Master of Population Health Sciences Program, Washington University, St. Louis, MO, USA.
Master of Population Health Sciences Program, Washington University, St. Louis, MO, USA; Brown School, Washington University, St. Louis, MO, USA.
Int J Drug Policy. 2020 Jan;75:102585. doi: 10.1016/j.drugpo.2019.10.011. Epub 2019 Nov 15.
Whether medical or recreational cannabis legalization impacts alcohol or cigarette consumption is a key question as cannabis policy evolves, given the adverse health effects of these substances. Relatively little research has examined this question. The objective of this study was to examine whether medical or recreational cannabis legalization was associated with any change in state-level per capita alcohol or cigarette consumption.
Dependent variables included per capita consumption of alcohol and cigarettes from all 50 U.S. states, estimated from state tax receipts and maintained by the Centers for Disease Control and National Institute for Alcohol Abuse and Alcoholism, respectively. Independent variables included indicators for medical and recreational legalization policies. Three different types of indicators were separately used to model medical cannabis policies. Indicators for the primary model were based on the presence of active medical cannabis dispensaries. Secondary models used indicators based on either the presence of a more liberal medical cannabis policy ("non-medicalized") or the presence of any medical cannabis policy. Difference-in-difference regression models were applied to estimate associations for each type of policy.
Primary models found no statistically significant associations between medical or recreational cannabis legalization policies and either alcohol or cigarette sales per capita. In a secondary model, both medical and recreational policies were associated with significantly decreased per capita cigarette sales compared to states with no medical cannabis policy. However, post hoc analyses demonstrated that these reductions were apparent at least two years prior to policy adoption, indicating that they likely result from other time-varying characteristics of legalization states, rather than cannabis policy.
We found no evidence of a causal association between medical or recreational cannabis legalization and changes in either alcohol or cigarette sales per capita.
随着大麻政策的发展，医用或娱乐用大麻合法化是否会影响酒精或香烟的消费是一个关键问题，因为这些物质对健康有不良影响。相对较少的研究探讨了这个问题。本研究的目的是检验医用或娱乐用大麻合法化是否与各州人均酒精或香烟消费的任何变化有关。
因变量包括来自美国 50 个州的人均酒精和香烟消费数据，分别由疾病控制和预防中心以及国家酒精滥用和酒精中毒研究所根据州税收收据和国家酒精滥用和酒精中毒研究所的数据估计。自变量包括医用和娱乐用大麻合法化政策的指标。分别使用三种不同类型的指标来模拟医用大麻政策。医用大麻政策的主要指标基于活跃的医用大麻药房的存在。次要模型使用的指标基于更宽松的医用大麻政策（“非医用化”）或任何医用大麻政策的存在。差异-差异回归模型用于估计每种政策的关联。
主要模型发现医用或娱乐用大麻合法化政策与人均酒精或香烟销售之间没有统计学上的显著关联。在一个次要模型中，医用和娱乐用大麻政策都与人均香烟销售量显著下降相关，而与没有医用大麻政策的州相比。然而，事后分析表明，这些减少至少在政策实施前两年就已经出现，表明这些减少可能是由于合法化州的其他随时间变化的特征，而不是大麻政策。
我们没有发现医用或娱乐用大麻合法化与人均酒精或香烟销售变化之间存在因果关系的证据。
