State marijuana policies and vaping associated lung injuries in the US.

Introduction:
This text provides an analysis of the relationship between marijuana policies and the prevalence of e-cigarette or vaping-associated lung injuries (EV ALI) in the US. The study examines how different recreational and medical marijuana policies relate to the incidence of EV ALI and the likelihood of vaping as the primary mode of marijuana use. The key points and main message of the text are summarized below.

Key Points:

* The study found that states with recreational marijuana (RM) legalization had a lower EV ALI incidence compared to states without legal RM.
* Among states with medical marijuana (MM) only, laws allowing home cultivation were associated with fewer EV ALI cases relative to those prohibiting it.
* Prohibitions on smoking as a mode of MM use were associated with increases in hospitalized EV ALI cases when excluding states that had this policy attribute but allowed sales of marijuana flower.
* Among those living in MM-only states, allowing home cultivation was associated with reduced odds of reporting vaping as one's primary mode of marijuana use.
* Operational dispensaries were associated with increased odds of vaping as the primary mode of use among those living in MM-only states.
* The findings suggest that understanding the implications of marijuana policy details is critical for informing regulatory decisions.
* Variation in MM policy attributes' associations with both EV ALI case counts and adults' mode of marijuana use suggests that carefully-crafted marijuana legalization policies may provide a means to reduce the risk of future outbreaks.

Main Message:
The study highlights the importance of considering the details of marijuana policies when examining their impact on public health. The findings suggest that recreational marijuana laws were associated with reduced EV ALI incidence, whereas the relationship's direction for medical marijuana laws depended on their policy attributes. Specifically, policy attributes expected to incentivize smoking marijuana relative to vaping it were associated with fewer EV ALI cases and a reduced likelihood of self-reporting vaping as one's primary mode of marijuana use. Associations were reversed for attributes expected to incentivize marijuana vaping over smoking. Therefore, close attention to these laws' details, particularly those expected to affect mode of use, is critical in reducing the risk of future outbreaks.

Friedman AS, Morean ME. State marijuana policies and vaping associated lung injuries in the US. Drug and alcohol dependence. 2021;228:109086. doi:10.1016/j.drugalcdep.2021.109086