Brief interventions via the internet have been shown to reduce university students’ alcohol intake. This study tested two smartphone applications (apps) targeting drinking choices on party occasions, with the goal of reducing problematic alcohol intake among Swedish university students.

Objective:To validate self reports of cigarette and smokeless tobacco (snus) use in a prospective cohort of adolescents.Design:A cross sectional analysis of a cohort sub-sample.Setting:County of Stockholm, Sweden.Subjects:520 adolescents in the final grade of junior high school (mean age 15.0 years).Main outcome measure:Concordance between self reported tobacco use and saliva cotinine concentration.Results:Using a cut point of 5 ng/ml saliva cotinine to discriminate active tobacco use, there was a 98% concordance between self reported non-use in the past month and cotinine concentration. The sensitivity of the questionnaire compared to the saliva cotinine test, used as the gold standard, was 90% and the specificity 93%. One hundred and fifteen out of 520 subjects (22%) reported monthly tobacco use. Among these, 67% (46/69) of the exclusive cigarette smokers, 82% (23/28) of exclusive snus users, and 94% (15/16) of mixed users (cigarettes + snus) had cotinine concentrations above 5 ng/ml. Among subjects reporting daily use 96% (64/67) had saliva cotinine concentrations above the cut point. Exclusive current cigarette users were more likely to be classified discordantly by questionnaire and cotinine test compared to snus users (odds ratio 3.2, 95% confidence interval 1.2 to 8.6).Conclusion:This study confirms the reliability of adolescents’ self reported tobacco use. In a context of low exposure to environmental tobacco smoke a cut off for saliva cotinine of 5 ng/ml reliably discriminated tobacco users from non-users. Irregular use of tobacco in this age group probably explains the discrepancy between self reported use and cotinine concentrations.

Purpose University students in a study on estimated blood alcohol concentration (eBAC) feedback apps were offered participation in a second study, if reporting continued excessive consumption at 6-week follow-up. This study evaluated the effects on excessive alcohol consumption of offering access to an additional skills training app. Method A total of 186 students with excessive alcohol consumption were randomized to an intervention group or a wait list group. Both groups completed online follow-ups regarding alcohol consumption after 6 and 12 weeks. Wait list participants were given access to the intervention at 6-week follow-up. Assessment-only controls (n = 144) with excessive alcohol consumption from the ongoing study were used for comparison. Results The proportion of participants with excessive alcohol consumption declined in both intervention and wait list groups compared to controls at first (p < 0.001) and second follow-ups (p = 0.054). Secondary analyses showed reductions for the intervention group in quantity of drinking at first follow-up (−4.76, 95% CI [−6.67, −2.85], Z = −2.09, p = 0.037) and in frequency of drinking at both follow-ups (−0.83, 95% CI [−1.14, −0.52], Z = −2.04, p = 0.041; −0.89, 95% CI [−1.16, −0.62], Z = −2.12, p = 0.034). The odds ratio for not having excessive alcohol consumption among men in the intervention group compared to male controls was 2.68, 95% CI [1.37, 5.25] (Z = 2.88, p = 0.004); the figure for women was 1.71, 95% CI [1.11, 2.64] (Z = 2.41, p = 0.016). Conclusion Skills training apps have potential for reducing excessive alcohol use among university students. Future research is still needed to disentangle effects of app use from emailed feedback on excessive alcohol consumption and study participation. Trial Registration NCT02064998

Background and aims: The COVID-19 pandemic has dramatically changed life circumstances for adolescents worldwide. With schools being closed and regular activities being cancelled, gaming and social media use are activities that might gain in importance. There is a risk that these online behaviours have negative effects on other important activities, such as being physically active, sleeping, and studying, as well as general well-being. The aim of this study was to investigate the effects of the COVID-19 pandemic on gaming and social media use, and its effects on the well-being of adolescents. Methods: A total of 1232 adolescents (82.5% female) participated in an anonymous web survey containing questions on gaming, social media use, and perceived negative consequences of gaming and social media use during the COVID-19 pandemic. The results were analysed with a quasi-Poisson regression model. Results: The results indicated an increase in gaming and social media use, which was associated with negative consequences and perceived well-being. A majority of adolescents reported that they used social media more than they felt comfortable with. There were large differences between boys and girls, with girls being more negatively affected across measures. Discussion: The increase in gaming and social media use during the COVID-19 pandemic might have negative effects on the well-being of adolescents, and on other activities that are important to health. Our interpretation of the findings is that gaming and social media use might partly function as coping mechanisms to deal with stress and/or boredom resulting from COVID-19 restrictions. There is a risk that these coping strategies become maladaptive over time. Conclusions: The restrictions from the COVID-19 pandemic have resulted in an increase in the amount of time adolescents spend gaming and on social media, which might have negative effects on their well-being. This study highlights the urgent need to consider adaptive and healthy coping strategies for adolescents given the pandemic may mean that daily living could continue to be altered in the near future.