Marijuana use trends among college students in states with and without legalization of recreational use: initial and longer-term changes from 2008 to 2018
Marijuana use trends among college students in states with and without legalization of recreational use: initial and longer-term changes from 2008 to 2018
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DOI：
10.1111/add.14939
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发表时间：
2020-01-13
期刊：
影响因子：
6
通讯作者：
Kerr, David C. R.
中科院分区：
文献类型：
--
作者：
Bae, Harold;Kerr, David C. R.
背景和目标美国的年轻成年大学生可能会受到大麻自由化趋势的影响。然而，在娱乐性大麻合法化（RML）之后，学生大麻使用的变化一次没有在一个以上的RML州进行过检查，或者在合法化后的1-2年内进行过检查。设计横断面全国大学健康评估调查，从2008年到2018年每年进行两次。在美国48个州共有587所4年制学院和大学。在美国各州上大学的18-26岁的本科生在2008年至2018年期间制定了RML（7个州n = 234 669）或没有制定RML（41个州n = 599 605）。测量自我报告的大麻使用（过去30天）和个人和背景的协变量，机构提供的机构和社区协变量和公开的日期，当国家颁布RML。调整协变量、状态差异和特定于状态的线性时间趋势（考虑到RML前的趋势），在同一时期，暴露于RML的学生中30天大麻使用的流行率比非RML州的学生增加更多[比值比（OR）= 1.23，95%置信区间（CI）= 1.19-1.28，P < 0.001];频繁用药（≥ 20天）组的OR值为1.18，95% CI为1.10-1.27，P < 0.001。交互模型支持更强的RML效应的学生谁是女性，居住在校外，年龄在21岁及以上;性取向没有温和的RML效应。在最早颁布RML的州（2012年），与RML前相比，RML后第二年至第六年的使用率有所增加。在第二合法化组（2015年）中，RML后的第一年和第二年有所增加，第三年增加幅度更大。在后来的州（2016-17），在RML之后的两年都观察到了增加。结论在2012年至2017年颁布娱乐性大麻立法的美国各州，有证据表明大学生使用大麻的总体趋势有所增加，性别、法律的使用年龄和校园居住地的影响也有所不同。
Background and aims Young adult college students in the United States are likely to be affected by marijuana liberalization trends. However, changes in students' marijuana use following recreational marijuana legalization (RML) have not been examined in more than one RML state at a time, or beyond 1-2 years post-legalization. Design Cross-sectional National College Health Assessment survey administered twice yearly from 2008 to 2018. Setting A total of 587 4-year colleges and universities in 48 US states. Participants Undergraduates aged 18-26 years attending college in US states that did (n = 234 669 in seven states) or did not (n = 599 605 in 41 states) enact RML between 2008 and 2018. Measurements Self-reported marijuana use (past 30 days) and individual and contextual covariates, institution-provided institutional and community covariates and publicly available dates when states enacted RML. Findings Adjusting for covariates, state differences and state-specific linear time trends (accounting for pre-RML trends), prevalence of 30-day marijuana use increased more among students exposed to RML [odds ratio (OR) = 1.23, 95% confidence interval (CI) = 1.19-1.28, P < 0.001] than among non-RML state students throughout the same time-period; the results were similar for frequent use (>= 20 days) (OR = 1.18, 95% CI = 1.10-1.27, P < 0.001). Interaction models supported stronger RML effects among students who were female, residing off-campus and aged 21 years and older; sexual orientation did not moderate RML effects. In the earliest states to enact RML (2012) there were increases in use prevalence in the second through the sixth year post-RML compared to pre-RML. In the second legalization group (2015) there were increases in the first and second year post-RML, and greater increases in the third year. In the later states (2016-17), increases were observed in both years after RML. Conclusions In US states that enacted recreational marijuana legislation from 2012 to 2017 there was evidence for a general trend towards greater increases in marijuana use by college students and differential impact by gender, legal using age and campus residence.