School of Psychological Science, Oregon State University, Corvallis, Oregon.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York.
Am J Prev Med. 2023 Dec;65(6):983-992. doi: 10.1016/j.amepre.2023.06.009. Epub 2023 Jun 17.
Young adults' cannabis and alcohol use patterns have changed after state recreational cannabis legalization according to studies based on college samples but not nationally representative samples. Associations between recreational cannabis legalization and changes in cannabis and alcohol use outcomes among young adults were examined, including differences by college enrollment and minor status (ages 18-20 vs 21-23 years).
Repeated cross-sectional data (2008-2019) were collected from college-eligible participants aged 18-23 years in the National Survey on Drug Use and Health. Self-reported past-month cannabis use and frequent use (≥20 days) and a proxy for past-year DSM-5 cannabis use disorder were primary outcomes; past-month frequent alcohol use and binge drinking were secondary outcomes. Multilevel logistic regression models quantified changes in outcome prevalence from the study years before to after recreational cannabis legalization, adjusting for secular trends. Analyses were conducted on March 22, 2022.
Prevalence increased from before to after recreational cannabis legalization for past-month cannabis use (from 21% to 25%) and past-year proxy cannabis use disorder (from 11% to 13%); the increases were statistically significant [adjusted odds ratio (95% CI) = 1.20 (1.08-1.32) and 1.14 (1.003-1.30), respectively]. Increases were detected for young adults who were not in college and who were aged 21-23 years. Recreational cannabis legalization impacts were not detected for secondary outcomes.
Some young adults appear sensitive to state recreational cannabis legalization, including in terms of cannabis use disorder risk. Additional prevention efforts should be directed to young adults who are not in college and timed to occur before age 21 years.
根据基于大学样本的研究，但不是全国代表性样本，年轻人的大麻和酒精使用模式在州休闲大麻合法化后发生了变化。本研究调查了休闲大麻合法化与年轻人中大麻和酒精使用结果变化之间的关联，包括大学生入学和未成年身份（18-20 岁与 21-23 岁）的差异。
从国家毒品使用与健康调查中，收集了年龄在 18-23 岁之间、有资格上大学的参与者在 2008-2019 年期间的重复横断面数据。主要结果是自我报告的过去一个月大麻使用和频繁使用（≥20 天）以及过去一年 DSM-5 大麻使用障碍的替代指标；次要结果是过去一个月频繁饮酒和 binge 饮酒。多水平逻辑回归模型量化了从休闲大麻合法化前到后的研究年份中，结果流行率的变化，调整了季节性趋势。分析于 2022 年 3 月 22 日进行。
从休闲大麻合法化前到后，过去一个月大麻使用（从 21%到 25%）和过去一年代理大麻使用障碍（从 11%到 13%）的流行率增加，这些增加具有统计学意义[调整后的优势比（95%可信区间）= 1.20（1.08-1.32）和 1.14（1.003-1.30）]。在没有上大学和年龄在 21-23 岁的年轻人中，检测到休闲大麻合法化的影响。次要结果未检测到休闲大麻合法化的影响。
一些年轻人似乎对州休闲大麻合法化敏感，包括大麻使用障碍风险。应针对没有上大学的年轻人，并在 21 岁之前开展更多的预防工作。
