High on the agenda
Rosanna Smart
University of California Working Paper, March 2015
Abstract:
Public opinion has grown more favorable to legalizing the sale and use of cannabis; many states now have "medical marijuana" laws (MMLs), and a few have legalized commercial production and sale for non-medical purposes. Prior research examining the effects of MML adoption has largely found reassuring evidence on the consequences of such policies -- no impact on adolescent cannabis use, and large decreases in crime rates, motor vehicle fatalities, suicides, and prescription opioid overdoses for adults. However, medical marijuana regimes vary greatly, and simple comparisons of states with such laws to states without them miss that variability. Reanalysis using a more sensitive measure of MML penetration (per-capita adult medical marijuana registration rates) confirms that growth in medical marijuana market size lowers alcohol and opioid-related poisoning deaths for older adults, and lessens traffic fatalities in accidents involving older drivers. However, larger medical marijuana markets lead to increased cannabis consumption by adolescents, accompanied by increases in traffic fatalities and alcohol poisoning mortality for this age group.
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Why Are There So Few Breweries in the South?
Stephan Gohmann
Entrepreneurship Theory and Practice, forthcoming
Abstract:
Most southern states have fewer breweries per population than the rest of the country. This paper examines why. The main outcome is that in the South, the number of breweries is negatively associated with higher campaign contributions from big breweries, the number of beer distributors per capita, and the Southern Baptist adherence rate. In the non-South, these associations are insignificant or positive. The limited number of breweries in the South follows the idea of bootleggers and Baptists where those who gain economically from limited competition — large breweries and distributors — side with groups morally opposed to alcohol to keep breweries out.
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Does Prescription Drug Coverage Increase Opioid Abuse? Evidence from Medicare Part D
Rosalie Liccardo Pacula, David Powell & Erin Taylor
NBER Working Paper, April 2015
Abstract:
Opioid abuse, as measured by deaths involving opioid analgesics and substance abuse treatment admissions, has increased dramatically since 1999, including a 20% increase in opioid-related mortality between 2005 and 2006. This paper examines whether the introduction of the Medicare Prescription Drug Benefit Program (Part D) in 2006 may have contributed to the increase in prescription drug abuse by expanding access to prescription drug benefits among the elderly. We test whether opioid abuse increased not only for the population directly affected by Part D (ages 65+) but also for younger ages. We compare growth in opioid prescriptions and abuse in states with relatively large ages 65+ population shares to states with smaller elderly population shares. Using data from the Drug Enforcement Agency’s Automation of Reports and Consolidated Orders System (ARCOS), we find opioid distribution increased faster in states with a larger fraction of its population impacted by Part D. We also find that this relative increase in opioids resulted in increases in opioid-related substance abuse treatment admissions. Interestingly, these states experienced significant growth in opioid abuse among both the 65+ population and the under 65 population, though the latter was not directly impacted by the implementation of Medicare Part D. We also find that opioid-related mortality increased disproportionately in the high elderly share states, though this relationship is not statistically different from zero.
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Alcohol Use in Films and Adolescent Alcohol Use
Andrea Waylen et al.
Pediatrics, forthcoming
Objectives: To investigate whether exposure to alcohol use in films (AUFs) is associated with early alcohol use, binge drinking, and alcohol-related problems in British adolescents.
Methods: Cross-sectional study with 5163 15-year-olds from the Avon Longitudinal Study of Parents and Children in the United Kingdom. We measured adolescent exposure to AUFs, age at onset of alcohol use, and binge-drinking behavior. We adjusted for early childhood social, family and behavioral factors, adolescent tobacco use, and peer drinking.
Results: After adjustment, adolescents with the highest exposure to AUFs were 1.2 (95% confidence interval [CI]: 1.1–1.3) times more likely to have tried alcohol compared with those least exposed and 1.7 (95% CI: 1.5–2.0) times more likely to binge drink. They were 2.4 (95% CI: 1.9–3.1) times more likely to drink weekly and 2.0 (95% CI: 1.7–2.4) times more likely to have alcohol-related problems than those least exposed.
Conclusions: Exposure to AUFs is associated with higher risk of alcohol use and alcohol-related problems in UK adolescents. Our findings provide evidence to support the argument that a review of film-rating categories and alcohol ratings for all films may help reduce problem-related alcohol consumption in young people.
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Margaretha de Looze et al.
European Journal of Public Health, April 2015, Pages 69-72
Background: This study examined trends in adolescent weekly alcohol use between 2002 and 2010 in 28 European and North American countries.
Methods: Analyses were based on data from 11-, 13- and 15-year-old adolescents who participated in the Health Behaviour in School-Aged Children (HBSC) study in 2002, 2006 and 2010.
Results: Weekly alcohol use declined in 20 of 28 countries and in all geographic regions, from 12.1 to 6.1% in Anglo-Saxon countries, 11.4 to 7.8% in Western Europe, 9.3 to 4.1% in Northern Europe and 16.3 to 9.9% in Southern Europe. Even in Eastern Europe, where a stable trend was observed between 2002 and 2006, weekly alcohol use declined between 2006 and 2010 from 12.3 to 10.1%. The decline was evident in all gender and age subgroups.
Conclusions: These consistent trends may be attributable to increased awareness of the harmful effects of alcohol for adolescent development and the implementation of associated prevention efforts, or changes in social norms and conditions. Although the declining trend was remarkably similar across countries, prevalence rates still differed considerably across countries.
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Ross O’Hara & Lynne Cooper
Archives of Sexual Behavior, May 2015, Pages 857-871
Abstract:
Overwhelming evidence indicates that sexual risk-taking behavior and alcohol use are linked, but the nature, strength, and timing of these relations may differ between gender and racial subgroups. These issues were addressed by examining the course and interrelations of both behaviors from adolescence into young adulthood, as well as how these patterns differed between both men and women and between Blacks and Whites. Data came from a representative, community-based sample of 1867 urban participants surveyed up to 5 times over a 15-year period. Although both prospective and trajectory analyses showed that adolescent involvement in one behavior predicted later involvement in the other, most patterns were moderated by gender, race, or both. In general, positive, bidirectional associations were discovered among men and Whites. Among women, adolescent sexual risk-taking behavior positively predicted later drinking, but not vice versa. For Blacks, adolescent alcohol use was inconsistently related to later sexual risk-taking behavior, and adolescent sexual risk-taking negatively predicted later alcohol use. Results suggest that associations between sexual risk-taking behavior and alcohol use are more complex than previously thought and that an adequate understanding of these links must account for both gender and racial differences.
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Behavioral Responses to Taxation: Cigarette Taxes and Food Stamp Take-Up
Kyle Rozema & Nicolas Ziebarth
Cornell University Working Paper, March 2015
Abstract:
This paper investigates a previously unexplored behavioral response to taxation: whether smokers compensate for higher cigarette taxes by enrolling in food stamps. First, we show theoretically that increases in cigarette taxes can induce food stamp take-up of non-enrolled, eligible smoking households. Then, we study the theoretical predictions empirically by exploiting between and within-household variation in food stamp enrollment from the Current Population Survey as well as data from the Consumer Expenditure Survey. The empirical evidence strongly supports the model predictions. Higher cigarette taxes increase the probability that low-income smoking households take-up food stamps.
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The Highs That Bind: School Context, Social Status and Marijuana Use
Matt Vogel et al.
Journal of Youth and Adolescence, May 2015, Pages 1153-1164
Abstract:
Substance use has been closely linked with the structural characteristics of adolescent social networks. Those who drink, smoke, and use drugs typically enjoy an elevated status among their peers. Rates of substance use vary substantially across schools, and indicators of school structure and climate account for at least part of this variation. Emerging research suggests peer-group processes are contingent on school context, but questions remain regarding the school-level mechanisms which condition the influence of network characteristics on substance use. The present study uses multilevel logistic regression models to examine the moderating influence of school connectedness, school drug culture, and global network density on the association between peer network status and marijuana use. The analyses draw on self, peer, and parental data from a sample of 7,548 high-school aged youth nested within 106 schools participating in the National Longitudinal Study of Adolescent to Adult Health (mean age = 15.2; % white = 59 %; male = 45 %). The results indicate that school connectedness significantly reduces the effect of social status on marijuana use. This provides evidence that school-level mechanisms can reduce the instrumentality of marijuana consumption in the status attainment process in adolescence.
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What Can the Brain Teach Us about Winemaking? An fMRI Study of Alcohol Level Preferences
Ram Frost et al.
PLoS ONE, March 2015
Abstract:
Over the last few decades, wine makers have been producing wines with a higher alcohol content, assuming that they are more appreciated by consumers. To test this hypothesis, we used functional magnetic imaging to compare reactions of human subjects to different types of wine, focusing on brain regions critical for flavor processing and food reward. Participants were presented with carefully matched pairs of high- and low-alcohol content red wines, without informing them of any of the wine attributes. Contrary to expectation, significantly greater activation was found for low-alcohol than for high-alcohol content wines in brain regions that are sensitive to taste intensity, including the insula as well as the cerebellum. Wines were closely matched for all physical attributes except for alcohol content, thus we interpret the preferential response to the low-alcohol content wines as arising from top-down modulation due to the low alcohol content wines inducing greater attentional exploration of aromas and flavours. The findings raise intriguing possibilities for objectively testing hypotheses regarding methods of producing a highly complex product such as wine.
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The Impact of Marijuana Decriminalization on California Drivers
Robin Pollini et al.
Drug and Alcohol Dependence, May 2015, Pages 135–140
Background: The liberalization of marijuana laws has led to concerns that such changes will increase “drugged driving” and crash-related mortality. California decriminalized marijuana effective January 1, 2011; we examine the impact of this change on marijuana-involved driving.
Methods: We used laboratory testing from roadside surveys and the Fatality Analysis Reporting System (FARS) to assess impacts on weekend nighttime drivers and fatally injured drivers, respectively. We calculated marijuana prevalence (measured by laboratory-confirmed delta-9-tetrahydrocannabinol [THC] in roadside surveys and cannabinoids in FARS) and compared corresponding 95% confidence intervals (CI) to identify statistically significant changes post-decriminalization. We also conducted multiple logistic regression analyses to determine whether the odds of marijuana-involved driving increased significantly after controlling for potential confounders.
Results: There was no statistically significant change in the prevalence of THC-positive driving among weekend nighttime drivers (n = 894) in 2012 (9.2%; 95% CI: 6.3, 12.2) compared to 2010 (11.3%; 95% CI: 8.5, 14.0) or in the adjusted odds of testing positive for THC (adjusted odds ratio [AOR] = 0.96; 95% CI: 0.57, 1.60). In contrast, we found a statistically significant increase in the prevalence of cannabinoids among fatally injured drivers in 2012 (17.8%; 95% CI: 14.6, 20.9) compared to the pre-decriminalization period 2008-2010 (11.8%; 95% CI: 10.3, 13.3). The adjusted odds of testing positive for cannabinoids were also significantly higher in 2012 (AOR = 1.67; 95% CI: 1.28, 2.18).
Conclusions: Our study generated discrepant findings regarding the impact of decriminalization on marijuana-involved driving in California. Factors that may have contributed to these findings, particularly methodological factors, are discussed.
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'High' Achievers? Cannabis Access and Academic Performance
Olivier Marie & Ulf Zölitz
London School of Economics Working Paper, March 2015
Abstract:
This paper investigates how legal cannabis access affects student performance. Identification comes from an exceptional policy introduced in the city of Maastricht which discriminated legal access based on individuals' nationality. We apply a difference-in-difference approach using administrative panel data on over 54,000 course grades of local students enrolled at Maastricht University before and during the partial cannabis prohibition.We find that the academic performance of students who are no longer legally permitted to buy cannabis increases substantially. Grade improvements are driven by younger students, and the effects are stronger for women and low performers. In line with how THC consumption affects cognitive functioning, we find that performance gains are larger for courses that require more numerical/mathematical skills. We investigate the underlying channels using students' course evaluations and present suggestive evidence that performance gains are driven by improved understanding of material rather than changes in students' study effort.
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Brennan Davis & Sonya Grier
Journal of Business Research, forthcoming
Abstract:
Urbanicity encompasses the different aspects of living in an urban area. While past research treats urban areas as homogeneous, this research employs an empirical study to show how intra-urban differences by poverty are associated with cigarette and alcohol consumption by adolescents. Results demonstrate that for higher poverty adolescents, those living in urban versus less urban areas consume significantly more alcohol and cigarettes. At the same time, for wealthier adolescents, those living in urban versus less urban areas consume significantly fewer of those items. The results are mediated by convenience store density, contributing to our understanding of the relationship between urban environments, specific area characteristics and problem consumption among adolescents. The results suggest that it might be useful to consider new ways of understanding problem consumption by studying distinct aspects of urbanicity related to the retail environment.
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The roles of outlet density and norms in alcohol use disorder
Jennifer Ahern, Laura Balzer & Sandro Galea
Drug and Alcohol Dependence, forthcoming
Background: Alcohol outlet density and norms shape alcohol consumption. However, due to analytic challenges we do not know: (a) if alcohol outlet density and norms also shape alcohol use disorder, and (b) whether they act in combination to shape disorder.
Methods: We applied a new targeted minimum loss-based estimator for rare outcomes (rTMLE) to a general population sample from New York City (n = 4000) to examine the separate and combined relations of neighborhood alcohol outlet density and norms around drunkenness with alcohol use disorder. Alcohol use disorder was assessed using the World Mental Health Comprehensive International Diagnostic Interview (WMH-CIDI) alcohol module. Confounders included demographic and socioeconomic characteristics, as well as history of drinking prior to residence in the current neighborhood.
Results: Alcohol use disorder prevalence was 1.78%. We found a marginal risk difference for alcohol outlet density of 0.88% (95% CI 0.00%-1.77%), and for norms of 2.05% (95% CI 0.89%-3.21%), adjusted for confounders. While each exposure had a substantial relation with alcohol use disorder, there was no evidence of additive interaction between the exposures.
Conclusions: Results indicate that the neighborhood environment shapes alcohol use disorder. Despite the lack of additive interaction, each exposure had a substantial relation with alcohol use disorder and our findings suggest that alteration of outlet density and norms together would likely be more effective than either one alone. Important next steps include development and testing of multi-component intervention approaches aiming to modify alcohol outlet density and norms towards reducing alcohol use disorder.
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Extraversion and the Rewarding Effects of Alcohol in a Social Context
Catharine Fairbairn et al.
Journal of Abnormal Psychology, forthcoming
Abstract:
The personality trait of extraversion has been linked to problematic drinking patterns. Researchers have long hypothesized that such associations are attributable to increased alcohol-reward sensitivity among extraverted individuals, and surveys suggest that individuals high in extraversion gain greater mood enhancement from alcohol than those low in extraversion. Surprisingly, however, alcohol administration studies have not found individuals high in extraversion to experience enhanced mood following alcohol consumption. Of note, prior studies have examined extraverted participants — individuals who self-identify as being highly social — consuming alcohol in isolation. In the present research, we used a group drinking paradigm to examine whether individuals high in extraversion gained greater reward from alcohol than did those low in extraversion and, further, whether a particular social mechanism (partners’ Duchenne smiling) might underlie alcohol reward sensitivity among extraverted individuals. Social drinkers (n = 720) consumed a moderate dose of alcohol, placebo, or control beverage in groups of 3 over the course of 36 min. This social interaction was video-recorded, and Duchenne smiling was coded using the Facial Action Coding System. Results indicated that participants high in extraversion reported significantly more mood enhancement from alcohol than did those low in extraversion. Further, mediated moderation analyses focusing on Duchenne smiling of group members indicated that social processes fully and uniquely accounted for alcohol reward-sensitivity among individuals high in extraversion. Results provide initial experimental evidence that individuals high in extraversion experience increased mood-enhancement from alcohol and further highlight the importance of considering social processes in the etiology of alcohol use disorder.
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Marin Kurti, Klaus von Lampe & Jacqueline Johnson
American Journal of Public Health, April 2015, Pages 750-756
Objectives: We examined the impact of a change in New York tax law on the numbers of untaxed cigarettes bootlegged from Native American reservations and resold in the South Bronx.
Methods: Discarded cigarette packs were systematically collected in 30 randomized South Bronx census tracks before and after the amended tax law went into effect in 2011. Also, administrative data were gathered on the number of taxed cigarettes sold in New York State, including sales to Native American reservations.
Results: Before the tax amendment, 42% of discarded cigarette packs collected in the South Bronx had no tax stamp. After the tax law went into effect, the percentage of cigarette packs without tax stamps declined to 6.2%. Simultaneously, the percentage of packs with out-of-state tax stamps rose from 18.3% to 66.3%. The percentage of packs with a combined New York State and New York City tax stamp did not change after the tax amendment.
Conclusions: After the tax amendment, the supply of contraband cigarettes appears to have quickly shifted from one lower-priced jurisdiction to another without a change in the overall prevalence of contraband cigarettes.
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Women’s Drinking Decisions in Sexually Risky Situations: Effects of a Low Level of Intoxication
Nora Noel et al.
Addictive Behaviors, August 2015, Pages 61–65
Introduction: Alcohol administration studies assessing alcohol’s deleterious effects on women’s threat perception and response in potential sexual assault situations usually employ a moderate to high dose (.07% BAC or more) and measure alcohol’s effects specifically on women’s sexual decisions. The current study used a low dose (.03%, equivalent to about 1–2 drinks) to assess women’s projected decisions on a different risky behavior: decisions to continue drinking and to drink higher amounts in a series of ecologically-valid sexual risk situations.
Methods: Young adult women (n = 17; M age = 21.8, sd = 1.3, range 21–25) participated in a three-session double-blind within subjects 2 (type of scenario) X 3( beverage) experiment, responding each time to 6 vignettes with an attractive man who was either Familiar or had Just Met her. In each session participants consumed a beverage (alcohol, placebo or water, random order) and projected emotional reactions and drinking decisions (likelihood and amount) in each of the 6 scenarios.
Results: Regardless of beverage, women predicted greater happiness, drinking likelihood, and drinking amount with “Familiar” men. However, there was also an interaction: They projected increased subsequent amounts in the .03% BAC (vs. water and placebo) condition differentially in the “Familiar” scenarios.
Conclusion: When the woman is Familiar with the man in a risky sexual situation, just one drink may increase subsequent projected alcohol amount over that originally intended. Implications include a low dose as a possible prime for more drinking, increasing sexual assault risk.
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The relationship between cannabis involvement and suicidal thoughts and behaviors
M.J. Delforterie et al.
Drug and Alcohol Dependence, May 2015, Pages 98–104
Background: In the present study, we examined the relationship between cannabis involvement and suicidal ideation (SI), plan and attempt, differentiating the latter into planned and unplanned attempt, taking into account other substance involvement and psychopathology.
Methods: We used two community-based twin samples from the Australian Twin Registry, including 9,583 individuals (58.5% female, aged between 27 and 40). The Semi-Structured Assessment of the Genetics of Alcoholism (SSAGA) was used to assess cannabis involvement which was categorized into: (0) no cannabis use (reference category); (1) cannabis use only; (2) 1-2 cannabis use disorder symptoms; (3) 3 or more symptoms. Separate multinomial logistic regression analyses were conducted for SI and suicide attempt with or without a plan. Twin analyses examined the genetic overlap between cannabis involvement and SI.
Results: All levels of cannabis involvement were related to SI, regardless of duration (Odds ratios [ORs] = 1.28–2.00, p < 0.01). Cannabis use and endorsing ≥3 symptoms were associated with unplanned (SANP; ORs = 1.95 and 2.51 respectively, p < 0.05), but not planned suicide attempts (p > 0.10). Associations persisted even after controlling for other psychiatric disorders and substance involvement. Overlapping genetic (rG = 0.45) and environmental (rE = 0.21) were responsible for the covariance between cannabis involvement and SI.
Conclusions: Cannabis involvement is associated, albeit modestly, with SI and unplanned suicide attempts. Such attempts are difficult to prevent and their association with cannabis use and cannabis use disorder symptoms requires further study, including in different samples and with additional attention to confounders.