Medical Cannabis Laws and Adolescent Alcohol Use Initiation.
Medical Cannabis Laws and Adolescent Alcohol Use Initiation.
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DOI：
10.26828/cannabis/2022.03.001
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Johnson, Julie K
中科院分区：
文献类型：
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作者：
Hard, Gregory A;Jones, Abenaa A;Das, Abhery;Johnson, Julie K
医用大麻法（MCLs）对青少年饮酒的影响尚不清楚。以往的文献调查酒精消费，而不是酒精启动青少年，并没有检查社会人口特征和国家一级的药房状态的影响。我们使用人口代表性，国家一级的数据来研究MCL和青少年饮酒之间的关系。这项研究的数据来自青少年风险行为调查（YRBS），这是一项全国代表性的、基于学校的横断面调查，由疾病控制中心（CDC）在1991年至2015年的奇数年进行。我们使用了差异中的差异模型，以评估前和后的影响，国家MCL颁布青少年饮酒开始。Logistic回归分析评估了MCL与不同起始年龄之间的相关性。我们进一步按种族/民族、性别和药房状态对结果进行分层。调整后的logistic回归模型结果显示，与有MCL的州的青少年相比，无MCL的州的青少年开始饮酒的几率更高（OR 1.37，[95% CI = 1.29，1.44]）。这种效应在不同年龄、人种/种族和性别组中是一致的。在多个年龄层（9-10岁、11-12岁和13-14岁）中也一致发现饮酒开始的自我报告减少，尽管这一发现在所有种族/民族中没有达到传统的统计检测水平。我们的研究结果支持一种替代效应，表明与没有MCL的州相比，患有MCL的州的青少年可能会用大麻代替酒精。考虑到医用大麻法律的不断发展和国家一级合法化法律的扩散，有必要进一步研究这些政策的影响，如成人使用大麻的法律，以进一步阐明其对青少年药物使用的影响。
The effects of medical cannabis laws (MCLs) on adolescent alcohol use remains unclear. Previous literature investigates alcohol consumption rather than alcohol initiation among adolescents, and does not examine the effect by sociodemographic characteristics and state-level dispensary status. We used population representative, state-level data to examine the relationship between MCLs and adolescent alcohol initiation. Data for this study were derived from the Youth Risk Behavior Survey (YRBS), a nationally representative, cross-sectional school-based survey administered by the Centers for Disease Control (CDC) in odd-numbered years from 1991 to 2015. We used a difference-in-difference model to assess pre and post effects of state MCL enactment on adolescent alcohol use initiation. Logistic regression analyses assessed associations between MCLs and varying ages of initiation. We further stratified our results by race/ethnicity, gender, and dispensary status. Results from adjusted logistic regression models showed higher odds of initiating alcohol among adolescents in states without MCLs when compared to adolescents in states with MCLs (OR 1.37, [95% CI = 1.29, 1.44]). This effect was consistent across age, race/ethnicity, and gender groups. Reductions in self-report of alcohol initiation were also consistently found in multiple age strata (9-10, 11-12, and 13-14), though this finding did not reach conventional levels of statistical detection in all race/ethnicities. Our findings support a substitutive effect, suggesting that adolescents in states with MCLs, as opposed to states without MCLs, may substitute cannabis for alcohol. Considering the evolving landscape of medical cannabis laws and the proliferation of state-level legalization laws, further research into the effects of such policies, such as adult-use cannabis laws, is warranted to further elucidate their effects on adolescent substance use.