Will cannabis legalization have unintended consequences for children's respiratory health? An ecological analysis

大麻合法化会对儿童的呼吸系统健康产生意想不到的后果吗？

基本信息

批准号：
10088469
负责人：
RENEE D GOODWIN
金额：
$ 12.19万
依托单位：
GRADUATE SCHOOL OF PUBLIC HEALTH AND HEALTH POLICY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-02-01 至 2023-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10088469
关键词：
Accident and Emergency department Adopted Adoption Adult Affect Age American Animals Asthma Cannabis Carcinogens Caring Chemicals Child Child Health Childhood Childhood Asthma Chronic Disease Cigarette Smoker Clinical Collection Country Data Data Set District of Columbia Emergency department visit Expenditure Exposure to Goals Government Guam Health Health Care Costs Health Surveys Home Hospitalization Hospitals Household Information Dissemination Inpatients Investigation Laboratory Study Laws Legal Legal Status Link Longitudinal Studies Lung diseases Marijuana Medical Medical Marijuana Natural experiment Outcome Parents Physicians Policies Population Prevalence Prevention Provider Public Health Public Health Education Puerto Rico Records Reporter Reporting Research Research Design Respiratory physiology Risk Risk Factors Schools Smoker Source Speed Statutes and Laws Surveys Symptoms Teenagers Time Tobacco use Toxicant exposure United States United States National Center for Health Statistics Wheezing Work Youth asthma exacerbation asthma inhaler asthma prevention cigarette smoking clinical implementation community intervention design environmental tobacco smoke environmental tobacco smoke exposure evidence base health care service utilization health service use in utero marijuana legalization marijuana use marijuana use in pregnancy marijuana user non-smoker offspring policy implication prenatal prenatal exposure programs public education residence respiratory respiratory health secondhand cannabis smoke smoking during pregnancy tobacco exposure trend

项目摘要

ABSTRACT Pediatric asthma is the most common chronic disease among children in the United States (US) and the leading cause of emergency department visits, inpatient pediatric hospitalization and missed school days. A key component of asthma prevention involves minimizing exposure to risk factors for asthma onset and effective asthma management requires the avoidance of triggers for asthma exacerbation. If asthma is well-managed, the vast majority of children with asthma can live symptom-free. Decades of research has identified secondhand tobacco smoke (STS) as a risk factor for asthma onset and exacerbation. The dissemination of this information via public health education programs has resulted in reductions in prenatal tobacco use and decreased exposure to STS among youth. Still, recent data suggest that STS exposure remains significantly higher among children ages 3-11, relative to teenagers and adults, potentially due to exposure in the home. Legalization of cannabis is growing rapidly across the US. Not surprisingly, cannabis use has increased more rapidly among adults in states where it has been legalized. Further, in contrast to declines in cigarette use, our recent work shows that cannabis use is increasing rapidly among parents with children in the home. While this is occurring among both parents who are cigarette smokers and among non-smokers, cannabis use is more than twice as common among cigarette smokers. Over 50% of children with asthma in the US live with a smoker. With the rapid legalization of marijuana across the country, systematic investigation of the potential impact of adoption of medical marijuana laws (MML) and recreational marijuana laws (RML) children’s respiratory health is urgently needed at a population level. To this end, the current study uses an ecological design to estimate key pediatric asthma outcomes before and after the adoption of MML and RML using nationally representative data collected between 1996 and 2022. Ecologic studies can be a critical first step in identifying key public health problems. An evidence base on the potential impact of the adoption of MML and RML on children’s respiratory health is essential to inform current and evolving policy, clinical and community interventions, and prevention programming needs in order to avert potentially unintended risks associated with cannabis popularization: increased exposure to secondhand cannabis smoke among children.

抽象的小儿哮喘是美国儿童中最常见的慢性疾病（美国），是紧急部门的探访，住院儿科住院和错过上学日。哮喘的关键组成部分预防涉及最大程度地减少对哮喘发作和有效哮喘管理的风险因素的接触，这需要避免触发哮喘加重。如果哮喘管理良好，那么绝大多数患有哮喘的儿童可以无症状。数十年的研究已经确定二手烟烟（STS）是哮喘发作的危险因素和恶化。通过公共卫生教育计划传播这些信息已导致减少产前烟草使用并改善了年轻人中STS的接触。尽管如此，最近的数据表明STS暴露仍然存在相对于青少年和成年人，3-11岁儿童的年龄较高，可能是由于家庭暴露。整个美国的大麻合法化正在迅速增长。毫不奇怪，大麻的使用量增加了在已合法化的州的成年人。此外，与使用香烟减少相反，我们最近的工作表明在家里有孩子的父母中，大麻的使用迅速增加。虽然这是父母之间发生的在吸烟者和非吸烟者中，使用大麻的人是吸烟者中常见的两倍以上。在美国，超过50％的哮喘儿童与吸烟者生活在一起。随着全国大麻的快速遗产，系统投资采用医用大麻法（MML）和娱乐大麻的潜在影响在人群一级迫切需要法律（RML）儿童呼吸健康。为此，当前的研究使用了使用MML和RML之前和之后，生态设计以估计关键的小儿哮喘结果在1996年至2022年之间收集的全国代表数据。生态学研究可能是确定的关键第一步关键的公共卫生问题。关于采用MML和RML对儿童的潜在影响的证据基础呼吸健康对于告知当前和不断发展的政策，临床和社区干预以及预防至关重要编程需求，以避免与大麻普及相关的潜在意外风险：增加儿童暴露于二手大麻烟雾。