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Background Individuals from low-income groups report disproportionate rates of cigarette use, secondhand smoke (SHS) exposure with increased morbidity and mortality. Smoking bans in public housing have been enacted in attempt to reduce tobacco use and SHS exposure among lower income individuals. This study investigated the support needs of tobacco users living in two public housing complexes in Detroit, Michigan (USA), including their perspectives on smoking, resources and barriers for smoking cessation, and the impact of policy changes. Methods This is a mixed-methods study, using a qualitative focus groups approach and a short survey, public housing residents interview data was analyzed to explore themes related to smoking-related issues. Specifically, six themes were assessed across four focus groups: (1) Quitting Smoking, (2) Current Smoking Cessation Resources, (3) Legal Mandates, (4) Education and Perceptions of Smoking, (5) Community Needs and Barriers, and (6) Medical Experiences. Results There were 59 participants; the majority (39/42, 93%) of smokers reported at least one quit attempt. During the focus groups, several participants indicated a desire to quit smoking but reported barriers to smoking cessation, such as lack of access to medications, social triggers to continue smoking, and socioeconomic stressors. A number of suggestions were provided to improve smoking cessation resources, including support groups, graphic images of smoking-related diseased tissue, and better communication with health care providers. Conclusions These findings demonstrate smoking bans in two public housing complexes can be effective yet are dependent upon a complex set of issues, including numerous barriers to care.

Little research has explored relationships between prenatal substance use policies and rates of maternal mortality across all 50 states, despite evidence that prenatal substance use elevates risk of maternal death. This study, utilizing publicly available data, revealed that state-level mandated testing laws predicted maternal mortality after controlling for population characteristics.

Methadone maintenance treatment (MMT) is an evidence-based intervention for opioid use disorder (OUD). Despite its effectiveness, drug use during treatment and dropout are common. Most MMT outcome studies have ignored or examined few protective factors. This study examines protective factor predictors of two primary MMT outcomes, drug abstinence and treatment retention. Patients ( N  = 118) initiating MMT completed baseline surveys. Urine drug screen and retention data were extracted from medical records. We assessed protective factors organized across five domains (treatment history, opioid-related, intrapersonal, relational, and socioeconomic/community). Bivariate and multivariable linear regression analyses and a Cox proportional-hazards model were conducted. Opioid-related factors (change readiness, use-related consequences) best predicted outcomes. Some treatment history (prior, earlier engagement) and socioeconomic/community (past 30-day income) factors had a protective influence, whereas intrapersonal factors (gratitude, searching for meaning-in-life) produced mixed findings. One relational factor (emotional support) approached significance. Our findings highlight innovative approaches that may help improve MMT outcomes.

The primary purpose of this study was to examine change across key outcomes of substance use, psychological distress, physical health symptoms, and deviant behaviors in an at-risk sample from adolescence into emerging adulthood. A number of predictors were identified based on models of development, including the Social Interactionist Model, the Risk Amplification Model, and the role of self-efficacy. A sample of 401 (n = 251 homeless adolescents) at-risk adolescents from the metropolitan Detroit area were recruited between 1997–2000 and followed for up to seven years. Multilevel modeling was used to examine baseline predictors of change in each of the four outcomes, to examine the time-varying effects of family environment factors and peer associations, and to test the moderating effect of self-efficacy on the relationships between early contextual family factors on key outcomes in emerging adulthood. Alcohol symptoms increased linearly over time. Changes in alcohol symptom count over time were predicted by being male, white, and endorsing a greater proportion of deviant peer relationships and conduct disorder symptoms at baseline. Interestingly, psychological distress ratings measured with a global severity rating of distress decreased over time. Homeless status, parental monitoring and conduct disorder symptoms were significant in the overall model, while change among females increased over time compared to males. Physical health symptoms were predicted by being female, lower parental monitoring, and greater conduct disorder symptoms. Illegal behaviors were predicted by being male and having greater conduct disorder symptoms. The second aim sought to explore time-varying associations of family conflict and deviant peer associations on each of the four outcomes. Both variables were significant predictors for change in alcohol symptoms, psychological distress, and physical health symptoms. However, illegal behavior change was predicted by family conflict but not change in deviant peer associations. The results from the third study aim failed to support self-efficacy as a moderator between parental deviance and any of the outcomes. Specifically, levels of self-efficacy failed to moderate the relationship between parental deviance with alcohol symptoms, psychological distress, physical health symptoms and illegal behaviors in adulthood. Increasing our understanding of trajectories toward negative outcomes is an important first step to developing prevention and intervention strategies to improve outcomes and reduce costs to society.