目的:自1996年以来,美国38个州已将大麻(医疗和/或成人娱乐)合法化。我们旨在估计国家大麻政策设计的三个维度的影响-制药,总体上的宽松和财政水平,酒精受损,乘员,轻型卡车和行人死亡率。
方法:对美国各州的观察性研究酒精受损,乘员,1994年至2020年轻型卡车和行人死亡人数。
方法:分析单位是州一级,由50个州和27年的时间序列数据组成,总共进行了1350个州年观测。
方法:与酒精损害相关的死亡率,行人,总居住者,乘用车和轻型卡车的死亡率是从国家公路交通安全管理局的死亡分析报告系统获得的,并且每行驶100亿英里的车辆进行标准化。国家大麻政策分为三个捆绑(尺度):制药、宽容和财政。
结果:药物组合与所有病死率的增加相关[β=0.145;95%置信区间(CI)=0.116-0.173;P<0.000]。许可束与较低的总死亡率相关(β=-0.319;95%CI=-0.361至-0.277;P<0.000)。财政捆绑通常与较高的死亡率相关(β=0.062;95%CI=0.043-0.081;P<0.000),乘员(β=0.070;95%CI=0.042-0.098;P<0.000),轻型卡车(β=0.049;95%CI=0.026-0.072;P<0.000)。
结论:美国州大麻法规影响交通安全。美国州大麻法规的更大放任似乎与交通死亡率的增加无关,但更大的医疗化和财政运作确实如此。
OBJECTIVE: Since 1996, 38 US states have legalized access to cannabis (medical and/or adult-use recreational). We aimed to estimate the effect of three dimensions of state cannabis policy design - pharmaceutical, permissive and fiscal - on levels of overall, alcohol-impaired, occupant, light truck and pedestrian fatality rates.
METHODS: Observational study of US states\' overall, alcohol-impaired, occupant, light truck and pedestrian fatalities between 1994 and 2020.
METHODS: The unit of analysis was at the state level, consisting of 50 states and 27 years of time series data, resulting in a total of 1350 state-year observations.
METHODS: Fatality rates associated with alcohol-impaired, pedestrian, total occupant, passenger car and light truck fatality rates were obtained from the Fatality Analysis Reporting System of the National Highway Traffic Safety Administration and normalized per 10 billion vehicle miles traveled. State cannabis policies are measured in three bundles (scales): pharmaceutical, permissive and fiscal.
RESULTS: The pharmaceutical bundle was associated with increases in all fatality rates [β = 0.145; 95% confidence interval (CI) = 0.116-0.173; P < 0.000]. The permissive bundle was associated with lower overall fatality rates (β = -0.319; 95% CI = -0.361 to -0.277; P < 0.000). The fiscal bundle was generally associated with higher fatality rates (β = 0.062; 95% CI = 0.043-0.081; P < 0.000), occupant (β = 0.070; 95% CI = 0.042-0.098; P < 0.000), light trucks (β = 0.049; 95% CI = 0.026-0.072; P < 0.000).
CONCLUSIONS: US state cannabis regulations influence traffic safety. Greater permissiveness in US state cannabis regulations does not appear to correlate with traffic fatality rate increases, but greater medicalization and fiscal operation does.