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
{"title":"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","authors":"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","doi":"10.1016/j.amepre.2025.108141","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108141"},"PeriodicalIF":4.5000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"YRacial and Ethnic Differences in Suicide Mortality among 12-25 Year Olds Following Medical and Recreational Cannabis Legalization in the United States.\",\"authors\":\"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\",\"doi\":\"10.1016/j.amepre.2025.108141\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":50805,\"journal\":{\"name\":\"American Journal of Preventive Medicine\",\"volume\":\" \",\"pages\":\"108141\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-10-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Preventive Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amepre.2025.108141\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Preventive Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amepre.2025.108141","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
YRacial and Ethnic Differences in Suicide Mortality among 12-25 Year Olds Following Medical and Recreational Cannabis Legalization in the United States.
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.
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.
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