Ups and downs
Is there a cannabis epidemic model? Evidence from France, Germany and USA
Stephane Legleye et al.
International Journal of Drug Policy, forthcoming
Background: Cannabis is the most popular illicit drug in the world, but the process of its diffusion through the population has rarely been studied. The unfolding of the tobacco epidemic was accompanied by a shift in the educational gradient of users across generations. As a consequence, cannabis may show the same pattern of widening social inequalities. We test the diffusion hypotheses that a positive value in older cohorts – the more educated experimenting more – shifts to a negative one in younger cohorts – the more educated experimenting less, first for males and then females.
Methods: Three nationwide subsamples (18-64 years old) of representative surveys conducted in France (n = 21,818), Germany (n = 7,887) and USA (n = 37,115) in 2009-2010 recorded age at cannabis experimentation (i.e., first use), educational level, gender, and age. Cumulative prevalence of experimentation was plotted for three retrospective cohorts (50-64, 35-49, 18-34 years old at data collection) and multivariate time-discrete logistic regression was computed by gender and generation to model age at experimentation adjusted on age at data collection and educational level. This latter was measured according to four categories derived from the International Standard Classification of Education (ISCED) and a relative (rather than absolute) index of education.
Results: The findings demonstrate a consistent pattern of evolution of the prevalence, gender ratio and educational gradient across generations and countries that supports the hypothesis of an “epidemic” of cannabis experimentation that mimics the epidemic of tobacco.
Conclusion: We provide evidence for a cannabis epidemic model similar to the tobacco epidemic model. In the absence of clues regarding the future of cannabis use, our findings demonstrate that the gender gap is decreasing and, based on the epidemic model, suggest that we may expect widening social inequalities in cannabis experimentation if cannabis use decreases in the future.
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The Effects of Medical Marijuana Laws on Illegal Marijuana Use
Yu-Wei Luke Chu
Journal of Health Economics, forthcoming
Abstract:
More and more states have passed laws that allow individuals to use marijuana for medical purposes. There is an ongoing, heated policy debate over whether these laws have increased marijuana use among non-patients. In this paper, I address that question empirically by studying marijuana possession arrests in cities from 1988 to 2008. I estimate fixed effects models with city-specific time trends that can condition on unobserved heterogeneities across cities in both their levels and trends. I find that these laws increase marijuana arrests among adult males by about 15–20%. These results are further validated by findings from data on treatment admissions to rehabilitation facilities: marijuana treatments among adult males increased by 10–20% after the passage of medical marijuana laws.
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Medical Marijuana Laws and Teen Marijuana Use
Mark Anderson, Benjamin Hansen & Daniel Rees
NBER Working Paper, July 2014
Abstract:
While at least a dozen state legislatures in the United States have recently considered bills to allow the consumption of marijuana for medicinal purposes, the federal government is intensifying its efforts to close medical marijuana dispensaries. Federal officials contend that the legalization of medical marijuana encourages teenagers to use marijuana and have targeted dispensaries operating within 1,000 feet of schools, parks and playgrounds. Using data from the national and state Youth Risk Behavior Surveys, the National Longitudinal Survey of Youth 1997 and the Treatment Episode Data Set, we estimate the relationship between medical marijuana laws and marijuana use. Our results are not consistent with the hypothesis that legalization leads to increased use of marijuana by teenagers.
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Crime and the Depenalization of Cannabis Possession: Evidence from a Policing Experiment
Imran Rasul, Jerome Adda & Brendon McConnell
Journal of Political Economy, forthcoming
Abstract:
We evaluate the impact on crime of a localized policing experiment that depenalized the possession of small quantities of cannabis in the London borough of Lambeth. We find that depenalization policy caused the police to reallocate effort towards non-drug crime. Despite the overall fall in crime attributable to the policy, we find the total welfare of local residents likely fell, as measured by house prices. We shed light on what would be the impacts on crime of a citywide depenalization policy, by developing and calibrating a structural model of the market for cannabis and crime.
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Amanda Richardson et al.
American Journal of Public Health, August 2014, Pages 1429-1436
Objectives: We monitored the prevalence and patterns of use of the array of tobacco products available to young adults, who are at risk for initiation and progression to established tobacco use.
Methods: We used data from waves 1 to 3 of GfK’s KnowledgePanel (2011–2012), a nationally representative cohort of young adults aged 18 to 34 years (n = 2144). We examined prevalence and patterns of tobacco product use over time, associated demographics, and state-level tobacco policy. We used multivariable logistic regression to determine predictors of initiation of cigarettes as well as noncombustible and other combustible products.
Results: The prevalence of ever tobacco use rose from 57.28% at wave 1 to 67.43% at wave 3. Use of multiple products was the most common pattern (66.39% of tobacco users by wave 3). Predictors of initiation differed by product type and included age, race/ethnicity, policy, and use of other tobacco products.
Conclusions: Tobacco use is high among young adults and many are using multiple products. Efforts to implement policy and educate young adults about the risks associated with new and emerging products are critical to prevent increased initiation of tobacco use.
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Probing the Smoking–Suicide Association: Do Smoking Policy Interventions Affect Suicide Risk?
Richard Grucza et al.
Nicotine & Tobacco Research, forthcoming
Introduction: Smokers exhibit elevated risk for suicide, but it is unknown whether smoking interventions reduce suicide risk. We examined whether state-level policy interventions—increases in cigarette excise taxes and strengthening of smoke-free air laws—corresponded to reduction in suicide risk during the 1990s and early 2000s. We also examined whether the magnitude of such reductions correlated with individuals’ predicted probability of smoking, as would be expected if the associations stemmed from changes in smoking behavior.
Methods: We paired individual-level data on suicide deaths from the U.S. Multiple Cause of Death files, years 1990–2004, with living population data from the same period. These were linked with state data on cigarette excise taxes and smoke-free air policies. Utilizing a quasi-experimental analytical approach, we estimated the association between changes in policy and suicide risk. To examine whether associations correlated with individuals’ probability of smoking, we used external survey data to derive a predicted probability of smoking function from demographic variables, which was then used to stratify the population by predicted smoking prevalence.
Results: Cigarette excise taxes, smoke-free air policies, and an index combining the two policies all exhibited protective associations with suicide. The associations were strongest in segments of the population where predicted smoking prevalence was the highest and weaker in segments of the population where predicted smoking prevalence was the lowest, suggesting that the protective associations were related to changes in smoking behavior.
Conclusion: These results provide support for the proposition that population interventions for smoking could reduce risk for suicide.
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Anthony Ecker, Ashley Richter & Julia Buckner
Addictive Behaviors, December 2014, Pages 1746–1749
Objective: Socially anxious cannabis users are especially vulnerable to cannabis-related impairment, yet mechanisms underlying this vulnerability remain unclear. Socially anxious persons may use cannabis despite related problems if they believe such problems are common, and thus socially acceptable. Yet no known studies have examined the impact of beliefs regarding others’ cannabis-related problems on one’s own use-related problems.
Method: This study investigated the impact of beliefs about a close friend’s experience with cannabis-related problems on the relationship between social anxiety and cannabis-related problems. The sample consisted of 158 (75% female) current (past-month) cannabis-using undergraduates.
Results: Believing one’s friend experienced more cannabis problems was related to experiencing more cannabis-related problems oneself. In fact, perceived friend’s problems accounted for 40% of the unique variance in one’s own cannabis problems. Descriptive norms (others’ use) and injunctive norms (others’ approval of risky use) were unrelated to number of one’s own problems. Social anxiety was related to experiencing more cannabis problems. This relation was moderated by perceived friend’s problems such that greater social anxiety was related to more cannabis-related problems among participants who believed their friend experienced more cannabis-related problems. This was not the case among participants who believed their friend experienced fewer problems.
Conclusions: Normative beliefs regarding a close friend’s cannabis problems were robustly and uniquely related to experiencing more cannabis-related impairment. Beliefs regarding friends’ experience with cannabis-related problems may play an especially important role in the experience of cannabis-related problems among socially anxious users.
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Electronic Cigarettes and Conventional Cigarette Use Among US Adolescents: A Cross-sectional Study
Lauren Dutra & Stanton Glantz
JAMA Pediatrics, July 2014, Pages 610-617
Objective: To examine e-cigarette use and conventional cigarette smoking.
Design, Setting, and Participants: Cross-sectional analyses of survey data from a representative sample of US middle and high school students in 2011 (n = 17 353) and 2012 (n = 22 529) who completed the 2011 and 2012 National Youth Tobacco Survey.
Results: Among cigarette experimenters (≥1 puff), ever e-cigarette use was associated with higher odds of ever smoking cigarettes (≥100 cigarettes; odds ratio [OR] = 6.31; 95% CI, 5.39-7.39) and current cigarette smoking (OR = 5.96; 95% CI, 5.67-6.27). Current e-cigarette use was positively associated with ever smoking cigarettes (OR = 7.42; 95% CI, 5.63-9.79) and current cigarette smoking (OR = 7.88; 95% CI, 6.01-10.32). In 2011, current cigarette smokers who had ever used e-cigarettes were more likely to intend to quit smoking within the next year (OR = 1.53; 95% CI, 1.03-2.28). Among experimenters with conventional cigarettes, ever use of e-cigarettes was associated with lower 30-day (OR = 0.24; 95% CI, 0.21-0.28), 6-month (OR = 0.24; 95% CI, 0.21-0.28), and 1-year (OR = 0.25; 95% CI, 0.21-0.30) abstinence from cigarettes. Current e-cigarette use was also associated with lower 30-day (OR = 0.11; 95% CI, 0.08-0.15), 6-month (OR = 0.11; 95% CI, 0.08-0.15), and 1-year (OR = 0.12; 95% CI, 0.07-0.18) abstinence. Among ever smokers of cigarettes (≥100 cigarettes), ever e-cigarette use was negatively associated with 30-day (OR = 0.61; 95% CI, 0.42-0.89), 6-month (OR = 0.53; 95% CI, 0.33-0.83), and 1-year (OR = 0.32; 95% CI, 0.18-0.56) abstinence from conventional cigarettes. Current e-cigarette use was also negatively associated with 30-day (OR = 0.35; 95% CI, 0.18-0.69), 6-month (OR = 0.30; 95% CI, 0.13-0.68), and 1-year (OR = 0.34; 95% CI, 0.13-0.87) abstinence.
Conclusions and Relevance: Use of e-cigarettes was associated with higher odds of ever or current cigarette smoking, higher odds of established smoking, higher odds of planning to quit smoking among current smokers, and, among experimenters, lower odds of abstinence from conventional cigarettes. Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among US adolescents.
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Craig Ross et al.
Alcoholism, forthcoming
Background: Being able to investigate the relationship between underage drinkers' preferences for particular brands and their exposure to advertising for those brands would represent a significant advance in alcohol marketing research. However, no previous national study has examined the relationship between underage youth exposure to brand-specific alcohol advertising and consumption of those brands.
Methods: We conducted a cross-sectional, Internet-based survey of a national sample of 1,031 youth, ages 13–20, who had consumed at least 1 drink of alcohol in the past 30 days. We ascertained all alcohol brands consumed by respondents in the past 30 days. The main outcome measure was brand-specific consumption during the past 30 days, measured as a dichotomous variable. The main predictor variable was exposure to brand-specific alcohol advertising on television. The respondents reported which of 20 television shows popular with youth they had watched during the past 30 days. For each respondent, we calculated a standard measure of potential exposure to the brand-specific alcohol advertising that aired on those shows during the preceding 12 months, based on Nielsen (New York, NY) estimates of the youth audience for each show's telecasts.
Results: Compared to no brand-specific advertising exposure, any exposure was associated with an increased likelihood of brand-specific consumption (adjusted odds ratio 3.02; 95% confidence interval: 2.61–3.49) after controlling for several individual- and brand-level variables. When measured as a continuous variable, the relationship between advertising exposure and brand consumption was nonlinear, with a large association at lower levels of exposure and diminishing incremental effects as the level of exposure increased.
Conclusions: There is a robust relationship between youth's brand-specific exposure to alcohol advertising on television and their consumption of those same alcohol brands during the past 30 days. This study provides further evidence of a strong association between alcohol advertising and youth drinking behavior.
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John Lang, Daniel Abrams & Hans De Sterck
University of Waterloo Working Paper, July 2014
Abstract:
Smoking of tobacco is predicted to cause approximately six million deaths worldwide in 2014. Responding effectively to this epidemic requires a thorough understanding of how smoking behaviour is transmitted and modified. Here, we present a new mathematical model of the social dynamics that cause cigarette smoking to spread in a population. Our model predicts that more individualistic societies will show faster adoption and cessation of smoking. Evidence from a new century-long composite data set on smoking prevalence in 25 countries supports the model, with direct implications for public health interventions around the world. Our results suggest that differences in culture between societies can measurably affect the temporal dynamics of a social spreading process, and that these effects can be understood via a quantitative mathematical model matched to observations.
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Tobacco Control Policies and Sudden Infant Death Syndrome in Developed Nations
Christian King, Sara Markowitz & Hana Ross
Health Economics, forthcoming
Abstract:
This paper estimates the effects of higher cigarette prices and smoke-free policies on the prevalence of Sudden Infant Death Syndrome (SIDS). Using a panel of developed countries over a 20 year period, we find that higher cigarette prices are associated with reductions in the prevalence of SIDS. However, we find no evidence that smoke-free policies are associated with declines in SIDS.
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Jonathan Daw et al.
Addictive Behaviors, forthcoming
Abstract:
Previous cross-sectional research has shown that adolescents’ cigarette use is interactively associated with that of their school peers and their 5HTTLPR genotype, such that the cigarette use of persons with more copies of the 5HTTLPR*S’ allele is more dependent on school peers’ cigarette use behaviors than their counterparts. This analysis seeks to extend this novel finding by examining whether the same conclusion can be reached when substituting neighborhood peers for school peers and examining the timing of the initiation of any and regular smoking in adolescence. A similar conclusion is reached using an independent sample with longitudinal measures of cigarette use among 6th through 8th graders clustered in 82 neighborhoods, of whom 1,098 contributed genetic data. The proportion of respondents who had ever smoked cigarettes by the first wave was calculated for each Census block group in the study. 5HTTLPR genotype was assayed using the method of Whisman and colleagues (2011). The timing of any or regular smoking initiation and over four years were modeled as dependent variables using Cox proportional hazards models. The interaction of neighborhood peer smoking behavior in the first wave and 5HTTLPR genotype statistically significantly predicted any smoking initiation (hazard ratio: 3.532; p-value = 0.002) and regular smoking initiation (hazard ratio: 5.686; p-value = 0.000), net of controls for sex, race/ethnicity, grade in the first wave of data, and parental educational attainment. These findings reach the same conclusions as previous cross-sectional research. The findings for any smoking initiation are consistent with the diathesis-stress model of gene-environment interaction; the findings for regular smoking initiation are consistent with the differential susceptibility model.
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Awareness of Novel Drug Legality in a Young Adult Population
Michael Singleton, John Stogner & Bryan Lee Miller
American Journal of Criminal Justice, September 2014, Pages 425-435
Abstract:
In recent years, use of substances commonly referred to as ‘legal highs’ has become a significant concern to policy makers and public health officials. Though legislation banning the use and possession of these novel and synthetic drugs often follows the initial media attention and public outcry, potential users may often be unaware of the legislation. A survey including self-reported drug use and perceptions of the legality of various psychoactive substances was administered to 2,346 students in randomly selected classes at a large public university to determine what portion accurately knew four types of novel drugs were locally illegal. Results indicated that numerous potential and current users incorrectly believed that the former ‘legal highs’ remained unrestricted. This sample did include a number of novel drug users; lifetime use of at least one novel drug was reported by 17.1 %, many of which reported using multiple types of novel drugs. Approximately one-third of the overall sample inaccurately believed that Salvia divinorum (34.7 %), K2/Spice (36.5 %), and Mr. Miyagi/Pot-pourri (32.1 %) were legal in the state and over half (50.3 %) inaccurately believed ‘bath salts’ (synthetic cathinones, MDPV, and other synthetic stimulants) remained legal. As these misperceptions have the potential to influence substance use decisions, they may need to be corrected through educational campaigns as widespread as the preceding media coverage that labeled the drug as ‘legal highs.’ Results also indicated that Blacks and previous users of the substances were more likely to hold inaccurate legal beliefs.
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Productive Addicts and Harm Reduction: How Work Reduces Crime – But Not Drug Use
Christopher Uggen & Sarah Shannon
Social Problems, February 2014, Pages 105-130
Abstract:
From the Works Progress Administration of the New Deal to the Job Corps of the Great Society era, employment programs have been advanced to fight poverty and social disorder. In today's context of stubborn unemployment and neoliberal policy change, supported work programs are once more on the policy agenda. This article asks whether work reduces crime and drug use among heavy substance users. And, if so, whether it is the income from the job that makes a difference, or something else. Using the nation's largest randomized job experiment, we first estimate the treatment effects of a basic work opportunity and then partition these effects into their economic and extra-economic components, using a logit decomposition technique generalized to event history analysis. We then interview young adults leaving drug treatment to learn whether and how they combine work with active substance use, elaborating the experiment's implications. Although supported employment fails to reduce cocaine or heroin use, we find clear experimental evidence that a basic work opportunity reduces predatory economic crime, consistent with classic criminological theory and contemporary models of harm reduction. The rate of robbery and burglary arrests fell by approximately 46 percent for the work treatment group relative to the control group, with income accounting for a significant share of the effect.
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Jessica O'Brien, Sarah Lichenstein & Shirley Hill
Journal of Studies on Alcohol and Drugs, July 2014, Pages 643–652
Objective: Individuals with multiple alcohol-dependent (AD) relatives are at increased risk for substance use disorders (SUDs). Prospective, longitudinal studies of high-risk (HR) individuals afford the opportunity to determine potential risk markers of SUDs. The current study assessed the effect of familial risk and genetic variation on Iowa Gambling Task (IGT) performance and tested for an association between IGT performance and SUD outcomes.
Method: Individuals from multiplex AD families (n = 63) and low-risk (LR; n = 45) control families, ages 16–34 years, were tested using a computerized version of the IGT. SUD outcomes were assessed at approximately yearly intervals. 5-HTTLPR and COMT genotypes were available for the majority of participants (n = 86).
Results: HR offspring showed poorer performance overall on the IGT and especially poor performance on the final trial block (Block 5), indicating a failure to improve decision making with previous experience. The 5-HTTLPR short-allele homozygote participants performed worse than long-allele carriers, with HR S/S carriers exhibiting particularly poor performance. There was no main effect of COMT on IGT performance and no significant COMT by Risk interaction. Significantly more individuals in the HR than LR group met criteria for SUD. Importantly, disadvantageous performance on IGT Block 5 was significantly associated with an earlier age at SUD onset.
Conclusions: This is the first study to show that both familial risk of SUD and 5-HTTLPR variation impact performance on the IGT. Poorer IGT performance was associated with earlier onset of SUD, suggesting that HR individuals who fail to appropriately attend to long-term costs and benefits during a decision-making task are especially at risk for developing SUD in adolescence and young adulthood.