Traffic fatalities within US states that have legalized recreational cannabis sales and their neighbours
Traffic fatalities within US states that have legalized recreational cannabis sales and their neighbours
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DOI：
10.1111/add.14536
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发表时间：
2019-05-01
期刊：
影响因子：
6
通讯作者：
Hall, Wayne
中科院分区：
文献类型：
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作者：
Lane, Tyler J.;Hall, Wayne
背景和目的越来越多的证据表明，大麻会损害驾驶能力。我们使用死亡率数据来调查娱乐性大麻的商业销售是否会影响大麻合法化州和邻近司法管辖区的交通死亡率。中断时间序列的交通死亡率调整季节性和自相关性。对研究期间（2009- 2016年）未实施医用或娱乐用大麻的国家进行比较，报告的变化为台阶效应和趋势效应。敏感性分析增加了6个月的“逐步引入”时间，以解释生产滞后。荟萃分析用于得出汇总结果。三个州将娱乐性大麻销售合法化[科罗拉多州（2014年1月），华盛顿州（2014年6月）和俄勒冈州（2015年10月）]以及九个邻近的司法管辖区[堪萨斯州，内布拉斯加州，新墨西哥州，俄克拉荷马州和犹他州（科罗拉多州的邻国）]；不列颠哥伦比亚省和俄勒冈州（与华盛顿相邻）；以及加州和内华达州（俄勒冈州的邻居）]。每月交通死亡率每百万居民使用死亡率数据从CDC WONDER和道路安全bc和人口普查数据。结果显示，交通事故死亡人数从1.08人/百万居民增加到-0.06人/月（P均< 0.001），但各站点之间存在显著的异质性（步长：I-2 = 73.7%, P I-2 = 68.4%, P = 0.001）。大麻合法化（步长：0.90,P < 0.001；趋势：-0.05,P = 0.007）和邻近地区（步长：1.15,P = 0.005；趋势：-0.06,P = 0.001）的效果相似。6个月的分期治疗产生了类似的效果，但效果更大（步长：1.36,P = 0.006；趋势：-0.07,P < 0.001）。逐步增加和趋势减少的结合表明，在实施娱乐性大麻销售后的一年中，美国科罗拉多州、华盛顿州和俄勒冈州及其邻近管辖区的交通死亡人数暂时平均增加了每百万居民的交通死亡人数。
Background and aims A growing body of evidence suggests that cannabis impairs driving ability. We used mortality data to investigate whether the commercial sale of cannabis for recreational use affected traffic fatality rates both in states that legalized it and in neighbouring jurisdictions. Design Interrupted time-series of traffic fatality rates adjusted for seasonality and autocorrelation. Changes are reported as step and trend effects against a comparator of states that had not implemented medicinal or recreational cannabis during the study period (2009-16). Sensitivity analyses added a 6-month 'phase-in' to account for lags in production. Meta-analyses were used to derive pooled results. Setting Three states that legalized recreational cannabis sales [Colorado (January 2014), Washington State (June 2014) and Oregon (October 2015] and nine neighbouring jurisdictions [Kansas, Nebraska, New Mexico, Oklahoma and Utah (Colorado neighbours); British Columbia and Oregon (Washington neighbours); and California and Nevada (Oregon neighbours)]. Measurements Monthly traffic fatalities rates per million residents using mortality data from CDC WONDER and RoadSafetyBC and census data. Findings There was a pooled step increase of 1.08 traffic fatalities per million residents followed by a trend reduction of -0.06 per month (both P < 0.001), although with significant heterogeneity between sites (step: I-2 = 73.7%, P I-2 = 68.4%; P = 0.001). Effects were similar in both legalizing (step: 0.90, P < 0.001; trend: -0.05, P = 0.007) and neighbouring sites (step: 1.15, P = 0.005; trend: -0.06, P = 0.001). The 6-month phase-in produced similar if larger effects (step: 1.36, P = 0.006; trend: -0.07, P < 0.001). Conclusions The combination of step increases and trend reductions suggests that in the year following implementation of recreational cannabis sales, traffic fatalities temporarily increased by an average of one additional traffic fatality per million residents in both legalizing US states of Colorado, Washington and Oregon and in their neighbouring jurisdictions.