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1.
PLoS One ; 16(10): e0257553, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34644338

RESUMO

BACKGROUND: California Proposition 56 increased cigarette excise tax by $2 per pack with equivalent increases on non-cigarette tobacco products. We estimated the changes in cigarette price, cigarette use, and non-cigarette use following the implementation of Proposition 56 in California in 2017. METHODS: Seven waves of Tobacco Use Supplements to the Current Population Survey (TUS-CPS) 2011-2019 data were used to obtain state-level aggregate self-reported outcomes, including cigarette price per pack, current and daily cigarette use, cigarette consumption per day, and current and daily use of non-cigarette tobacco products (hookah, pipe, cigar, and smokeless tobacco). A modified version of a synthetic control method was used to create a "synthetic" California that best resembled pre-policy sociodemographic characteristics and outcome trends in California while correcting time-invariant pre-policy differences. Various sensitivity analyses were also conducted. RESULTS: The implementation of Proposition 56 was associated with an increase in self-reported cigarette price per pack in California ($1.844, 95%CI: $0.153, $3.534; p = 0.032). No evidence suggested that Proposition 56 was associated with the changes in the prevalence of current or daily cigarette use, cigarette consumption per day, or the prevalence of current or daily use of non-cigarette tobacco products. CONCLUSION: Most of the cigarette tax increase following Proposition 56 in California was passed on to consumers. There is a lack of evidence that the implementation of Proposition 56 was associated with the changes in the use of cigarettes and other tobacco products such as hookah, pipe, cigar, and smokeless tobacco.


Assuntos
Produtos do Tabaco/economia , Uso de Tabaco/epidemiologia , California/epidemiologia , Humanos , Prevalência , Impostos/economia , Indústria do Tabaco/economia , Tabaco sem Fumaça/economia
3.
Sex Med ; 9(4): 100386, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34273785

RESUMO

INTRODUCTION: Dehydroepiandrosterone sulfate (DHEAS) has been reported to be associated with sexual function and general psychological health respectively, however, no one has ever examined their mutual relationships in a single study. AIM: The aim of the present study was to find out whether DHEAS, general psychological health, and erectile function were all associated with each other. METHODS: A cross-sectional study was conducted on 34 patients with erectile dysfunction (ED) and 32 healthy controls (HC). The levels of serum DHEAS were assessed by chemiluminescence method. Erectile function and general psychological health were measured by International Index for Erectile Function-5 (IIEF-5) and General Health Questionnaire 20(GHQ-20) respectively. MAIN OUTCOME MEASURE: The primary outcome measure of this study was the mutual correlations of serum DHEAS levels, general psychological health and erectile function. RESULTS: Compared to HC, patients with ED had a significant lower serum levels of DHEAS (6.43 ± 2.70 µmol/L vs 9.48 ± 2.82 µmol/L, P < .001) and higher scores on GHQ-20 (35.06 ± 8.56 vs 24.97 ± 2.55, P < .001). Multivariate binary logistic regression showed that both serum levels of DHEAS (OR = 0.667, 95% CI = 0.512-0.869, P = .003) and psychological distress (scores of GHQ-20 > 28) (OR = 6.921, 95% CI = 1.821-26.305, P = .005) were significantly associated with ED. However, no significant association between psychological distress and serum levels of DHEAS was found (OR = 0.798, 95% CI = 0.623-1.021, P = .072) after controlling for ED. Partial correlation analysis revealed that both scores of GHQ-20 (r = -0.595, P < .001) and DHEAS (r = 0.450, P < .001) were significantly correlated with scores of IIEF-5, while no significant relationship was found between scores of GHQ-20 and DHEAS (r = 0.116, P = .363) after controlling for scores of IIEF-5 and age. CONCLUSION: Both serum levels of DHEAS and general psychological health are significantly associated with erectile dysfunction in sexually active adult men but the relationship between general psychological health and erectile function seems to be independent of DHEAS. Li K, Liang S, Shi Y, et al. The Relationships of Dehydroepiandrosterone Sulfate, Erectile Function and General Psychological Health. Sex Med 2021;9:100386.

4.
Artigo em Inglês | MEDLINE | ID: mdl-34206501

RESUMO

Vaping products containing cannabidiol (CBD), a cannabis-derived compound used in wellness products and available in all 50 US states, were recently implicated in outbreaks of poisonings. Little is known about the commercial availability of CBD products in vape shops (i.e., stores that sell e-cigarettes). To document the availability and marketing of CBD products in online vape shops, in June 2020, we used the Google Chrome browser without cached data to collect the first two pages of search results generated by five Google queries (n = 100 search results) indicative of shopping for vaping products (e.g., "order vapes"). We then determined whether and what type of CBD products could be mail-ordered from the returned websites, and whether any explicit health claims were made about CBD. Over a third of the search results (n = 37; 37.0%) directed to vape shops that allowed visitors to also mail-order CBD. These shops sold 12 distinct categories of CBD products-some with direct analogs of tobacco or cannabis products including CBD cigarettes, edibles, flowers, pre-rolled joints, and vapes. Two vape shops made explicit health claims of the therapeutic benefits of CBD use, including in the treatment of anxiety, inflammation, pain, and stress. The abundance and placement of CBD in online vape shops suggests a growing demand and appeal for CBD products among e-cigarette users. Additional surveillance on the epidemiology of CBD use and its co-use with tobacco is warranted.


Assuntos
Canabidiol , Sistemas Eletrônicos de Liberação de Nicotina , Vaping , Marketing , Uso de Tabaco
5.
Contemp Clin Trials Commun ; 22: 100771, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33997462

RESUMO

Currently one-third of children in the United States have overweight or obesity (OW/OB). The goal of Healthy People 2020 is to reduce the proportion of children with OW/OB and increase the proportion of primary care visits that include nutrition and weight-related counseling. Unfortunately, many health care providers find it difficult to offer effective weight-related counseling and treatment in the primary care setting. Therefore, new models of care are needed that allow a greater proportion of children with OW/OB and their parents to access care and receive quality weight management treatment. The current paper describes the GOT Doc study which is designed to test the effectiveness of a Guided Self-Help (GSH) model of obesity treatment that can be delivered in the primary care setting compared to a traditional Family-Based Behavioral weight loss treatment (FBT) delivered at an academic center. We will assess the impact of this program on attendance (access to care) and changes in child BMI percentile/z-score. We will also examine the impact of this treatment model on change in child lifestyle behaviors, parent support behaviors, and parent self-efficacy and empowerment to make behavior change. Finally, we will assess the cost-effectiveness of this model on changes in child BMI percentile/z-score. We believe the GSH intervention will be a cost-effective model of obesity management that can be implemented in community practices around the country, thereby increasing access to treatment for a broader proportion of our population and decreasing rates of childhood obesity.

6.
Addiction ; 116(11): 3069-3079, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33887075

RESUMO

BACKGROUND AND AIMS: Cannabis use disorder (CUD) during pregnancy has increased dramatically in the United States (US). This study examined the associations between prenatal CUD and adverse neonatal outcomes and heterogeneities in the associations by mothers' tobacco use status and race/ethnicity. DESIGN: Population-based, retrospective cohort study. SETTING: California, USA. PARTICIPANTS: A total of 4.83 million mothers who delivered a live singleton birth during 2001 to 2012 and their paired infants. Data were obtained from mother-infant linked hospital discharge records and birth and death certificates. Identified by ICD-9 codes recorded at delivery, 20 237 mothers had prenatal CUD. MEASUREMENTS: Neonatal outcomes included length of gestation, preterm birth, birth weight, admission into neonatal intensive care unit, hospitalization within 1 year of birth, and death within 1 year of birth. Propensity score matching was used to balance maternal, paternal, and infant characteristics in the comparisons between infants exposed and unexposed to prenatal CUD. FINDINGS: CUD increased from 2.8 to 6.9 per 1000 deliveries during 2001 to 2012. Multivariable regressions in matched samples estimated that prenatal CUD was associated with greater odds of being small for gestational age (OR = 1.13, 95% CI = 1.08, 1.18), preterm birth (OR = 1.06, 95% CI = 1.01, 1.12), low birth weight (OR = 1.13, 95% CI = 1.07, 1.20), and death within 1 year of birth (OR = 1.35, 95% CI = 1.12, 1.62). Compared with infants whose mothers were tobacco non-users, infants whose mothers were tobacco users had greater odds of preterm birth, low birth weight, hospitalization, and death in association with prenatal CUD. Compared with infants whose mothers were non-Hispanic White, infants whose mothers were Hispanic had greater odds of hospitalization and death and infants whose mothers were non-Hispanic Black had greater odds of being small for gestational age in association with prenatal CUD. CONCLUSION: Prenatal cannabis use disorder appears to be associated with escalated odds of major adverse neonatal outcomes, with heterogeneities in the associations by mothers' tobacco use status and race/ethnicity.


Assuntos
Cannabis , Abuso de Maconha , Nascimento Prematuro , Humanos , Recém-Nascido , Mães , Gravidez , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos
7.
Chem Commun (Camb) ; 57(26): 3291-3294, 2021 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-33656042

RESUMO

The sensitive and accurate detection of mature miRNA without the signal interference by pre-miRNAs is highly important. Herein, a size-selective DNA nanocage-based activatable CRISPR/Cas12a system was developed to achieve this goal.


Assuntos
Sistemas CRISPR-Cas , DNA/química , MicroRNAs/análise , Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas , DNA/genética , Humanos , MicroRNAs/sangue , MicroRNAs/genética , Nanoestruturas/química , Hibridização de Ácido Nucleico
8.
Anal Chem ; 93(11): 4967-4974, 2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33703873

RESUMO

Taking advantage of the excellent trans-cleavage activity, CRISPR-based diagnostics (CRISPR-Dx) has shown great promise in molecular diagnostics. However, the single-stranded DNA reporter of the current CRISPR-Dx suffers from poor stability and limited sensitivity, which make their application in complex biological environments difficult. Herein, we, for the first time, explore the trans-cleavage activity of CRISPR/Cas12a toward the substrate on gold nanoparticles and apply the new phenomenon to develop a spherical nucleic acid (SNA) reporter for stable and sensitive CRISPR-Dx biosensing. By anchoring the DNA substrate on gold nanoparticles, we discovered different trans-cleavage activities of different types of the Cas12a system (e.g., LbCas12a and AsCas12a) on a nanoparticle surface. The further study suggests that the trans-cleavage activity of LbCas12a on the nanoparticle surface is highly dependent on the density and length of DNA strands. Based on these interesting discoveries, we furthermore develop SNA reporter-based fluorescent CRISPR-Dx for stable and sensitive biosensing application. Compared to traditional ssDNA reporters, the SNA reporter exhibits improved stability, which enables the stable application in a complex serum environment. In addition, the SNA reporter system with tunable density exhibits high sensitivity with a detection limit of 10 fM, which is about 2 orders of magnitude lower than that of the ssDNA reporter system. Finally, the practical application of SNA reporter-based CRISPR-Dx in clinical serum was successfully achieved. These results indicate their significant potential in future research on biology science and medical diagnoses.


Assuntos
Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas , Nanopartículas Metálicas , Sistemas CRISPR-Cas/genética , DNA de Cadeia Simples/genética , Ouro
9.
Chem Asian J ; 16(8): 857-867, 2021 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-33638271

RESUMO

Clustered regularly interspaced short palindromic repeats (CRISPR) is a promising technology in the biological world. As one of the CRISPR-associated (Cas) proteins, Cas12a is an RNA-guided nuclease in the type V CRISPR-Cas system, which has been a robust tool for gene editing. In addition, due to the discovery of target-binding-induced indiscriminate single-stranded DNase activity of Cas12a, CRISPR-Cas12a also exhibits great promise in biosensing. This minireview not only gives a brief introduction to the mechanism of CRISPR-Cas12a but also highlights the recent developments and applications in biosensing and gene regulation. Finally, future prospects of the CRISPR-Cas12a system are also discussed. We expect this minireview will inspire innovative work on the CRISPR-Cas12a system by making full use of its features and advantages.


Assuntos
Proteínas de Bactérias/genética , Técnicas Biossensoriais , Proteínas Associadas a CRISPR/genética , Sistemas CRISPR-Cas/genética , Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas/genética , Endodesoxirribonucleases/genética , Edição de Genes , Regulação da Expressão Gênica/genética , Humanos
10.
Tob Control ; 2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33542070

RESUMO

BACKGROUND: Heated tobacco products (HTP) generate nicotine-containing aerosol by heating tobacco rather than burning it. The US Food and Drug Administration (FDA) has recently authorised the sale of one HTP brand, iQOS, in the USA. This study examined the awareness, use and risk perceptions of HTP in the USA following FDA authorisation. METHODS: A national probability sample of 20 449 US adults completed an online survey between November 2019 and February 2020. In addition to assessing awareness and use of HTP, two ratios were calculated: the ratio of those who experimented with HTP given that they had heard about it (E/H) and the ratio of those who currently used HTP given experimentation (C/E). These ratios for HTP were compared against those for e-cigarettes from a similar national survey in 2012. RESULTS: Overall, 8.1% of respondents had heard of HTP. Only 0.55% had tried and 0.10% were current users. The rate of experimentation among those who heard about HTP and the rate of current use among experimenters were, however, similar to those for e-cigarettes in 2012: E/H and C/E for HTP were 6.8% and 18.2%, respectively; and 10.7% and 17.8%, respectively for e-cigarettes. The majority of respondents considered HTP either less harmful than (11.6%), or equally harmful as e-cigarettes (42.7%). CONCLUSIONS: Only a small fraction of US population in 2020 have tried any HTP. However, the similarity in early adoption rates following awareness, suggests that future adoption for HTP may be similar to that for e-cigarettes, if HTP are marketed more aggressively.

11.
Addiction ; 116(7): 1782-1793, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33217090

RESUMO

BACKGROUND AND AIMS: Different cannabis administration methods have differential impacts on health. This study aimed to describe administration methods among cannabis users in the United States categorized by (1) use purpose and (2) state legalization status. DESIGN: Cross-sectional, probability-based online survey in 2020. SETTING: All 50 states and Washington DC in the United States. PARTICIPANTS: A total of 21 903 adults (18+) were recruited from a probability-based online panel to provide nationally representative estimates. METHODS: Eleven administration methods were grouped into combustion, vaporization, ingestion and topicals. Weighted prevalence was reported among (1) medical-only, recreational-only and dual-purpose users based on self-reported purposes and (2) users in states that legalized both recreational and medical cannabis (RCL states), legalized medical cannabis only and did not legalize cannabis. FINDINGS: Among past-year users, the proportions of medical-only, recreational-only and dual-purpose users were 25.55, 43.81 and 30.64%, respectively. The most common primary methods were combustion (42.08%) and topicals (28.65%) for medical purposes and combustion (72.07%) and ingestion (15.05%) for recreational purposes. Dual-purpose users were more likely to report combustion and vaporization but less likely to report ingestion and topicals as primary methods for medical use than medical-only users (P < 0.001) and more likely to report combustion and topicals but less likely to report ingestion as primary methods for recreational use than recreational-only users (P < 0.041). A higher proportion of dual-purpose users (82.82%) used more than one method than medical-only (40.52%) and recreational-only users (63.91%) (P < 0.001). For both medical and recreational purposes, RCL states had the lowest rate of combustion and the highest rates of ingestion and topicals reported as primary methods (P < 0.033). The rate of using more than one administration method did not differ across states (P > 0.05). CONCLUSION: Cannabis users whose purposes are medical, recreational or both tend to differ in their selected administration methods.


Assuntos
Cannabis , Alucinógenos , Maconha Medicinal , Adulto , Estudos Transversais , Humanos , Inquéritos e Questionários , Estados Unidos/epidemiologia
12.
Int J Drug Policy ; 91: 102793, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32482489

RESUMO

BACKGROUND: Consumers' access to cannabis has been considerably expanded in US states where recreational cannabis was legalized and commercialized. However, little is known about the important factors influencing consumers' purchase decisions in cannabis retail dispensaries. This study examined cannabis users' perceptions of the relative importance of policy-relevant factors when they made cannabis purchase decisions. METHODS: An online survey was administered to 817 adult cannabis users in seven states in the US (California, Colorado, Maine, Massachusetts, Nevada, Oregon, and Washington) that had approved cannabis commercialization by the time of interview in January 2018. Twenty policy-relevant cannabis attributes were evaluated, including those pertaining to product characteristics, quality, package characteristics, price and free sample, store characteristics, and restrictions on use. A best-worst scaling experiment was employed, which asked respondents to select the most and the least important attributes in a choice scenario. Each respondent answered 10 choice scenarios, each including a random combination of four attributes out of the 20. The relative importance of each attribute was evaluated using hierarchical Bayesian estimation of mixed logit models. RESULTS: Overall, 'quality', 'strain type', 'price', 'THC' (tetrahydrocannabinol) and 'pesticide' were the top five important attributes affecting cannabis users' willingness to buy cannabis in a dispensary. These five attributes jointly accounted for approximately half of the total importance. In subsample analysis, both recreational and dual-purpose users attached higher importance to 'quality', 'THC', and 'price', whereas medical users tended to think 'CBD' (cannabidiol) and 'pesticide' were more important. All cannabis users perceived 'package' to be the least important attribute. Gender had no major differences in perceptions. CONCLUSIONS: Cannabis users in general perceived product characteristics, quality, and price to be important factors in their willingness to buy cannabis in dispensaries. There were heterogeneities in the perceptions by cannabis use purposes. The findings might deserve consideration in cannabis policy design.


Assuntos
Cannabis , Adulto , Teorema de Bayes , Colorado , Humanos , Massachusetts , Oregon , Washington
13.
Med Care ; 58(12): 1111-1115, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32925468

RESUMO

BACKGROUND: Since early 2016, an increasing number of states passed legislations that limit the duration and/or dosage of initial opioid prescriptions or opioids for acute pain. OBJECTIVE: The objective of this study was to assess changes in the number of opioid prescriptions covered by Medicaid and received by Medicaid patients associated with state implementation of legislative limits on initial opioid prescriptions. RESEARCH DESIGN: We explored the natural experiment resulting from the staggered implementation of state legislative limits. The analysis adopted a Difference-in-Differences framework and controlled for other major state policies bearing implications for prescription opioid use. The main analysis included 26 states that implemented limits from early 2016 to late 2018. A secondary analysis included all 50 states and the District of Columbia. MEASURES: Population-adjusted state-quarter level counts of Schedule II and III opioid prescriptions received by Medicaid patients, based on data from the Medicaid State Drug Utilization Data and state Medicaid enrollment reports for 2013-2018. RESULTS: Implementation of legislative limits on initial opioid prescriptions was associated with a 7% reduction in the number of opioid prescriptions per 100 Medicaid enrollees. Such reduction was largely attributable to a reduction in Schedule II opioid prescriptions. Secondary analysis by including all jurisdictions and sensitivity checks supported the robustness of results. CONCLUSION: The recent implementation of state legislative limits on initial opioid prescriptions was associated with meaningful reductions in the volume of Schedule II opioid prescriptions received by Medicaid patients.


Assuntos
Analgésicos Opioides/administração & dosagem , Prescrições de Medicamentos/estatística & dados numéricos , Medicaid/estatística & dados numéricos , Padrões de Prática Médica/legislação & jurisprudência , Padrões de Prática Médica/estatística & dados numéricos , Humanos , Estados Unidos
14.
Drug Alcohol Depend ; 215: 108183, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32791286

RESUMO

OBJECTIVES: To assess 1) the validity of online crowdsourcing platforms in enumerating licensed brick-and-mortar marijuana dispensaries and 2) the validity of state licensing directory and online crowdsourcing platforms in enumerating active brick-and-mortar marijuana dispensaries in California. METHODS: We obtained business lists from California Bureau of Cannabis Control (BCC) licensing directory and three online crowdsourcing platforms (Weedmaps, Leafly, and Yelp) in May 2019. Calls were made to verify street address, operation status, dispensary category (recreational-only, medical-only, recreational & medical), and presence of storefronts in May-July 2019. Validity measures, including sensitivity, specificity, positive predictive value, and negative predictive value, were calculated when applicable. RESULTS: In identifying licensed dispensaries in BCC, Leafly had the highest sensitivity (.66) and Yelp had the highest specificity (.87). The dispensary category posted on online crowdsourcing platforms in over 25 % licensed dispensaries and the dispensary category claimed in call verification in over 10 % licensed dispensaries disagreed with the approved category in BCC. There were 2121 businesses combined from BCC and online crowdsourcing platforms, among which 826 were verified to be active brick-and-mortar dispensaries. Weedmaps had the highest sensitivity (.80) and Yelp had the highest negative predictive value (.74) in identifying verified dispensaries. Weedmaps overall had the highest sensitivity in all three dispensary categories. Weedmaps had the highest sensitivity in more populated counties whereas BCC had the highest sensitivity in less populated counties. CONCLUSIONS: Each secondary data source has strengths and limitations. The findings inform surveillance and research regarding how to best strategize data use when resources are limited.


Assuntos
Maconha Medicinal/economia , Cannabis , Comércio , Alucinógenos , Humanos , Armazenamento e Recuperação da Informação
15.
Nat Commun ; 11(1): 1518, 2020 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-32251279

RESUMO

Size selectivity is an important mechanism for molecular recognition based on the size difference between targets and non-targets. However, rational design of an artificial size-selective molecular recognition system for biological targets in living cells remains challenging. Herein, we construct a DNA molecular sieve for size-selective molecular recognition to improve the biosensing selectivity in living cells. The system consists of functional nucleic acid probes (e.g., DNAzymes, aptamers and molecular beacons) encapsulated into the inner cavity of framework nucleic acid. Thus, small target molecules are able to enter the cavity for efficient molecular recognition, while large molecules are prohibited. The system not only effectively protect probes from nuclease degradation and nonspecific proteins binding, but also successfully realize size-selective discrimination between mature microRNA and precursor microRNA in living cells. Therefore, the DNA molecular sieve provides a simple, general, efficient and controllable approach for size-selective molecular recognition in biomedical studies and clinical diagnoses.


Assuntos
Aptâmeros de Nucleotídeos/química , Técnicas Biossensoriais/métodos , DNA Catalítico/química , Sondas Moleculares/química , Aptâmeros de Nucleotídeos/metabolismo , DNA Catalítico/metabolismo , MicroRNAs/metabolismo , Sondas Moleculares/metabolismo , Tamanho da Partícula , Precursores de RNA/metabolismo , Especificidade por Substrato
16.
Addiction ; 115(10): 1890-1899, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32080937

RESUMO

BACKGROUND AND AIMS: Recreational cannabis has been legalized in 11 states and District of Columbia (DC) in the United States. Among these, 10 states further permitted retail sale to provide a legal supply to adults. This study examined the associations of cannabis exposures with recreational cannabis legalization and commercialization. DESIGN: Secondary data analysis of state-quarter level cannabis exposures during 2010-17 in the United States. Linear regressions with a difference-in-differences design were used to compare pre- and post-legalization trends in states that legalized recreational cannabis to contemporaneous trends in states that did not legalize recreational cannabis. SETTING: United States, including all 50 states and DC. CASES: Cannabis exposures reported to the US National Poison Data System. MEASUREMENTS: The primary outcome was state age-adjusted cannabis exposures reported to the US National Poison Data System per 1 000 000 population per quarter. The two policy variables of interest included (1) the enactment of recreational cannabis legalization (i.e. removing penalties for adults' possession of cannabis in a small amount for recreational use) and (2) the initiation of recreational cannabis commercialization (i.e. providing a legal supply of cannabis to adults through licensed dispensaries). FINDINGS: The association between a state's enactment of recreational cannabis legalization and its changes in cannabis exposures was statistically non-significant overall. After controlling for recreational cannabis legalization, however, the initiation of recreational cannabis commercialization was associated with 5.06-5.80 more exposures per 1 000 000 population per quarter (67-77% increase relative to the pre-legalization average), depending on the composition of comparison states. The increase associated with commercialization was higher among minors than adults (7.97-9.53 versus 3.83-4.21 more exposures), higher among males than females (6.16-7.56 versus 3.76-3.91 more exposures) and higher among exposures with medical consequences than those without medical consequences (4.09-4.79 versus 0.97-1.01 more exposures). CONCLUSION: An increase in cannabis exposures reported to the US National Poison Data System was observed following recreational cannabis commercialization in the United States.


Assuntos
Cannabis/envenenamento , Legislação de Medicamentos , Uso da Maconha/legislação & jurisprudência , Adulto , Feminino , Humanos , Masculino , Estados Unidos , Adulto Jovem
17.
J Adolesc Health ; 66(1): 72-78, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31604606

RESUMO

PURPOSE: After marijuana commercialization, the presence of recreational marijuana dispensaries (RMDs) was rapidly increasing. The point-of-sale marketing poses concerns about children's exposure. This study examined advertising and promotions that potentially appeal to children and access restrictions in RMDs around California schools. METHODS: This was a cross-sectional and observational study conducted from June to September 2018. Trained fieldworkers audited retail environments in 163 RMDs in closest proximity to 333 randomly sampled public schools in California. RESULTS: About 44% of schools had RMDs located within 3 miles. Regarding interior marketing, 74% of RMDs had at least one instance of child-appealing products, packages, paraphernalia, or advertisements. RMDs closer to a school had a higher proportion with interior child-appealing marketing. More than three fourths of RMDs had generic promotional activities; particularly, 28% violated the free-sample ban. Regarding exterior marketing, only 2% of RMDs had those appealing to children. More than 60% of RMDs had exterior signs indicative of marijuana. Approximately, one-third had generic advertisements, and 13% had advertisements bigger than 1,600 square inches. Regarding access restrictions, almost all RMDs complied with age verification, but 84% had no age limit signs, and only 40% had security personnel. CONCLUSIONS: Despite minimal point-of-sale marketing practices appealing to children on the exterior of RMDs around California schools, such practices were abundant on the interior. Marketing practices not specifically appealing to children were also common on both the interior and exterior of RMDs. Dispensaries' violation of age verification law, lack of security personnel, and presence of child-appealing marketing should be continuously monitored and prevented.


Assuntos
Marketing , Maconha Medicinal , Instituições Acadêmicas , Produtos do Tabaco , California , Criança , Comércio , Estudos Transversais , Humanos
18.
Drug Alcohol Depend ; 206: 107754, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31786399

RESUMO

OBJECTIVES: States in the US are controlling opioid prescribing to combat the opioid epidemic. Prescription Drug Monitoring Programs (PDMPs) were widely adopted, whereas less attention was given to pain clinic laws. This study examined the associations of mandatory use of PDMPs and pain clinic laws with prescription opioid exposures. METHODS: State-level quarterly prescription opioid exposures reported to the National Poison Data System during 2010-2017 were analyzed. The primary outcome was age-adjusted rates of prescription opioid exposures per 1,000,000 population. The primary policy variables included the implementation of mandatory use of PDMPs alone, the implementation of pain clinic laws alone, and the implementation of both mandatory use of PDMPs and pain clinic laws. Linear regressions were used to examine the associations, controlling for other opioid policies, marijuana policies, socioeconomic factors, state fixed effects, time fixed effects, and state-specific time trends. RESULTS: Requiring mandatory use of PDMPs alone was not associated with significant changes in prescription opioid exposures. The implementation of pain clinic laws with or without concurrent mandatory use of PDMPs was associated with 5 fewer prescription opioid exposures per 1,000,000 population or a 9 % reduction compared to the pre-policy period (p < 0.01). Further analysis revealed that the reduction associated with pain clinic laws was pronounced in exposures reported by healthcare facilities. CONCLUSIONS: This multi-state study provided new evidence that the implementation of pain clinic laws was associated with a significant reduction in prescription opioid exposures. Pain clinic laws may deserve further evaluation and consideration.


Assuntos
Analgésicos Opioides/envenenamento , Clínicas de Dor/legislação & jurisprudência , Dor/tratamento farmacológico , Dor/epidemiologia , Centros de Controle de Intoxicações/legislação & jurisprudência , Programas de Monitoramento de Prescrição de Medicamentos/legislação & jurisprudência , Adulto , Analgésicos Opioides/efeitos adversos , Feminino , Humanos , Masculino , Clínicas de Dor/tendências , Centros de Controle de Intoxicações/tendências , Padrões de Prática Médica/legislação & jurisprudência , Padrões de Prática Médica/tendências , Programas de Monitoramento de Prescrição de Medicamentos/tendências , Estados Unidos/epidemiologia
19.
Subst Abus ; : 1-8, 2019 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-31697195

RESUMO

Background: In the past two decades, the U.S. saw an alarmingly increasing trend of benzodiazepine prescribing. Mandatory use of Prescription Drug Monitoring Programs (PDMPs) was suggested to have the potential to reduce opioid prescribing, but little is known about its impacts on benzodiazepines. This study examined whether PDMP data use mandates were associated with changes in benzodiazepine prescribing in the U.S. Methods: Aggregate state quarterly prescription drug records of benzodiazepines for Medicaid enrollees during 2010-2017 were obtained from the U.S. Medicaid State Drug Utilization Data. Three population-adjusted outcome variables were evaluated, including quantity, dosage, and Medicaid spending of benzodiazepine prescriptions per quarter per 100 Medicaid enrollees. The primary policy variable was the state-wide implementation of PDMP data use mandates for benzodiazepines. To account for between-state variations in mandates, an additional policy variable was considered to indicate strong mandates on PDMP data use, which required all prescribers to query a patient's PDMP records for first prescribing and subsequent prescribing at least every 12 months. Linear regressions with difference-in-difference approach were used to assess the associations between PDMP data use mandates and benzodiazepine prescribing, controlling for state-level time-varying policy and socioeconomic covariates. Results: The state-wide implementation of PDMP data use mandates for benzodiazepines was not associated with quantity, dosage, or Medicaid spending of benzodiazepine prescriptions. Strong mandates on PDMP data use were not associated with any benzodiazepine prescribing outcomes, either. Conclusions: There was no evidence for the associations between PDMP data use mandates for benzodiazepines and changes in benzodiazepine prescribing among Medicaid enrollees. Future research is warranted to replicate the study in other populations using individual patient records and continuously monitor the trends in benzodiazepine prescribing in association with PDMPs.

20.
Int J Drug Policy ; 74: 1-10, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31382201

RESUMO

BACKGROUND: Recreational cannabis has been legalized in 11 states and Washington DC in the US. However, little is known about individual preferences for legal cannabis products. This study estimated the impacts of tetrahydrocannabinol (THC), cannabidiol (CBD), warning messages, and price on preferences for cannabis flowers. METHODS: A cross-sectional online survey with discrete choice experiments was implemented in October 2017. A sample of 2400 adults aged 21 years or older were recruited from 6 US states with recreational cannabis legalization, consisting of 1200 past-year nonusers and 1200 past-year users. Each respondent was randomly assigned to 12 discrete choice scenarios, each asking them to choose from an opt-out option and 3 cannabis flower products with varying levels in THC, CBD, warning messages, and price. The impacts of product attributes on individual choices were analyzed with nested logit regressions. RESULTS: Both cannabis nonusers and users preferred higher CBD and lower price. Users also preferred higher THC. The results on warning messages were mixed: graphic warning on drugged driving and text warning message had positive impacts on nonusers' and users' preferences for cannabis flowers, respectively, whereas FDA disapproval disclaimer had negative impacts on nonusers' preferences. Heterogeneities in preferences were revealed among nonusers by former use status and among users by reason of use. Particularly, medical cannabis users were not as responsive to THC as recreational cannabis users or dual users were. Regarding relative importance of the attributes, all respondents but medical cannabis users perceived price as the most important attribute (relative importance 51-64%), whereas medical cannabis users perceived CBD as the most important attribute (relative importance 47%). CONCLUSION: The findings indicated that product characteristics may have influences on US adults' choices of legal cannabis flower products and may deserve consideration for cannabis regulatory framework.


Assuntos
Canabidiol/provisão & distribuição , Comércio/estatística & dados numéricos , Dronabinol/provisão & distribuição , Fumar Maconha/economia , Adulto , Canabidiol/economia , Cannabis/química , Comportamento de Escolha , Comércio/legislação & jurisprudência , Estudos Transversais , Dronabinol/economia , Feminino , Flores , Humanos , Legislação de Medicamentos , Masculino , Fumar Maconha/epidemiologia , Maconha Medicinal/economia , Maconha Medicinal/provisão & distribuição , Pessoa de Meia-Idade , Rotulagem de Produtos , Inquéritos e Questionários , Adulto Jovem
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