Oregon Ballot Measure 110 (BM 110) reduced the penalties for non-commercial possession of a controlled substance, downgrading them from a felony or misdemeanor to a new Class E violation, punishable by a maximum $100 fine. In this paper, we investigate whether BM 110 was associated with changes in drug-related fatal traffic crashes in Oregon after its implementation in February 2021. To do so, we used Fatality Analysis Reporting System (FARS) data from 2018 to 2021 to calculate population-adjusted state-level drug-related fatal traffic crashes. We also employed a modified synthetic control method to create a "synthetic" Oregon, designed to closely resemble the state's pre-policy sociodemographic characteristics and outcome trends while correcting for time-invariant pre-policy differences. The findings show that BM 110 was not associated with changes in drug-related fatal traffic crashes per 100,000 population (0.114, 95% CI: -0.106, 0.334). These results suggest that the implementation of BM 110 did not change drug-related fatal traffic crashes in Oregon in the early period following its adoption.
Importance Recreational cannabis legalization (RCL) has been advocated as a way to reduce the number of individuals interacting with the US criminal justice system; in theory, however, cannabis decriminalization can achieve this objective without generating the negative public health consequences associated with RCL. It is still unclear whether RCL can bring additional benefits in terms of reducing cannabis possession arrests in states that have already decriminalized cannabis. Objective To examine whether RCL was associated with changes in cannabis possession arrests in US states that had already decriminalized cannabis during the study period and whether these changes differed across age and racial subgroups. Design, Setting, and Participants This repeated cross-sectional study used cannabis possession arrest data from the Federal Bureau of Investigation Uniform Crime Reporting Program (UCRP) for US states from 2010 through 2019. Statistical analysis was conducted from October 6, 2021, to October 12, 2022. Exposures Implementation of statewide RCL. Main Outcomes and Measures Cannabis possession arrest rates per 1000 population per year were assessed with a quasi-experimental difference-in-differences design and were used to estimate the association of RCL with arrest rates in RCL states that had or had not decriminalized cannabis before RCL. This association was also examined in subgroups for age (adults vs youths) and race (Black vs White). Results This study included UCRP data for 31 US states, including 9 states that implemented RCL during the study period (4 without and 5 with decriminalization) and 22 non-RCL states. In the 4 states that had not decriminalized cannabis before legalization, RCL was associated with a 76.3% decrease (95% CI, −81.2% to −69.9%) in arrest rates among adults. In the 5 states that had already decriminalized cannabis, RCL was still associated with a substantial decrease in adult arrest rates (−40.0%; 95% CI, −55.1% to −19.8%). There was no association of RCL with changes in arrest rates among youths. In addition, changes in arrest rates associated with RCL did not differ among Black and White individuals. Conclusions and Relevance In this repeated cross-sectional study, RCL was associated with a sizable reduction in cannabis possession arrests among adults in states that had already decriminalized cannabis during the study period (2010-2019), albeit the magnitude was smaller compared with states that had not decriminalized cannabis before RCL. In addition, RCL did not seem to be associated with changes in arrest rates among youths or disparities in arrest rates among Black and White individuals.
( Int J Obstet Anesth. 2022;51:103550) As 2.5% of births in the United States are impacted by uterine atony, identifying high-risk women can promote timely treatment and subsequently minimize adverse outcomes. However, there is no current risk assessment model that solely focuses on the risk for uterine atony rather than the overall risk for postpartum hemorrhage (PPH). This retrospective study created and tested 2 risk prediction models for antepartum and intrapartum uterine atony.
Abstract Three cigarette smoking behaviors influence lung cancer rates: how many people start, the amount they smoke, and the age they quit. California has reduced smoking faster than the rest of the United States and trends in these three smoking behaviors should inform lung cancer trends. We examined trends in smoking behavior (initiation, intensity, and quitting) in California and the rest of United States by regression models using the 1974–2014 National Health Interview Surveys (n = 962,174). Lung cancer mortality data for 1970–2013 was obtained from the National Surveillance, Epidemiology, and End Results (SEER) Program. Among those aged 18 to 35 years, California had much larger declines than the rest of the United States in smoking initiation and intensity, and increased quitting. In 2012–2014, among this age group, only 18.6% [95% confidence interval (CI), 16.8%–20.3%] had ever smoked; smokers consumed only 6.3 cigarettes/day (95% CI, 5.6–7.0); and 45.7% (95% CI, 41.1%–50.4%) of ever-smokers had quit by age 35. Each of these metrics was at least 24% better than in the rest of the United States. There was no marked California effect on quitting or intensity among seniors. From 1986 to 2013, annual lung cancer mortality decreased more rapidly in California and by 2013 was 28% lower (62.6 vs. 87.5/100,000) than in the rest of the United States. California's tobacco control efforts were associated with a major reduction in cigarette smoking among those under age 35 years. These changes will further widen the lung cancer gap that already exists between California and the rest of the United States.
Objective To compare trends in cigarette smoking and nicotine vaping among US population aged 17–18 years and 18–24 years. Methods Regression analyses identified trends in ever and current use of cigarettes and e-cigarettes, using three US representative surveys from 1992 to 2022. Results From 1997 to 2020, cigarette smoking prevalence among those aged 18–24 years decreased from 29.1% (95% CI 27.4% to 30.7%) to 5.4% (95% CI 3.9% to 6.9%). The decline was highly correlated with a decline in past 30-day smoking among those aged 17–18 years (1997: 36.8% (95% CI 35.6% to 37.9%; 2022: 3.0% (95% CI 1.8% to 4.1%). From 2017 to 2019, both ever-vaping and past 30-day nicotine vaping (11.0% to 25.5%) surged among those 17–18 years, however there was no increase among those aged 18–24 years. Regression models demonstrated that the surge in vaping was independent of the decline in cigarette smoking. In the 24 most populous US states, exclusive vaping did increase among those aged 18–24 years, from 1.7% to 4.0% to equivalent to 40% of the decline in cigarette smoking between 2014–15 and 2018–19. Across these US states, the correlation between the changes in vaping and smoking prevalence was low (r=0.11). In the two US states with >US$1/fluid mL tax on e-cigarettes in 2017, cigarette smoking declined faster than the US average. Conclusions Since 1997, a large decline in cigarette smoking occurred in the US population under age 24 years, that was independent of the 2017–19 adolescent surge in past 30-day e-cigarette vaping. Further research is needed to assess whether the 2014–15 to 2018–19 increase in exclusive vaping in those aged 18–24 years is a cohort effect from earlier dependence on e-cigarette vaping as adolescents.
Cigarette marketing contributes to initiation of cigarette smoking among young people, which has led to restrictions on use of cigarette advertising. However, little is known about other tobacco advertising and progression to tobacco use in youth and young adults.To investigate whether receptivity to tobacco advertising among youth and young adults is associated with progression (being a susceptible never user or ever user) to use of the product advertised, as well as conventional cigarette smoking.The Population Assessment of Tobacco and Health (PATH) Study at wave 1 (2013-2014) and 1-year follow-up at wave 2 (2014-2015) was conducted in a US population-based sample of never tobacco users aged 12 to 24 years from wave 1 of the PATH Study (N = 10 989). Household interviews using audio computer-assisted self-interviews were conducted.Advertising for conventional cigarettes, electronic cigarettes (e-cigarettes), cigars, and smokeless tobacco products at wave 1.Progression to susceptibility or ever tobacco use at 1-year follow-up in wave 2.Of the 10 989 participants (5410 male [weighted percentage, 48.3%]; 5579 female [weighted percentage, 51.7%]), receptivity to any tobacco advertising at wave 1 was high for those aged 12 to 14 years (44.0%; 95% confidence limit [CL], 42.6%-45.4%) but highest for those aged 18 to 21 years (68.7%; 95% CL, 64.9%-72.2%). e-Cigarette advertising had the highest receptivity among all age groups. For those aged 12 to 17 years, susceptibility to use a product at wave 1 was significantly associated with product use at wave 2 for conventional cigarettes, e-cigarettes, cigars, and smokeless tobacco products. Among committed never users aged 12 to 17 years at wave 1, any receptivity was associated with progression toward use of the product at wave 2 (conventional cigarettes: adjusted odds ratio [AOR], 1.43; 95% CL, 1.23-1.65; e-cigarettes: AOR, 1.62; 95% CL, 1.41-1.85; cigars: AOR, 2.01; 95% CL, 1.62-2.49; and smokeless [males only]: AOR, 1.42; 95% CL, 1.07-1.89) and with use of the product (conventional cigarettes: AOR, 1.54; 95% CL, 1.03-2.32; e-cigarettes: AOR, 1.45; 95% CL, 1.19-1.75; cigars: AOR, 2.07; 95% CL, 1.26-3.40). Compared with those not receptive to any product advertising, receptivity to e-cigarette advertising, but not to cigarette advertising, was independently associated with those aged 12 to 21 years having used a cigarette at wave 2 (AOR, 1.60; 95% CL, 1.08-2.38).Receptivity to tobacco advertising was significantly associated with progression toward use in adolescents. Receptivity was highest for e-cigarette advertising and was associated with trying a cigarette.
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