YRacial and Ethnic Differences in Suicide Mortality among 12-25 Year Olds Following Medical and Recreational Cannabis Legalization in the United States.

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine Pub Date : 2025-10-07 DOI:10.1016/j.amepre.2025.108141

Christopher J Hammond, Madison Hyer, Anne E Boustead, Rheanna Platt, Andrea S Young, Mary A Fristad, Danielle L Steelesmith, Guy Brock, Deborah S Hasin, Cynthia A Fontanella

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引用次数: 0

Abstract

Introduction: Cannabis legalization has often been framed as social justice reform in the US, but may have unintended downstream outcomes that vary by race and ethnicity. One such outcome is suicide, which is rising among US youth and associated with cannabis use. This study examined associations between state medical and recreational cannabis law (MCL and RCL) enactment and changes in suicide mortality by race and ethnicity in US youth.

Methods: Suicide deaths (N= 113,512) from the 2000-2019 National Vital Statistics System (NVSS) death files for 12-25 year-olds were examined in relation to time-varying cannabis law status, across racial and ethnic subgroups, using a staggered-adoption difference-in-difference approach that controlled for time-varying state-level and individual-level covariates. NVSS data were obtained in 2022. Analyses were conducted from June 2024 to July 2025.

Results: Unadjusted annual suicide rates were 9.7, 12.8, and 16.7 per 100,000 youth for no-CL, MCL, and RCL states, respectively. Significant Race/Ethnicity-by-CL effects were observed. Asian/Pacific Islander youth living in MCL and RCL states had increased incident rate ratios (IRR) for suicide deaths compared to Asian/Pacific Islander youth living in No-CL states (MCL: IRR=1.30; 95% CI,1.13-1.50; RCL: IRR=1.42; 95%CI,1.20-1.67). Hispanic youth living in RCL states had increased suicide deaths when compared to Hispanic youth living in MCL states (IRR=1.15; 95%CI,1.04-1.27) and No-CL states (IRR=1.32; 95%CI,1.03-1.71). CL-related differences in suicides for American Indian/Alaska Native and Non-Hispanic Black and White youth were nonsignificant. Findings were consistent across sensitivity analyses.

Conclusions: MCL and RCL were associated with increased suicide deaths in Asian/Pacific Islander and Hispanic youth. Mechanisms through which CLs differentially impact suicide mortality among youth of different racial and ethnic backgrounds warrant further study and should inform legislative reform.

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美国医疗和娱乐用大麻合法化后12-25岁青少年自杀死亡率的种族差异

在美国，大麻合法化通常被视为社会正义改革，但可能会产生意想不到的下游结果，因种族和民族而异。其中一个后果就是自杀，美国年轻人的自杀率正在上升，这与大麻的使用有关。本研究考察了国家医疗和娱乐大麻法（MCL和RCL）的颁布与美国青年种族和民族自杀死亡率变化之间的关系。方法：研究了2000-2019年国家生命统计系统（NVSS）死亡档案中12-25岁青少年的自杀死亡人数（N= 113,512）与时变大麻法律状态的关系，跨种族和族裔亚组，采用交错采用的差异中差方法，控制时变的州层面和个人层面的协变量。NVSS数据于2022年获得。分析时间为2024年6月至2025年7月。结果：未调整的年自杀率分别为9.7 / 10万，12.8 / 10万，MCL / 10万，RCL / 10万。观察到显著的种族/民族- cl效应。生活在MCL和RCL州的亚洲/太平洋岛民青年的自杀死亡发生率比（IRR）高于生活在无cl州的亚洲/太平洋岛民青年（MCL: IRR=1.30; 95%CI, 1.13-1.50; RCL: IRR=1.42; 95%CI,1.20-1.67）。与生活在MCL州（IRR=1.15; 95%CI,1.04-1.27）和No-CL州（IRR=1.32; 95%CI,1.03-1.71）的西班牙裔青年相比，生活在RCL州的西班牙裔青年自杀死亡人数增加。美国印第安人/阿拉斯加原住民与非西班牙裔黑人和白人青年的自杀相关差异不显著。敏感性分析的结果是一致的。结论：MCL和RCL与亚洲/太平洋岛民和西班牙裔青年自杀死亡增加有关。不同种族和民族背景的青少年自杀死亡率差异的机制值得进一步研究，并应为立法改革提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Preventive Medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

8.60

自引率

1.80%

发文量

395

审稿时长

32 days

期刊介绍： The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.