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Month: January 2026

Noncompliance with laws to prevent polysubstance misuse

Noncompliance with laws to prevent polysubstance misuse

The effectiveness of statutes to combat hazardous polysubstance use (for example, alcohol and cannabis together) has rarely been evaluated. A multi-institutional team led by Klein Buendel researchers assessed compliance with a state law prohibiting recreational cannabis sales to apparently intoxicated customers in one of the first states to legalize cannabis sales. The assessment has been published in Alcohol: Clinical and Experimental Research.

In January to June 2024, pseudo-patrons visited 189 recreational cannabis stores twice in two large metropolitan areas and attempted to purchase cannabis while displaying alcohol intoxication behaviors. Observers recorded whether sellers were willing to sell the product along with characteristics of the stores (busyness, cleanliness, and signage) and cannabis sellers (sex, race and ethnicity, and age). Neighborhood characteristics by U.S. census tract were obtained (income, race, and ethnicity; population density). Sex and race and ethnicity of the pseudo-patrons, and extent and type of intoxication cues, were recorded. Descriptive statistics and logistic regression were used to describe the sales rate and predictors of the sales rate.

Assessments were completed at 173 stores. Sellers were willing to sell cannabis to pseudo-intoxicated buyers at 255 of 346 visits (73.7%). Sellers refused buyers at both visits in 6.9% of stores but in 54.3% were willing to sell at both visits. Sellers refused cannabis sales at higher rates in stores with signs saying, “no sales to intoxicated customers” (34.3%), particularly when buyers displayed more obvious signs of intoxication (39.8%).

Low compliance with the state regulation possibly occurred because sellers were unaware of the law, perceived little deterrence by the law, or lacked the skills to recognize and refuse intoxicated customers. Noncompliance with the law on selling cannabis to apparently alcohol-intoxicated customers increases the risks of polysubstance impairment and harm.

This research is supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (AA031591; Dr. W. Gill Woodall and Dr. David Buller, Multiple Principal Investigators). Additional collaborating authors include Dr. Robert Saltz from the Pacific Institute for Research and Evaluation; Dr. James Fell from Fell Consulting; Dr. Gary Cutter from the University of Alabama; and Lila Martinez, Amanda Brice, and Noah Chirico from Klein Buendel.

Development of an Online Cancer Prevention Intervention for Rural Emerging Adults

Development of an Online Cancer Prevention Intervention for Rural Emerging Adults

A multi-state research team from Arizona, Colorado, New Mexico, and Utah has published research on a rural health intervention in the Journal of Medical Internet Research. The study developed and pilot tested a theory-based intervention via the web to reduce six cancer risk factors among rural emerging adults through community-engaged research.

The rapid growth of user-generated web-based health information increases the complexity of cancer information seeking. One promising strategy for promoting high-quality cancer information consumption is through targeted interventions that are intentionally designed to reach individuals in the online spaces they occupy. However, there is a paucity of evidence-based information on the best strategies for designing and implementing web-based health behavior change interventions to improve individuals’ cancer-related knowledge and prevent cancer.

This mixed methods approach describes the development of an online cancer prevention intervention aimed at rural emerging adults aged 18-26 years in the United States and delivered in Facebook private groups. The intervention was guided by behavior change theory and co-created with young adults and Stakeholder Organization Advisory Boards to ensure relevance, accessibility, and appropriateness. The paper reported on three formative surveys, a pilot intervention, protocol development, and the community-engaged process for intervention development.

The authors developed 400 posts for a Facebook feed aimed at reducing six cancer risk behaviors (unhealthy diet, lack of physical activity, tobacco use, alcohol use, sun exposure, and human papillomavirus infection) with iterative input from the emerging adults and stakeholder advisory boards. Formative surveys with rural 297 emerging adults and a pilot study of the intervention with this 26 people from this population were conducted. In the pilot study, the intervention reached a sample of participants across several rural counties, with sustained engagement over a one-month period. Key modifications to the intervention content and design emerged from both advisory boards, the formative surveys, and the pilot intervention, focusing on using perceived reliable sources and direct links to source material.

The authors concluded that this web-based cancer prevention intervention is scalable and delivers engaging, evidence-informed health information to rural emerging adults. They offered key insights into the design and implementation of web-based cancer prevention interventions for emerging adults by describing the resources, timelines, and expertise needed to design and implement the intervention. Considerations for fully engaging young people and community stakeholder partners are presented, and how their involvement resulted in modifications that strengthened the intervention was discussed. Finally, the authors highlighted the importance of theory-based health-behavior messaging, digital messaging skillsets, and platform-tailored dissemination strategies for maximizing web-based intervention acceptability.

The research is supported by a grant from the National Cancer Institute (CA268037; Dr. David Buller and Dr. Andrew Sussman, Multiple Principal Investigators). Dr. Buller is the Director of Research at Klein Buendel. Dr. Sussman is from the University of New Mexico Comprehensive Cancer Center. Other collaborating investigators are from the University of Utah, the University of Arizona, the University of Colorado, and Colorado State University. The lead author of the Journal of Medical Internet Research paper is Dr. Echo Warner from the College of Nursing and the Huntsman Cancer Institute at the University of Utah.