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，也是导致儿童哮喘的主要原因急诊就诊、儿科住院和缺课是哮喘的一个重要组成部分。预防包括尽量减少接触哮喘发作的危险因素，有效的哮喘管理需要避免哮喘恶化的诱因如果哮喘得到良好的控制，绝大多数哮喘儿童都可以痊愈。数十年的研究已确定二手烟（STS）是哮喘发作的危险因素。通过公共卫生教育计划传播这一信息已导致疾病的减少。产前吸烟和青少年接触 STS 的减少尽管如此，最近的数据表明，STS 接触仍然存在。相对于青少年和成人，3-11 岁儿童的感染率明显更高，这可能是由于在家中暴露所致。大麻合法化在美国迅速发展，毫不奇怪，大麻的使用增长得更快。此外，与香烟使用量的下降相反，我们最近的研究表明：家里有孩子的父母吸食大麻的现象正在迅速增加，而这种情况也发生在父母双方身上。在吸烟者和不吸烟者中，吸食大麻的比例是吸烟者的两倍多。在美国，超过 50% 的哮喘儿童与吸烟者生活在一起。随着大麻在全国范围内的迅速合法化，对采用医用大麻法 (MML) 和娱乐性大麻的潜在影响进行系统调查法律（RML）在人口层面迫切需要儿童呼吸健康。为此，当前的研究采用了一项研究。使用生态设计来评估采用 MML 和 RML 前后的关键儿科哮喘结局 1996 年至 2022 年间收集的全国代表性数据。生态研究可能是确定关于采用 MML 和 RML 对儿童的潜在影响的证据基础。呼吸系统健康对于为当前和不断发展的政策、临床和社区干预以及预防提供信息至关重要为避免与大麻普及相关的潜在意外风险而进行的规划需求：增加儿童接触二手大麻烟雾。