52; p = 0.041) were significantly associated with illegal substance use in early adulthood. Multi-dimensional factors in childhood and adolescence that were significantly associated with illegal substance use in early adulthood among gay and bisexual men were identified. Besides traditional bullying, the effect of cyberbullying and school performance on illegal substance use should not be ignored. This study is limited to the cross-sectional design and possible recall bias. Mental health professionals must routinely assess these significant factors to prevent and intervene in illegal substance use among gay and bisexual men. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

12 pages, 753 KiB

Open AccessArticle

Effect of Sex on the Association Between Nonmedical Use of Opioids and Sleep Disturbance Among Chinese Adolescents: A Cross-Sectional Study

by Di Xiao, Lan Guo, Meijun Zhao, Sheng Zhang, Wenyan Li, Wei-Hong Zhang and Ciyong Lu

Int. J. Environ. Res. Public Health 2019, 16(22), 4339; https://doi.org/10.3390/ijerph16224339 - 7 Nov 2019

Cited by 7 | Viewed by 2656

Abstract

Sleep disturbance and non-medical prescription opioid use (NMPOU) are currently growing public health concerns, and sex differences may result in differential exposure to frequency of NMPOU or sleep disturbance. This study aimed to explore the association between the frequency of lifetime or past-year [...] Read more.

Sleep disturbance and non-medical prescription opioid use (NMPOU) are currently growing public health concerns, and sex differences may result in differential exposure to frequency of NMPOU or sleep disturbance. This study aimed to explore the association between the frequency of lifetime or past-year NMPOU and sleep disturbance and to evaluate whether there was any sex difference in this association among Chinese adolescents. A cross-sectional study was performed in seven randomly selected Chinese provinces through the 2015 School-Based Chinese Adolescents Health Survey. A total of 159,640 adolescents were invited to participate and among them, 148,687 adolescents’ questionnaires were completed and qualified for this study (response rate: 93.14%). All analyses were performed for boys and girls separately. There were significant sex differences in the prevalence of lifetime or past-year opioid misuse and sleep disturbance (p < 0.05). Among girls, frequent lifetime NMPOU (adjusted odds ratio [aOR] = 2.09, 95% CI = 1.80–2.44) and past-year NMPOU (aOR = 2.16, 95% CI = 1.68–2.77) were positively associated with sleep disturbance. Among boys, these associations were also statistically significant, while the magnitudes of associations between frequent lifetime NMPOU or past-year NMPOU and sleep disturbance were greater in girls than those in boys. There is a significant sex difference in the prevalence of lifetime or past-year NMPOU and sleep disturbance. Furthermore, exposure to more frequent lifetime or past-year NMPOU is associated with a greater risk of sleep disturbance, especially among girls. Taking into account the sex difference for lifetime or past-year NMPOU may help to decrease the risk of sleep disturbance. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

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18 pages, 325 KiB

Open AccessArticle

Multi-Service Programs for Pregnant and Parenting Women with Substance Use Concerns: Women’s Perspectives on Why They Seek Help and Their Significant Changes

by Carol Hubberstey, Deborah Rutman, Rose A. Schmidt, Marilyn Van Bibber and Nancy Poole

Int. J. Environ. Res. Public Health 2019, 16(18), 3299; https://doi.org/10.3390/ijerph16183299 - 8 Sep 2019

Cited by 22 | Viewed by 6143

Abstract

Within Canada, several specialized multi-service prevention programs work with highly vulnerable pregnant and early parenting women with substance use issues. Experiences of trauma, mental health, poverty, and other factors associated with the social determinants of health complete the picture. Program evaluations have demonstrated [...] Read more.

Within Canada, several specialized multi-service prevention programs work with highly vulnerable pregnant and early parenting women with substance use issues. Experiences of trauma, mental health, poverty, and other factors associated with the social determinants of health complete the picture. Program evaluations have demonstrated their value, but less has been said as to women’s reasons for choosing to seek help from these programs, what they were hoping to gain, or what difference they believe has occurred as a result. The Co-creating Evidence project is a multi-year (2017–2020) national evaluation of holistic programs serving women at high risk of having an infant with prenatal alcohol or substance exposure. The evaluation uses a mixed methods design involving quarterly program output and “snapshot” client data, as well as in-person, semi-structured interviews and questionnaires with clients, program staff, and program partners. This article presents findings from interviews with women regarding why they sought help, how they used the services, and what they perceived to be the most significant change in their lives as a result. Obtaining help with substance use was the top theme for what women hoped to get from their participation in their program; however, women’s reasons were often intertwined. Additional motivations included wanting information, support or assistance with: child welfare; pregnancy; housing; getting connected to health care or prenatal care; and opportunities for peer support. With respect to the most significant life change, themes included: reduced substance use; improved housing; stronger mother–child connection; and improved wellness and social connections. Findings demonstrated that vulnerable, marginalized pregnant and parenting women who are using substances will seek help when health and social care services are configured in such a way as to take into consideration and address their unique roles, responsibilities, and realities. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

Review

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14 pages, 438 KiB

Open AccessReview

Technology-Based Substance Use Interventions: Opportunities for Gender-Transformative Health Promotion

by Julie Stinson, Lindsay Wolfson and Nancy Poole

Int. J. Environ. Res. Public Health 2020, 17(3), 992; https://doi.org/10.3390/ijerph17030992 - 5 Feb 2020

Cited by 8 | Viewed by 3964

Abstract

Drawing on data from a scoping review on sex, gender and substance use, this narrative review explores the use of gender-informed and technology-based approaches in substance use prevention and health promotion interventions. With an ever-changing landscape of new technological developments, an understanding of [...] Read more.

Drawing on data from a scoping review on sex, gender and substance use, this narrative review explores the use of gender-informed and technology-based approaches in substance use prevention and health promotion interventions. With an ever-changing landscape of new technological developments, an understanding of how technology-based interventions can address sex, gender, and intersecting equity considerations related to substance use is warranted. Current technology-based approaches to substance use prevention and health promotion are described and assessed for gender-specific and gender transformative outcomes, and limitations are discussed related to inclusivity, access, confidentiality, and a dearth of research on technological approaches that integrate gender-based analysis. A call for action designed to advance technology-based health promotion, prevention and brief interventions that address gender equity simultaneously with substance use is proposed. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

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31 pages, 724 KiB

Open AccessReview

Gender Norms, Roles and Relations and Cannabis-Use Patterns: A Scoping Review

by Natalie Hemsing and Lorraine Greaves

Int. J. Environ. Res. Public Health 2020, 17(3), 947; https://doi.org/10.3390/ijerph17030947 - 4 Feb 2020

Cited by 84 | Viewed by 9266

Abstract

Currently, boys and men use cannabis at higher rates than girls and women, but the gender gap is narrowing. With the legalization of recreational cannabis use in Canada and in multiple US states, these trends call for urgent attention to the need to [...] Read more.

Currently, boys and men use cannabis at higher rates than girls and women, but the gender gap is narrowing. With the legalization of recreational cannabis use in Canada and in multiple US states, these trends call for urgent attention to the need to consider how gender norms, roles and relations influence patterns of cannabis use to inform health promotion and prevention responses. Based on a scoping review on sex, gender and cannabis use, this article consolidates existing evidence from the academic literature on how gender norms, roles and relations impact cannabis-use patterns. Evidence is reviewed on: adherence to dominant masculine and feminine norms and cannabis-use patterns among adolescents and young adults, and how prevailing norms can be both reinstated or reimagined through cannabis use; gendered social dynamics in cannabis-use settings; and the impact of gender roles and relations on cannabis use among young adults of diverse sexual orientations and gender identities. Findings from the review are compared and contrasted with evidence on gender norms, roles and relations in the context of alcohol and tobacco use. Recommendations for integrating gender transformative principles in health promotion and prevention responses to cannabis use are provided. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

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16 pages, 495 KiB

Open AccessReview

Sex- and Gender-Based Analysis in Cannabis Treatment Outcomes: A Systematic Review

by Andreea C. Brabete, Lorraine Greaves, Natalie Hemsing and Julie Stinson

Int. J. Environ. Res. Public Health 2020, 17(3), 872; https://doi.org/10.3390/ijerph17030872 - 30 Jan 2020

Cited by 16 | Viewed by 12601

Abstract

There is evidence that sex- and gender-related factors are involved in cannabis patterns of use, health effects and biological mechanisms. Women and men report different cannabis use disorder (CUD) symptoms, with women reporting worse withdrawal symptoms than men. The objective of this systematic [...] Read more.

There is evidence that sex- and gender-related factors are involved in cannabis patterns of use, health effects and biological mechanisms. Women and men report different cannabis use disorder (CUD) symptoms, with women reporting worse withdrawal symptoms than men. The objective of this systematic review was to examine the effectiveness of cannabis pharmacological interventions for women and men and the uptake of sex- and gender-based analysis in the included studies. Two reviewers performed the full-paper screening, and data was extracted by one researcher. The search yielded 6098 unique records—of which, 68 were full-paper screened. Four articles met the eligibility criteria for inclusion. From the randomized clinical studies of pharmacological interventions, few studies report sex-disaggregated outcomes for women and men. Despite emergent evidence showing the influence of sex and gender factors in cannabis research, sex-disaggregated outcomes in pharmacological interventions is lacking. Sex- and gender-based analysis is incipient in the included articles. Future research should explore more comprehensive inclusion of sex- and gender-related aspects in pharmacological treatments for CUD. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

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15 pages, 742 KiB

Open AccessReview

Sex and Gender Interactions on the Use and Impact of Recreational Cannabis

by Lorraine Greaves and Natalie Hemsing

Int. J. Environ. Res. Public Health 2020, 17(2), 509; https://doi.org/10.3390/ijerph17020509 - 14 Jan 2020

Cited by 71 | Viewed by 12429

Abstract

Cannabis is the second most frequently used substance in the world and regulated or legalized for recreational use in Canada and fourteen US states and territories. As with all substances, a wide range of sex and gender related factors have an influence on [...] Read more.

Cannabis is the second most frequently used substance in the world and regulated or legalized for recreational use in Canada and fourteen US states and territories. As with all substances, a wide range of sex and gender related factors have an influence on how substances are consumed, their physical, mental and social impacts, and how men and women respond to treatment, health promotion, and policies. Given the widespread use of cannabis, and in the context of its increasing regulation, it is important to better understand the sex and gender related factors associated with recreational cannabis use in order to make more precise clinical, programming, and policy decisions. However, sex and gender related factors include a wide variety of processes, features and influences that are rarely fully considered in research. This article explores myriad features of both sex and gender as concepts, illustrates their impact on cannabis use, and focuses on the interactions of sex and gender that affect three main areas of public interest: the development of cannabis use dependence, the impact on various routes of administration (ROA), and the impact on impaired driving. We draw on two separate scoping reviews to examine available evidence in regard to these issues. These three examples are described and illustrate the need for more comprehensive and precise integration of sex and gender in substance use research, as well as serious consideration of the results of doing so, when addressing a major public health issue such as recreational cannabis use. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

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17 pages, 485 KiB

Open AccessReview

Gender Informed or Gender Ignored? Opportunities for Gender Transformative Approaches in Brief Alcohol Interventions on College Campuses

by Lindsay Wolfson, Julie Stinson and Nancy Poole

Int. J. Environ. Res. Public Health 2020, 17(2), 396; https://doi.org/10.3390/ijerph17020396 - 7 Jan 2020

Cited by 6 | Viewed by 3540

Abstract

Brief alcohol interventions are an effective strategy for reducing harmful and risky alcohol use and misuse. Many effective brief alcohol interventions include information and advice about an individual’s alcohol use, changing their use, and assistance in developing strategies and goals to help reduce [...] Read more.

Brief alcohol interventions are an effective strategy for reducing harmful and risky alcohol use and misuse. Many effective brief alcohol interventions include information and advice about an individual’s alcohol use, changing their use, and assistance in developing strategies and goals to help reduce their use. Emerging research suggests that brief interventions can also be expanded to address multiple health outcomes; recognizing that the flexible nature of these approaches can be helpful in tailoring information to specific population groups. This scoping review synthesizes evidence on the inclusion of sex and gender in brief alcohol interventions on college campuses, highlighting available evidence on gender responsiveness in these interventions. Furthermore, this scoping review offers strategies on how brief alcohol interventions can be gender transformative, thereby enhancing the effectiveness of brief alcohol interventions as harm reduction and prevention strategies, and in promoting gender equity. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

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18 pages, 876 KiB

Open AccessReview

Fathers’ Views and Experiences of Creating a Smoke-Free Home: A Scoping Review

by Rachel O’Donnell, Kathryn Angus, Peter McCulloch, Amanda Amos, Lorraine Greaves and Sean Semple

Int. J. Environ. Res. Public Health 2019, 16(24), 5164; https://doi.org/10.3390/ijerph16245164 - 17 Dec 2019

Cited by 16 | Viewed by 5245

Abstract

Enabling parents to create a smoke-free home is one of the key ways that children’s exposure to second-hand smoke (SHS) can be reduced. Smoke-free home interventions have largely targeted mothers who smoke, and there is little understanding of the barriers and facilitators that [...] Read more.

Enabling parents to create a smoke-free home is one of the key ways that children’s exposure to second-hand smoke (SHS) can be reduced. Smoke-free home interventions have largely targeted mothers who smoke, and there is little understanding of the barriers and facilitators that fathers experience in creating a smoke-free home. Systematic searches combining terms for fathers, homes, and SHS exposure were run in April 2019 in Web of Science’s Citation Indices, PsycINFO, and PubMed for English-language studies published since 2008. The searches identified 980 records for screening, plus 66 records from other sources. Twelve studies reported in 13 papers were included in this scoping review. Eight of the studies were conducted in Asian countries (five in China, one in India, one in Japan, and one in Iran), three were conducted in Canada, and one in Turkey. Findings were extracted in verbatim text for thematic analysis. The review identified that attitudes and knowledge, cultural and social norms, gender power relations, and shifting perceptions and responsibilities related to fatherhood can impact on fathers’ views of their role in relation to creating and maintaining a smoke-free home. There were too few published studies that had assessed smoke-free home interventions with fathers to draw conclusions regarding effective approaches. Research is clearly needed to inform our understanding of fathers’ roles, successes and challenges in creating and maintaining a smoke-free home, so that father-inclusive rather than mother-led interventions can be developed to benefit entire households and improve gender equity as well as health. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

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14 pages, 663 KiB

Open AccessReview

Using a Developmental-Relational Approach to Understand the Impact of Interpersonal Violence in Women Who Struggle with Substance Use

by Naomi C. Z. Andrews, Mary Motz, Bianca C. Bondi, Margaret Leslie and Debra J. Pepler

Int. J. Environ. Res. Public Health 2019, 16(23), 4861; https://doi.org/10.3390/ijerph16234861 - 3 Dec 2019

Cited by 8 | Viewed by 4805

Abstract

Substance use among women is a major public health concern. This review article takes a developmental-relational approach to examine processes through which early relational trauma and violence in relationships may lead to substance use. We examine how early exposure to violence in relationships [...] Read more.

Substance use among women is a major public health concern. This review article takes a developmental-relational approach to examine processes through which early relational trauma and violence in relationships may lead to substance use. We examine how early exposure to violence in relationships can impact neurological development, specifically through interference with physiological mechanisms (e.g., the hypothalamic-pituitary-adrenal axis), brain structure and functioning (e.g., the hippocampus and prefrontal cortex), and neuropsychological development (e.g., executive functioning and emotion regulation) across the lifespan. Further, we discuss the impact of exposure to violence on the development of relational capacity, including attachment, internal working models, and subsequent interpersonal relationships across the lifespan, and how these developmental pathways can lead to continued problematic substance use in women. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

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9 pages, 276 KiB

Open AccessReview

Addressing the Impact of Interpersonal Violence in Women Who Struggle with Substance Use Through Developmental-Relational Strategies in a Community Program

by Mary Motz, Naomi C. Z. Andrews, Bianca C. Bondi, Margaret Leslie and Debra J. Pepler

Int. J. Environ. Res. Public Health 2019, 16(21), 4197; https://doi.org/10.3390/ijerph16214197 - 30 Oct 2019

Cited by 11 | Viewed by 3230

Abstract

From a developmental–relational framework, substance use in women can be understood as relating to early experiences of violence in relationships and across development. This article uses a developmental-relational approach to outline specific strategies that can be used by service providers and to guide [...] Read more.

From a developmental–relational framework, substance use in women can be understood as relating to early experiences of violence in relationships and across development. This article uses a developmental-relational approach to outline specific strategies that can be used by service providers and to guide interventions for women with substance use issues. By reviewing research and clinical work with women attending a community-based prevention and early intervention program, we describe how specific components of programming can target the developmental and intergenerational pathway between experiences of violence in relationships and substance use. We include the voices of women who attended the program to support the strategies discussed. Specifically, these strategies address the impact of interpersonal violence on substance use by promoting the process of repair and reintegration for women whose neurological development, sense of self, and capacity to form relationships have been significantly impacted by experiences of violence in relationships. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

Other

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10 pages, 285 KiB

Open AccessCommentary

The Presence and Consequences of Abortion Aversion in Scientific Research Related to Alcohol Use during Pregnancy

by Sarah C.M. Roberts

Int. J. Environ. Res. Public Health 2019, 16(16), 2888; https://doi.org/10.3390/ijerph16162888 - 13 Aug 2019

Cited by 6 | Viewed by 5930

Abstract

Recent research has found that most U.S. state policies related to alcohol use during pregnancy adversely impact health. Other studies indicate that state policymaking around substance use in pregnancy—especially in the U.S.—appears to be influenced by an anti-abortion agenda rather than by public [...] Read more.

Recent research has found that most U.S. state policies related to alcohol use during pregnancy adversely impact health. Other studies indicate that state policymaking around substance use in pregnancy—especially in the U.S.—appears to be influenced by an anti-abortion agenda rather than by public health motivations. This commentary explores the ways that scientists’ aversion to abortion appear to influence science and thus policymaking around alcohol and pregnancy. The three main ways abortion aversion shows up in the literature related to alcohol use during pregnancy include: (1) a shift from the recommendation of abortion for “severely chronic alcoholic women” to the non-acknowledgment of abortion as an outcome of an alcohol-exposed pregnancy; (2) the concern that recommendations of abstinence from alcohol use during pregnancy lead to terminations of otherwise wanted pregnancies; and (3) the presumption of abortion as a negative pregnancy outcome. Thus, abortion aversion appears to influence the science related to alcohol use during pregnancy, and thus policymaking—to the detriment of developing and adopting policies that reduce the harms from alcohol during pregnancy. Full article

(This article belongs to the Special Issue Sex, Gender and Substance Use)

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