Evolving Disparities in Cannabis Use Among Youth by Demographics and Tobacco and Alcohol Use in the U.S.: 2013-2021.

INTRODUCTION: This study investigated the prevalence of past 30-day cannabis use among U.S. youth by cigarette use, alcohol use, demographics, and state-of-residence cannabis legal status in 2021 and examined whether changes in cannabis use prevalence were modified by these factors from 2013 to 2021. METHODS: Data were drawn from the 24 states that collected cannabis use data participating in the Youth Risk Behavior Surveillance System from 2013 to 2021. Logistic regression analyses estimated past 30-day cannabis prevalence in 2021 and produced AORs by current cigarette, alcohol, and state-of-residence cannabis legal status. The same method was used with year as the exposure, adjusting for sex, race, and ethnicity, to assess trends in prevalence from 2013 to 2021. RESULTS: In 2021, cannabis use was more common among female youth (16.75% vs 13.83% [AOR=1.26, 95% CI=1.16, 1.37]) and non-Hispanic Black and Hispanic youth than among non-Hispanic White youth (17.19%, 16.14% vs 14.60% [AOR=1.25, 95% CI=1.12, 1.39 and AOR=1.16, 95% CI=1.04, 1.29, respectively]). Cannabis use was much more common among youth who reported any past 30-day cigarette or alcohol use (44.90% vs 6.48% [AOR=11.80, 95% CI=10.57, 13.18]). Declines in cannabis use were observed independent of state-level cannabis law from 2013 to 2021, and cannabis use prevalence did not differ significantly by state-of-residence cannabis legal status among the 24 participating states in 2021. CONCLUSIONS: Public health officials should carefully consider the potential impact of expanding commercialization of cannabis as a wellness product on youth cannabis use, especially with regard to minoritized populations and co-use with tobacco and alcohol. National and state-level public health education on cannabis use and youth-oriented prevention of cannabis uptake are long overdue.

Asthma prevalence among US 9th-12th graders who report past 30-day cannabis use in 2019.

INTRODUCTION: Little is known about the relationship between cannabis use and asthma among youth in the US. The aims of this study were to estimate prevalence of asthma among youth who reported any cannabis use in the past 30 days, relative to those who did not, and to investigate the relationship between frequency of cannabis use and prevalence of asthma, adjusting for demographic characteristics and cigarette use. METHODS: Data were drawn from the 2019 Youth Risk Behavior Surveillance System (YRBSS), a CDC national high school survey, which collects data from students in grades 9-12 across the US bi-annually. Logistic regression was used to examine the prevalence of asthma among youth who reported any past 30-day cannabis use, relative to no use, and by frequency of cannabis use, adjusting for demographic characteristics and cigarette use. RESULTS: Asthma was more common among youth who reported any cannabis use, relative to youth who reported no use (29.07% vs. 23.62%; AOR = 1.25 (1.20, 1.30)). Asthma was greater among youth who reported more frequent cannabis use; asthma was highest among youth who reported having used cannabis "40 or more times" in the month (31.38%; AOR = 1.35 (1.25, 1.45)) CONCLUSION: Asthma is more common among youth who use cannabis, relative to those who do not, and the prevalence of asthma increases with frequency of use among 9th-12th graders in the US. More public health and clinical research is needed quickly to produce scientific data that can inform clinical guidelines and public health policy, as well as parents and youth, on the potential relationship between cannabis use and respiratory health among youth.

Cannabis use and the prevalence of current asthma among adolescents and adults in the United States.

OBJECTIVES: Cannabis use has increased among adolescents and adults in the United States (US) in recent years. Few data are available on the prevalence of asthma by frequency of cannabis use. This study aimed to estimate the prevalence of asthma by frequency of past 30-day cannabis use among US individuals. METHODS: Data were drawn from the 2020 National Survey on Drug Use and Health (NSDUH), a nationally representative, annual cross-sectional survey of US individuals aged 12 and older in the United States (N = 32,893). Logistic regression models were used to examine the relationship between frequency of any cannabis and/or blunt (i.e., cannabis smoked in a hollowed-out cigar) use in the past 30 days and current asthma, adjusting for demographics and current cigarette smoking. RESULTS: Current asthma was more common among US individuals who reported cannabis use in the past 30-days, relative to those who did not (9.8% vs. 7.4%, p < 0.0001). The odds of asthma was significantly greater among individuals reporting cannabis use 20-30 days/month (Adjusted Odds Ratio [AOR] = 1.67, 95% CI:1.21, 2.31), blunt use 6-15 and 20-30 days/month (AOR = 1.9, 95% CI:1.1, 3.2; AOR = 2.2, 95% CI:1.4, 3.6), respectively, than among those without. A positive linear relationship was observed between frequency of a) cannabis use (p < 0.0001) and b) blunt use (p < 0.0001) and current asthma prevalence. CONCLUSIONS: Findings suggest a dose-response relationship between frequency of current cannabis use and the prevalence of current asthma in the US individuals.

Assessing the Association of Solitary Confinement Ban With Adolescent Self-Harm in New York City Jails.

This study sought to evaluate the association of a solitary confinement ban with self-harm among adolescents in New York City's jail system. Data were extracted from medical records on 5,038 adolescent incarcerations from October 1, 2013, through July 12, 2016, and compared incarcerations before the ban (February 20, 2015) with those after the ban. Of the 2,503 adolescent incarcerations pre-ban, there were 171 self-harm gestures among 106 incarcerations (4.2% of incarcerations). Post-ban, there were 2,100 adolescent incarcerations and 105 self-harm gestures among 71 incarcerations (3.4% of incarcerations; p < .01). The post-ban group experienced significantly lower self-harm risk compared with the pre-ban (Crude incident rate ratio, 1.35 vs. 1.81; p < .05). In adjusted analysis, the hazard of self-harm associated with solitary confinement exposure was 1.51 times that of incarcerations with no solitary exposure (p < .05) . This signifies negative health outcomes of adolescent solitary confinement and the need for policy change consideration.

Central Obesity Is Associated With an Increased Rate of Multisite Pain in Older Adults.

Objective: Central obesity has been associated with several adverse health events, but little research exists about the longitudinal effects of central obesity on multisite pain. The purpose of this study was to assess if central obesity, as measured by waist circumference measurement, was associated with an increased rate of having multisite pain among older adults aged 65 years and older. Design: The National Health and Aging Trends Study is a longitudinal cohort study initiated in 2011 and intended to be representative of Medicare beneficiaries in the contiguous United States. Methods: There were 7,145 community-dwelling participants included in this study. Data for this study were collected annually between 2011 and 2018. Researchers assessed if waist circumference risk level was associated with an increased rate ratio of multisite pain. Weighted data were used in a multivariable generalized estimating equation model that used a log link specified with a Poisson distribution. Results: Participants with high-risk waist circumferences (98 cm or greater for women and 109 cm or greater for men) had a 11% higher rate of multisite pain than those with low-risk waist circumferences [rate ratio (RR) 1.11, 95% CI: 1.07-1.15] adjusting for gender, age, race, education, probable major depression, arthritis, and multimorbidity count. Conclusion: As measured by waist circumference, central adiposity is associated with multisite pain in older adults. While more research is needed, reducing waist circumference may prove beneficial in reducing the burden of multisite pain.

The Association of Pain Levels and Low Physical Activity among Older Women.

There is an integral research gap regarding whether there is a relationship between pain levels and low physical activity among older women. This is a secondary analysis of a longitudinal cohort study, the Women's Health and Aging Study (WHAS) II. Our analyses included 436 community-dwelling women between the ages of 70 and 79, who were followed for 10.5 years. We employed marginal structural modeling, which controls for time-dependent confounding, with the aim of assessing the potential direct association between pain levels and low physical activity and assess a graded relationship. Compared to women with no pain, those with widespread pain were nearly half as likely to be moderately active versus low active (aOR: 0.46, 95% confidence interval (CI): 0.22, 0.96). A graded association was observed across the four pain levels (no pain or mild pain, other pain, moderate or severe lower extremity pain, and widespread pain) on low physical activity. Our findings indicate that reducing chronic widespread pain in older women may increase moderate physical activity, and therefore reduce the downstream health risks of low physical activity, including morbidity and mortality risk.

Poor Lower Extremity Functioning Is Associated with Modest Increased Incidence of Probable Dementia.

Lower extremity functioning in older adults provides a measure of poor physical performance and can predict negative health outcomes. The consequences of reduced lower extremity functioning on cognitive decline, measured as time-varying variables, have not been well documented in previous studies. We aimed to evaluate whether lower extremity functioning is associated with an increased incidence rate of probable dementia among older adults using data from the National Health and Aging Trends Study (NHATS). Participants (n = 6457) were followed for 8 years to examine the relationship between lower extremity functioning, as measured by the Short Physical Performance Battery (SPPB), and incident probable dementia. Using weighted data, a multivariable Poisson regression with generalized estimating equations (GEE) was used to calculate incidence rate ratios (IRR), adjusting for covariates and clustering. Participants with low SPPB scores (0-5) had a 5% increase in incident probable dementia when compared with those who had good SPPB scores (10-12) in the adjusted model (IRR = 1.05; 95% CI = 1.04-1.07). Lower extremity functioning is associated with a modest increase in incident probable dementia. The SPPB score may be helpful in identifying subjects at risk of dementia. Efforts aimed at improving physical functioning may lead to better cognitive outcomes.

Clinical Outcomes of Specialized Treatment Units for Patients With Serious Mental Illness in the New York City Jail System.

OBJECTIVE: New York City's (NYC) Correctional Health Services has introduced specialized treatment units for patients with serious mental illness in the NYC jail system. With multidisciplinary mental health staffing and a coordinated approach with NYC's Department of Correction, these units expand therapeutic options for patients vulnerable to clinical instability and physical harm, including those at high risk of psychiatric medication nonadherence and those returning to jail from psychiatric hospitalization. This study evaluated the extent to which these units improve clinical outcomes for this population. METHODS: This retrospective, observational cohort study included adult males with serious mental illness with a length of jail stay of ≥14 days between January 1, 2016, and March 31, 2018. Patients on treatment units were matched with patients of similar characteristics (control group) by using propensity score matching (N=302 pairs). Rates of self-injury, injury due to violence, and psychiatric medication adherence were analyzed. RESULTS: Most patients on treatment units had diagnoses of schizophrenia spectrum and other psychotic disorders (81%), and most had a violent felony as their most severe charge (68%). Compared with patients in a control group, those on the treatment units had lower rates per 100 person-days of injury due to violence at 30 and 60 days (0.04, 95% confidence interval [CI]=0.02-0.07, and 0.03, 95% CI=0.02-0.06, respectively) and higher mean medication adherence (77% versus 55%, p<0.001). They also experienced lower rates of self-injury, although the difference was not statistically significant. CONCLUSIONS: Initial outcomes indicate substantial benefits to patients, demonstrating the value of a rehabilitative approach to psychiatric care in jail.