Marine dissolved organic carbon (DOC), an active reservoir in the global carbon cycle, has an average age of 6000 years and is comprised of biochemicals which may or may not cycle on different time scales. The primary objective of this thesis is to investigate the relationship between radiocarbon (¹⁴C) signature and chemical composition of various fractions within DOC. Specifically, this thesis was designed to provide an analytical framework to explicitly explore the relationship between DOC molecular weight, chemical composition, and reactivity. Chapter 2 describes spatial and temporal total organic carbon (TOC) concentration gradients in 2005 from the California Cooperative Fisheries Oceanic Cooperative (CalCOFI) region, which is the main study area for this thesis. Chapter 3 describes a novel solid phase extraction (SPE) method and reports the chemical and isotopic characteristics of fractionated DOC components based on their solubility. These fractions are compared to DOC isolated by the widely applied UF techniques and the results indicate that chemical composition and ¹⁴C content were related. Using compound specific isotope analysis (CSIA) of sugars and lipids, Chapter 4 shows that both SPE DOC and UDOC contain specific compounds with similar chemical and isotopic characteristics and residence times. In Chapter 5, CSIA was applied to SPE samples collected from the Delaware River and Estuary and the terrestrially influenced Eel River Margin to examine whether riverine DOC inputs contribute specific compounds or common components to the coastal ocean. Finally, the final chapter discusses the implications and significance of these results for marine DOC cycling

Health services research is a multidisciplinary field that examines ways to organize, manage, finance, and deliver high-quality care. This specialty within substance abuse research developed from policy analyses and needs assessments that shaped federal policy and promoted system development in the 1970s. After the authorization of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA), patient information systems supported studies of treatment processes and outcomes. Health services research grew substantially in the 1990s when NIAAA and NIDA moved into the National Institutes of Health and legislation allocated 15% of their research portfolio to services research. The next decade will emphasize research on quality of care, adoption and use of evidence-based practices (including medication), financing reforms and integration of substance abuse treatment with primary care and mental health services.

Objective

This study assessed changes in smoking-related outcomes in two cross-sectional samples of clients enrolled in addiction treatment and whether tobacco-free grounds policies were associated with smoking-related outcomes.

Method

Clients in 25 programs were surveyed in 2015 (N=1176) and 2016 (N=1055). The samples were compared on smoking prevalence, cigarettes per day (CPD), thinking of quitting, past year quit attempts, staff and clients smoking together, attitudes towards quitting, and tobacco-related services. Second, programs with (n=6) and without (n=17) tobacco-free grounds at both time points were compared on smoking-related outcomes. Last, we examined changes in these measures for two programs that adopted tobacco-free grounds between 2015 and 2016.

Results

There was one difference across years, such that the mean score for the tobacco Program Service scale increased from 2.37 to 2.48 (p=0.043, effect size=0.02). In programs with tobacco-free grounds policies, compared to those without, both CPD and the rate of staff and clients smoking together were significantly lower. In the two programs where tobacco-free grounds were implemented during study years, client smoking prevalence decreased (92.5% v. 67.6%, p=0.005), the rate of staff and clients smoking together decreased (35.6% v. 4.2%, p=0.031), mean CPD decreased (10.62v. 8.24, p<0.001) and mean tobacco services received by clients increased (2.08v. 3.05, p<0.001).

Conclusion

Addiction treatment programs, and agencies responsible for licensing, regulating and funding these programs, should implement tobacco-free grounds policies.

Objective

To explore use of tobacco products in relationship to marketing exposure among persons in addiction treatment.

Method

A random sample of treatment programs was drawn from the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN). Participants in each program completed surveys concerning use of tobacco products (N=1113). Exposure to tobacco marketing and counter-marketing, advertising receptivity, and perceived health risks of smoking were tested for their association with use of multiple tobacco products.

Results

Prevalence of combustible cigarette use was 77.9%. Weekly or greater use of other products was: e-cigarettes (17.7%), little filtered cigars (8.6%), smokeless tobacco (5.2%), and standard cigars (4.6%) with 24.4% using multiple tobacco products. Compared to single product users, multiple product users smoked more cigarettes per day (OR=1.03, 95% CI 1.01-1.05, p<0.001), were more likely to have tried to quit (OR=1.41, 95% CI 1.02-1.96, p=0.041), reported greater daily exposure to advertising for products other than combustible cigarettes (OR=1.93, CI 1.35-2.75, p<0.001), and greater daily exposure to tobacco counter-marketing (OR=1.70, 95% CI: 1.09-2.63, p=0.019).

Conclusion

Heavier smokers and those trying to quit may be more likely to use e-cigarettes, little filtered cigars, or smokeless tobacco and have greater susceptibility to their advertising. This highlights the importance of regulating advertising related to smoking cessation as their effectiveness for this purpose has not been demonstrated.