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Natural American Spirit (NAS), a heavily advertised and top selling premium cigarette brand popular among young adults that promotes itself to consumers using the terms “additive free,” “natural,” and “organic.” The FDA has taken steps to stop NAS from using the misleading product descriptors “natural” and “additive-free” but the issue remains unsettled. This project provides scientific evidence on the terms “natural,” “additive-free,” and “organic,” use of the claim “natural” as part of the brand name, and the use of written claims that may imply the product is “natural” and “additive-free” (e.g., “ingredients: tobacco and water”). Specifically, we aim to 1) understand consumer perceptions of the NAS brand name, descriptors (e.g, “organic”, “Tobacco Ingredients: Tobacco and Water”), and imagery in NAS advertising by conducting twelve focus groups with young adult (ages 18-24) smokers and nonsmokers, 2) assess the effect of such descriptors in print advertising on cigarette risk perceptions and use intentions among 2400 young adult (18-24) smokers and non-smokers using a between-subjects online experiment, and 3) examine population differences in tobacco perceptions, use intentions, and use between NAS and other brand (OB) smokers, comparing them over time via longitudinal analysis of the Population Assessment of Tobacco and Health (PATH) survey study.

• Project dates: 09/14/2018 – 08/31/2023
• MPIs
  • Cristine Delnevo, Ph.D. – Rutgers University
  • Andrew Strasser, Ph.D. – University of Pennsylvania, Philadelphia
• Co-Investigator: Jennifer Pearson, Ph.D.

Seven medications have been approved for the treatment of tobacco addiction in the United States, five that are nicotine replacement and two are non-nicotine. Three of the NRT products (i.e. patch, gum, lozenge) are available as over-the-counter (OTC) products because clinical trials have shown that they are safe and effective without healthcare provider involvement. After multiple studies, including one of the largest smoking cessation trials (`EAGLES' study) ever conducted, the evidence is clear that varenicline has the greatest probability of helping the most smokers quit and results in adverse events that are no worse than current OTC NRT products. Given these data, the time has come to explore whether varenicline is safe and effective as an OTC medication. In addition, because earlier research found that .5mg twice a day (b.i.d.) varenicline is as effective as the currently FDA-approved 1.0mg b.i.d but with lower incidence of nausea and sleep disturbance, there is value in assessing whether the lower dose will work as well as the higher dose in an OTC environment. Thus, the primary goal of this research is to test whether varenicline is a solid candidate for switching from prescription (Rx) to OTC, and whether a dose lower than that currently approved is as effective in an OTC environment. To understand the within- person mechanisms explaining how and when OTC varenicline might improve cessation outcomes, we also assess experience with OTC varenicline using intensive longitudinal data collection.

• Funding: NIH R01DA044125
• Project dates: 09/30/2017 – 06/30/2022
• PI: Scott Leischow
• Co-Investigators: Jennifer Pearson, MPH, Ph.D.; Mitch Nides, Ph.D., LA Clinical Trials

Opioid use and overdose death are increasing nationwide, but especially in rural states such as �鶹ӳ��.  People who experience a non-fatal overdose and are treated in the emergency department are at elevated risk for dying of a subsequent overdose in the absence of intervention. The proposed study will test the effectiveness of a peer recovery support-based intervention for providing opioid overdose patients treated in �鶹ӳ��’s emergency departments with opioid overdose education and naloxone, and linking those patients to medication for opioid use disorder using a peer outreach model implemented via the State’s SAMHSA STR Program.

• Funding: ArnoldVentures
• Project dates: 2/14/18 – 4/30/2022
• PI: Karla Wagner, Ph.D.
• Co-Investigators
  • Roy Oman, Ph.D., UNR SCHS Division of SBH/HAP
  • Minggen Lu, Ph.D., UNR SCHS Division of Epi/Biostats
  • Nancy Roget, MS, UNR CASAT
  • Katherine Hepworth, Ph.D., UNR Reynolds School of Journalism

As states legalize adult recreational cannabis use, policymakers must regulate a new industry with little science to inform their decisions. A central question emerging from this process is how, if at all, cannabis legalization affects adolescent cannabis use, and the role of dispensary availability or advertising density in adolescent consumption. The primary goal of this project is to examine whether recreational cannabis legalization in �鶹ӳ��, including cannabis dispensary and outdoor cannabis advertising density, is associated with changes in cannabis use and associated vehicular risk behaviors among �鶹ӳ��n adolescents. Methods include a secondary analysis of the �鶹ӳ�� and New Mexico 2017 and 2019 YRBS surveys using a difference-in-difference approach, and state-level analyses that combine geospatial and advertising image data collected to document dispensary and outdoor advertising density with YRBS survey data.

• Funding: NIH R15DA047606
• Project dates: 3/15/2019 – 2/28/2022
• PI: Jennifer Pearson, MPH, Ph.D.
• Co-I: Kristen Clements-Nolle, Ph.D., UNR SCHS Division of Epi/Biostats

Black/African American and Latinx women are at elevated risk for HIV/AIDS compared to white women. This study will applies social network methods to understanding the network-level influences on HIV status, HIV risk behavior, and history of HIV testing among Black/African American and Latinx women at risk for HIV, with a focus on the influence of discrimination, medical mistrust, and other barriers to HIV testing.

• Funding: NIH R01DA038183
• Project dates: 5/1/2015 – 1/31/2022
• PI: Karla Wagner, Ph.D.
• Co-Investigators:
  • Harold Green Jr., Ph.D., Indiana University
  • Jamila K. Stockman, Ph.D., University of California San Diego

Drug-related overdose deaths are now the largest cause of injury death in the United States, with more people dying of overdose than in motor vehicle crashes. One recent response to such deaths is equipping law enforcement officers with naloxone and training them to refer overdose victims to drug treatment once they are revived. This study examines the use of naloxone by the San Diego Sheriff’s Department, and how procedures to respond to overdoses as medical emergencies and refer overdose victims to treatment impact health outcomes and attitudes among people who use drugs. 

• Funding: NIH R01DA040646
• Project dates: 5/1/2016 – 2/28/2021
• PI: Peter Davidson, Ph.D., University of California San Diego
• Co-Is:
  • Karla Wagner, Ph.D.
  • Wei Yang, Ph.D. – UNR SCHS Division of Epi/Biostats

The rapid expansion of new tobacco products including electronic cigarettes and heated tobacco products is increasing a concern among low and middle-income countries. The tobacco and vape companies have tested these new products in several Latin America countries raising concerns about the spread of these addictive products, especially among the youth. The goal of this project is to examine new tobacco products in Latin America and the Caribbean and explain the different types of these products, the regulatory framework, how tobacco companies are promoting these products and public health groups are helping regulate these products. This study will review tobacco industry internal documents, public health reports, media sources and legislative websites to document these new developments in the region.          

• Funding: Campaign for Tobacco Free Kids
• Project dates: 08/01/20-07/30/21
• PI: Eric Crosbie, PhD, MA
• Co-I: Ernesto Sebrié, MD and Gianella Severini, Campaign for Tobacco Free Kids

Both the tobacco industry and the food industry have used similar tactics to promote their products and lobby governments to avoid mandated public health regulations. This is especially alarming in Africa where these products are growing in terms of sales faster than any other continent. The goal of this project is to mentor undergraduate students examining tobacco advertising, promotion and sponsorship (TAPS) in Africa and the food industry’s usage of ILSI to interfere in nutrition policy. This study will review tobacco industry and food industry internal documents, public health reports, media sources and legislative websites to document these new developments. The study will also use WHO and Campaign for Tobacco Free Kids legislative databases to analyze various TAPS policies.

• Funding: UNR Undergraduate Research
• Project dates: 07/01/20-06/30/21
• PI: Eric Crosbie, PhD, MA
• Co-I: Nina Machin, Johnny Hartman, UNR undergraduate students

The increasing burden of non-communicable diseases (NCDs) now account for 41 million deaths annually and remains the most preventable disease and death worldwide. Mexico has some of the highest rates of diabetes and to combat the country’s diabetes epidemic it has undertaken some drastic measures including adopting a front-of-pack nutrition labeling policy. The goal of this project is to examine the adoption and implementation of front-of-pack nutrition labeling in Mexico and understand how the government was able to approve this innovative policy. This study will review public health reports, media sources and legislative websites to document these developments in Mexico.                                       

• Funding: University Ozmen Institute for Global Studies
• Project dates: 07/01/20-06/30/21
• PI: Eric Crosbie, Ph.D., MA

The legalization of cannabis products in several states in the U.S., including in California and �鶹ӳ�� followed as created concerns among public health scholars surrounding the regulatory framework of cannabis. Given the legality of cannabis, the cannabis industry has marketed and promoted these products raising concerns about pricing and marketing practices to target youth and adolescents. The goal of this project is to examine the pricing and marketing of cannabis products in cannabis dispensaries in the United State, specifically in the Bay Area and Washoe County to see what patterns are developing in different contexts. This study uses a website coding instrument and in-person visits using ethnographic approaches to document the pricing and marketing of cannabis products in cannabis dispensaries.                         

• Funding: NIH R01DA040545
• Project dates: 10/01/19-09/30/21
• PI: Pam Ling, Ph.D. - UCSF
• Co-I:
  • Eric Crosbie, Ph.D., MA
  • Louisa Holmes, Ph.D., Penn State

The increasing burden of non-communicable diseases (NCDs) now account for 41 million deaths annually and remains the most preventable disease and death worldwide. Colombia has some of the highest rates of diabetes but faces immense pressure from the food and beverage industry. The goal of this project is to use the Truth Tobacco Industry Documents (TTID) and Food Industry Documents (FID) archives to explore and identify specific examples of food and beverage industry opposition to public health efforts within the country of Colombia.     

• Funding: Global Health Advocacy Incubator
• Project dates: 05/01/19-02/01/21
• Co-PI: Eric Crosbie, Ph.D., MA
• Co-PI: Laura Schmidt, Ph.D., UCSF
• Co-I: Cristen Kearns, UCSF

The increasing burden of non-communicable diseases (NCDs) now account for 41 million deaths annually and remains the most preventable disease and death worldwide. Mexico has some of the highest rates of diabetes and to combat the country’s diabetes epidemic it has undertaken some drastic measures including adopting a front-of-pack nutrition labeling policy. The goal of this project is to use the Truth Tobacco Industry Documents (TTID) and Food Industry Documents (FID) archives to explore and identify specific examples of food and beverage industry opposition to public health efforts within the country of Mexico.    

• Funding: El Poder del Consumidor
• Project dates: 03/01/19-02/28/21
• Co-PI: Eric Crosbie, Ph.D., MA
• Co-PI: Laura Schmidt, Ph.D., UCSF
• Co-I: Cristen Kearns, UCSF

Drug overdoses involving methamphetamine increased 3.6-fold from 2011 to 2016 - surpassing the increase in heroin-related deaths during that period. Rates of cocaine-related deaths also doubled from 2011 to 2016. Methamphetamine use is largely concentrated in the Western US, and �鶹ӳ�� and New Mexico have been disproportionately burdened by the opioid epidemic and high rates of methamphetamine use. This Multi-Site Pilot Project in Rio Arriba County, NM and Washoe County, NV examines how changes in drug availability, use, and interaction between methamphetamine and opioids influence health outcomes, with a focus on groups underrepresented in drug use research.

• Funding: Mountain West Clinical Translational Research Infrastructure Network U54GM104944
• Project dates: 7/15/2019 – 6/30/2020 (no cost extension pending)
• PI: Karla Wagner, Ph.D.
• Co-PI: Kimberly Page, Ph.D., University of New Mexico

This study investigates whether comprehensive �鶹ӳ�� opioid prescribing policy has been able to increase access to guideline-concordant pain care in primary care among adult Medicaid patients. The law of interest closely aligns with some CDC guidelines for pain care in primary care, but there are also guidelines recommended by the CDC that are not explicitly mentioned in the law. This study examines changes in guideline-concordant practices that are mentioned explicitly by the law as well as changes in related guideline-concordant practices that are not explicitly mentioned in the law. This study will further address potential differences in the effects of the law in urban areas and rural/frontier areas, where �鶹ӳ��’s opioid epidemic is particularly hard-hitting. Studying the Medicaid population brings focused attention to a population that is at higher risk for fatal opioid overdoses than other populations. The study will be conducted using measures constructed from five years of Medicaid outpatient and prescription drug claims data using CPT and ICD10 codes. It will employ an interrupted time series design with a comparison group (Colorado).  

• Funding: 1 R15 DA049195-01A1
• Prject dates: 7/1/2020-11/30/2022
• PI: Sarah Friedman
• Co-Is:
  • Karla Wagner, Ph.D.
  • Minggen Lu, Ph.D., UNR SCHS Division of Epi/Biostats

Prescription drug use patterns are often considered in isolation with limited attention focused on the effects that place-based characteristics have on individual-level drug use outcomes and health information uptake.  This study combines an innovative geographical information system (GIS) approach with the Comprehensive Model of Information Seeking framework to determine how suburban and semi-rural prescription opioid users seek information about their drug use and how they access prevention and treatment resources in their community.

• Funding: NIH R21DA045293
• Project dates: 7/2/2018 – 6/30/2020
• PI: Tommi Gaines, Ph.D., University of California San Diego
• Co-Is: Karla Wagner, Ph.D.; Peter Davidson, Ph.D., University of California San Diego

Opioid overdose is the leading cause of accidental death in the United States. This aims to optimize the use of 911 dispatch data to provide near-real time surveillance to identify individuals most at risk for future overdose death – those who have been treated by EMS and/or ED clinicians for a non-fatal opioid overdose.

• Funding: �鶹ӳ�� INBRE Pilot Grant Program P20 GM103440
• Project dates: 4/1/2017 – 3/31/2018
• PI: Karla Wagner, Ph.D.
• Co-I: Brian Labus, University of �鶹ӳ��, Las Vegas

The goal of this study was to evaluate how primarily African American and menthol smokers experience and initiate e-cigarette use. Specific aims are: (1) to examine how the immediate environmental and psychological contexts of cigarette and e-cigarette use vary within subjects; (2) to examine how these contexts vary between subjects by menthol preference and race; and (3) to examine participants’ “lived experience” of the meaning, influences, and utility of cigarette and e-cigarette use. The Moment Study was an observational study involving three weeks of ecological momentary assessment (EMA), two weeks of e-cigarette trial, and in-depth interview data collection, followed by 30-day follow-up telephone contact to assess cigarette and e-cigarettes use. 

• Funding: NIH R21DA036472
• Project dates: 09/30/2013 – 08/31/2016
• PI: Jennifer Pearson, MPH, Ph.D.
• Co-I: Thomas Kirchner, Ph.D., New York University