2004年至2017年期间，采用双重差分法研究大麻合法化对美国香烟和大麻使用差异的影响。
A difference-in-difference approach to examining the impact of cannabis legalization on disparities in the use of cigarettes and cannabis in the United States, 2004-17.
作者信息
Weinberger Andrea H, Wyka Katarzyna, Kim June H, Smart Rosanna, Mangold Michael, Schanzer Ellen, Wu Melody, Goodwin Renee D
机构信息
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
Department of Epidemiology and Population Health, Yeshiva University Albert Einstein College of Medicine, Bronx, NY, USA.
出版信息
Addiction. 2022 Jun;117(6):1768-1777. doi: 10.1111/add.15795. Epub 2022 Feb 1.
AIMS
To estimate the impact of recreational and medical cannabis laws (RCL, MCL) on the use of cannabis and cigarettes in the United States.
DESIGN
A difference-in-difference approach was applied to data from the 2004-17 National Survey on Drug Use and Health (NSDUH).
SETTING
United States.
PARTICIPANTS
Nationally representative cross-sectional survey of Americans aged 12 years and older (combined analytical sample for 2004-17, n = 783 663).
MEASUREMENTS
Data on past-month use of (1) cigarettes and (2) cannabis were used to classify respondents into four groups: cigarette and cannabis co-use, cigarette-only use, cannabis-only use or no cigarette or cannabis use. State of residence was measured by self-report. MCL/RCL status came from state government websites.
FINDINGS
Difference-in-difference analyses suggest that MCL was associated with an increase in cigarette-cannabis co-use overall [adjusted odds ratio (aOR) = 1.09; 95% confidence interval (CI) = 1.02-1.16], with the greatest increases among those aged 50 years and above (aOR = 1.60; CI = 1.39-1.84), married (aOR = 1.19; CI = 1.07-1.31), non-Hispanic (NH) black (aOR = 1.14; CI = 1.02-1.07) and with a college degree or above (aOR = 1.15; CI = 1.06-1.24). MCL was associated with increases in cigarette-only use among those aged 50 years and above (aOR = 1.07; CI = 1.01-1.14) and NH black (aOR = 1.16; CI = 1.06-1.27) and increases in cannabis-only use among those aged 50 years and above (aOR = 1.24; CI = 1.07-1.44) and widowed/divorced/separated (aOR = 1.18; CI = 1.01-1.37). RCL was associated with an increase in cannabis-only use overall (aOR = 1.21; 95% CI = 1.09-1.34), a decline in cigarette-only use overall (aOR = 0.89; 95% CI = 0.81-0.97) and increases in co-use among those who were married (aOR = 1.24; CI = 1.02-1.50) and aged 50 years and above (aOR = 1.37; CI = 1.03-1.84).
CONCLUSIONS
Recreational and medical cannabis legalization have had a varying impact on the use, and co-use, of cannabis and cigarettes in the United States.
目的
评估娱乐性和医用大麻法律（RCL，MCL）对美国大麻和香烟使用情况的影响。
设计
采用双重差分法对2004 - 2017年全国药物使用和健康调查（NSDUH）的数据进行分析。
地点
美国。
参与者
对12岁及以上美国人进行的具有全国代表性的横断面调查（2004 - 2017年合并分析样本，n = 783663）。
测量
过去一个月内（1）香烟和（2）大麻使用情况的数据用于将受访者分为四组：同时使用香烟和大麻、仅使用香烟、仅使用大麻或既不使用香烟也不使用大麻。居住州通过自我报告测量。MCL/RCL状态来自州政府网站。
研究结果
双重差分分析表明，MCL总体上与香烟 - 大麻同时使用的增加相关[调整优势比（aOR）= 1.09；95%置信区间（CI）= 1.02 - 1.16]，在50岁及以上人群中增加幅度最大（aOR = 1.60；CI = 1.39 - 1.84），已婚人群（aOR = 1.19；CI = 1.07 - 1.31），非西班牙裔（NH）黑人（aOR = 1.14；CI = 1.02 - 1.07）以及拥有大学学位或以上人群（aOR = 1.15；CI = 1.06 - 1.24）。MCL与50岁及以上人群中仅使用香烟的增加相关（aOR = 1.07；CI = 1.01 - 1.14）以及NH黑人（aOR = 1.16；CI = 1.06 - 1.27），与50岁及以上人群中仅使用大麻的增加相关（aOR = 1.24；CI = 1.07 - 1.44）以及丧偶/离婚/分居人群（aOR = 1.18；CI = 1.01 - 1.37）。RCL总体上与仅使用大麻的增加相关（aOR = 1.21；95% CI = 1.09 - 1.34），与仅使用香烟的总体下降相关（aOR = 0.89；95% CI = 0.81 - 0.97）以及已婚人群（aOR = 1.24；CI = 1.02 - 1.50）和50岁及以上人群中同时使用的增加相关（aOR = 1.37；CI = 1.03 - 1.84）。
结论
娱乐性和医用大麻合法化对美国大麻和香烟的使用及同时使用情况产生了不同影响。
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