The University of Texas at Austin, Steve Hicks School of Social Work, 1925 San Jacinto Blvd, Austin, TX 78712, United States.
The University of Texas at Austin, Steve Hicks School of Social Work, 1925 San Jacinto Blvd, Austin, TX 78712, United States.
Drug Alcohol Depend. 2021 Apr 1;221:108631. doi: 10.1016/j.drugalcdep.2021.108631. Epub 2021 Feb 16.
Despite significant geographical heterogeneity of sociodemographic and clinical characteristics, little is known about potential differences in cannabis use behaviors in U.S. geographic areas. In this study, we examined cannabis use behaviors in large metropolitan, small metropolitan, and nonmetropolitan areas. We focused on interactions between geographic areas and health insurance status and medical cannabis laws (MCL).
Data came from the 2015-2018 National Survey on Drug Use and Health (NSDUH; N = 171,766 adults; N = 36,175 cannabis users). Weighted chi-squares tests of independence and multivariable Poisson regression models were used to examine study questions.
Past-year use was highest in large metropolitan areas (16.08 %). Frequent use was highest among nonmetropolitan area users (48.67 %). Uninsured adults had a higher likelihood of past-year use (RRR = 1.21, 95 % CI = 1.14, 1.29) and frequent use (RRR = 1.27, 95 % CI = 1.14, 1.41), but a lower likelihood of cannabis use disorder (RRR = 0.77, 95 % CI = 0.66, 0.89). Uninsured adults in nonmetropolitan areas had a higher likelihood (RRR = 1.62, 95 % CI = 1.39, 1.88) of past-year use than insured nonmetropolitan area adults. MCL state residency was associated with a higher likelihood of frequent use among nonmetropolitan (RRR = 1.39, 95 % CI = 1.11, 1.74) and small metropolitan users (RRR = 1.30, 95 % CI = 1.15, 1.47). Cannabis use disorder likelihood did not vary by geographic area.
Lack of health insurance and MCL state residency are significant variables affecting cannabis use behaviors in small metropolitan and/or nonmetropolitan areas.
尽管社会人口统计学和临床特征存在显著的地域异质性，但对于美国地理区域内潜在的大麻使用行为差异知之甚少。在这项研究中，我们研究了大都市、小城市和非城市地区的大麻使用行为。我们专注于地理区域与健康保险状况和医用大麻法（MCL）之间的相互作用。
数据来自 2015-2018 年国家药物使用与健康调查（NSDUH；N=171766 名成年人；N=36175 名大麻使用者）。使用独立性加权卡方检验和多变量泊松回归模型来检验研究问题。
过去一年的使用率在大都市地区最高（16.08%）。非城市地区使用者的高频使用比例最高（48.67%）。未参保成年人过去一年使用大麻的可能性更高（RRR=1.21，95%CI=1.14，1.29）和高频使用（RRR=1.27，95%CI=1.14，1.41），但大麻使用障碍的可能性较低（RRR=0.77，95%CI=0.66，0.89）。非城市地区未参保成年人过去一年使用大麻的可能性高于参保非城市地区成年人（RRR=1.62，95%CI=1.39，1.88）。医用大麻法州居住状态与非城市（RRR=1.39，95%CI=1.11，1.74）和小城市（RRR=1.30，95%CI=1.15，1.47）使用者高频使用的可能性增加有关。大麻使用障碍的可能性不因地理区域而异。
缺乏健康保险和医用大麻法州居住状态是影响小城市和/或非城市地区大麻使用行为的重要变量。
