Twitter-Based Intervention for Young Adult African American Blunt Smokers

NIDA, K23DA042130

8/15/2017 – 7/31/2023

LaTrice Montgomery, PhD (University of Cincinnati)

Theresa Winhusen, PhD; Vicki L. Plano Clark, PhD; Alan J. Budney, PhD, Judith J. Prochaska, PhD (mentors); Dylanne Twitty, BA (research assistant)

This Mentored Patient-Oriented Research Career Development Award (K23) will develop the applicant, Dr. LaTrice Montgomery, into an independent investigator who can evaluate digital health technologies to improve engagement and treatment of cannabis and tobacco co-use among African American young adults. The career plan proposes training and stage IA-IB intervention development research and extends the applicant’s prior research and training to address career development goals in three areas: 1) clinical trials methodology and longitudinal data analysis, especially for smoking cessation trials (Winhusen), 2) the development of internet- based social media interventions to address co-use of cannabis and tobacco among African American young adults (Prochaska and Budney) and 3) mixed methods research (Plano Clark). These goals will be accomplished through formal coursework, seminars, and conferences under the mentorship of leaders in the addiction field. In this application, three related studies will be conducted that build on the applicant’s training goals and will contribute to an increased understanding of how social media can be applied to promote blunt use reduction among African American young adults. Blunts (hollowed-out tobacco cigar shells that are filled with cannabis) are widely used among African American young adults and have been associated with more severe cannabis use problems, such as inability to cut down use, and health problems, such as an increased risk of cardiovascular and pulmonary diseases due to high levels of carbon monoxide exposure. Despite these negative drug use and health effects, few interventions have been designed to address blunt use, especially among African American young adults. Social media sites, such as Twitter, present unique opportunities to deliver online health-based interventions due to their popularity and ability to reach underserved and vulnerable populations who might be reluctant to enter or remain engaged in traditional substance abuse treatment. The applicant will therefore apply the training and skills acquired from this award to the following research aims: (1) use mixed methods to characterize the cultural norms, patterns of blunt use, quit experiences, treatment needs, and attitudes and preferences toward social-media based interventions for blunt use reduction among African American young adults, (2) draw integrated conclusions from mixed methods data to inform the development and pilot testing of a Twitter-based intervention and 3) conduct a small randomized clinical trial to test the acceptability, feasibility and initial efficacy of a Twitter-based treatment intervention for African American young adult blunt smokers. The training experience and results from the proposed work will position the applicant to pursue future independent NIH funding to develop this line of research and adapt and test future internet-based social media interventions for cannabis and tobacco co-use among African American young adults.

The combined use of tobacco and cannabis through blunts is a serious public health problem among African American youth due to the increased risk of acquiring smoking-related diseases, and for developing a lifelong addiction to both of these substances. Thus, there is an urgent need for effective treatments to address cannabis and tobacco co-use, especially through the use of blunts (hollowed-out tobacco cigar shells that are filled with cannabis), among African American young adults. This project involves the development and evaluation of a low-cost, fully automated and accessible internet-based social media (i.e., Twitter) treatment intervention to help reduce blunt use among young African American adults, which will have a significant public health impact for an understudied and underserved population.