Cannabis Legalization's Effects on Youth and Adult Nicotine and Tobacco Use

大麻合法化对青少年和成人尼古丁和烟草使用的影响

• 批准号: 10801535
• 负责人: Abigail S. Friedman
• 金额: $ 58.1万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10801535
• 关键词: 20 year old; Acceleration; Accounting; Address; Adult; Affect; Age; Attention; Behavior; Cannabis; Cannabis policy; Cannabis retail; Cigar; Cigarette; Communities; Community Health; Complement; Costs and Benefits; Data; Databases; District of Columbia; Drug usage; Economics; Electronic Nicotine Delivery Systems; Elements; Ensure; Environment; Epidemic; Formulation; Health; Heterogeneity; Home; Laws; Legal; Licensing; Link; Literature; Methods; Modeling; Modification; Morbidity - disease rate; Nicotine; Patient Self-Report; Pattern; Peer Review; Persons; Policies; Policy Maker; Policy Research; Prevalence; Prevention; Price; Proxy; Public Health; Quasi-experiment; Randomized; Recreation; Regulation; Research; Role; Sales; Smoker; Smoking; Societies; Structure; Surveys; THC concentration; Taxes; Testing; Time; Tobacco; Tobacco use; Variant; Work; Youth; age group; cigarette smoking; cost; density; expectation; geographic difference; health data; improved; marijuana legalization; marijuana use; marijuana use disorder; mortality; nicotine use; non-cigarette tobacco product; preempt; preventable death; public policy on tobacco; simulation; sociodemographics; success; theories; tobacco products; tool; young adult

PROJECT SUMMARY The past 20 years have seen significant changes in the US’s legal cannabis landscape alongside marked changes in tobacco use, the leading cause of preventable mortality. Yet recreational cannabis legalization’s (RCL’s) effects on tobacco product use remain unclear: few peer-reviewed studies directly test these effects and quasi-experimental analyses—methods to generate causal estimates in the absence of randomization— yield mixed findings on whether cannabis is an economic complement or substitute for cigarettes. These dynamics are crucial: laws increasing cannabis access will decrease use of its substitutes and increase use of its complements. Moreover, quasi-experimental studies largely ignore RCL’s effects on use of non-cigarette tobacco products like cigars and electronic nicotine delivery systems (ENDS), as well as potential effects of state cannabis policy details (e.g., tax rates, formulation restrictions) and local cannabis laws (e.g., local taxes, home delivery bans). If such effects are not anticipated, policymakers’ expectations of RCL’s costs and benefits will be incorrect, and both state and local policymakers may miss opportunities to structure cannabis laws in a manner that better protects their community’s health. To address this, we will compile a cannabis policy database covering state RCL policy details, local cannabis policies, and retailer density, and match it to nationally representative, restricted-use data from the National Survey on Drug Use and Health. Aim 1A will use these data to characterize variation in local access to cannabis retailers, local cannabis policies, and state RCL policy details likely to impact cannabis access and use within RCL states. Aim 1B will assess these policies’ relationships to cannabis retailer density, perceived ease of cannabis access, and cannabis use, elucidating their strength as unconfounded proxies for local cannabis retailer density and ease of access, and clarifying whether the policies’ effects on cannabis use are strong enough to allow instrumental variable analyses of cannabis use’s effect on tobacco product use. Considering cigarettes, cigars, ENDS, and blunts, Aim 2 will estimate RCL’s direct effects on adult tobacco product use, test for effect modification from state RCL policy details and local cannabis laws, and simulate implications for tobacco product use under alternative RCL scenarios (e.g., federal RCL, different cannabis tax rates, preempting local bans on retail sales). Aim 3 will conduct parallel analyses and simulations for 12-20 year-olds. Results will extend the literature on RCL’s effects on tobacco product use by accounting for a range of tobacco products, and increase its rigor by considering effect modification due to variation in state policy details and local cannabis laws, separately for underage versus 21+ age-groups. Moreover, simulations of alternative policies’ effects on tobacco and nicotine use will clarify potential unanticipated costs or benefits of different state and local cannabis policies, helping policymakers identify policy options to best ensure continued progress towards eliminating tobacco’s toll in their community.

项目摘要 在过去的20年中，美国的合法大麻景观发生了重大变化 烟草使用的变化是可预防死亡率的主要原因。然而娱乐大麻合法化的 （RCL）对烟草产品使用的影响尚不清楚：很少有同行评审研究直接测试这些效果 和准实验分析 - 在没有随机化的情况下产生因果估计的方法 - 关于大麻是经济完成还是替代香烟的结果，结果混合了。这些 动态至关重要：增加大麻访问的法律将减少其替代品的使用，并增加使用的使用 它的完成。此外，准实验研究在很大程度上忽略了RCL对使用非二烟的影响 烟草和电子尼古丁输送系统（末端）等烟草产品，以及 国家大麻政策细节（例如税率，公式限制）和当地大麻法（例如，地方税收， 送货禁令）。如果没有预期的效果，则决策者对RCL成本的期望和 福利将是不正确的，州和地方决策者都可能错过结构大麻的机会 法律以更好地保护社区健康的方式。为了解决这个问题，我们将编译一份大麻 涵盖州RCL政策详细信息，本地大麻政策和零售商密度的策略数据库，并将其与 全国代表性的限制性数据来自全国药物使用和健康调查。目标1a将 使用这些数据来表征当地访问大麻零售商，当地大麻政策和状态的变化 RCL政策细节可能会影响RCL州内的大麻访问和使用。 AIM 1B将评估这些政策 与大麻零售商密度的关系，可感知的大麻通道和大麻的使用，阐明了他们的 强度是当地大麻零售商密度的不符代理，并易于使用，并确定是否存在 政策对大麻使用的影响足够强，可以允许对大麻使用的仪器变量分析 对烟草产品使用的影响。考虑到公民，平民，终点和钝器，AIM 2将估计RCL的直接 对成人烟草产品使用的影响，测试对国家RCL政策细节和本地的效果修改 大麻法，并模拟对替代RCL场景中烟草产品使用的影响（例如， 联邦RCL，不同的大麻税率，在零售销售方面抢占当地禁令。 AIM 3将平行进行 12-20岁的年龄段的分析和模拟。结果将扩大有关RCL对烟草影响的文献 通过会计使用一系列烟草产品的产品使用，并通过考虑效果来增加其严格性 由于国家政策细节和当地大麻法的差异而导致的修改，分别用于未成年 21多个年龄段。此外，模拟替代政策对烟草和尼古丁使用的影响将澄清 不同州和地方大麻政策的潜在意外成本或收益，帮助决策者 确定政策选择，以最好地确保取消烟草对社区的损失的持续进展。