Cannabis legalization was not broadly associated with changes in pediatric asthma rates, but some increases were observed among older teens and minority youth in states with recreational legalization.
Public health researchers, pediatricians, and policymakers evaluating the health impacts of cannabis legalization on children.
2.56 DID increasein asthma prevalence among 12-17 year olds in recreational cannabis legalization states
What the researchers found
While overall pediatric asthma declined 1.1% from 2011-2019, states with recreational cannabis legalization showed increased asthma prevalence among 12-17 year olds (DID=2.56, p=.028) and among some minoritized racial/ethnic groups.
Why it matters
As cannabis legalization expands, understanding its potential secondhand smoke effects on children is critical for public health policy, especially for vulnerable populations.
The numbers in context
Overall 1.1% decrease in pediatric asthma (2011-2019). In RCL states vs. illegal states: DID=2.56 (p=.028) for youth 12-17; DID=4.45 (p=.004) for some NH minoritized race/ethnicity groups in 2018-2019.
How the study worked
Ecological study using 2011-2019 National Survey on Children Health data. Difference-in-difference analysis compared asthma prevalence changes across states with different cannabis legal statuses.
Who was studied
Representative sample of minor children in the United States from the National Survey on Children Health (2011-2019).
What this study cannot tell us
Ecological design cannot establish individual-level causation. Self-reported asthma diagnosis may vary in accuracy. State-level analysis may mask within-state variation. Cannot directly measure secondhand cannabis smoke exposure.
How to read the evidence
Ecological study with difference-in-difference design provides population-level evidence but cannot establish individual causation.
When this study was published
Uses national survey data spanning 2011-2019, covering the early period of state-level recreational cannabis legalization.
The bigger picture
This study connects cannabis policy changes to children respiratory health outcomes, suggesting that legalization may disproportionately affect certain age and racial/ethnic groups through secondhand exposure.
Replication
Ecological study; individual-level research needed to confirm associations.
Funding
Not specified in abstract
Conflicts of interest
Not specified in abstract
Questions still open
- Is the increase in teen asthma in RCL states due to direct or secondhand cannabis exposure?
- What role do edibles versus smoked cannabis play in these respiratory health trends?
Read the original research
Cannabis legalization and childhood asthma in the United States: An ecologic analysis.
Preventive medicine, 170, 107414
Citation
Goodwin, Renee D; Wyka, Katarzyna; Luo, Man; Weinberger, Andrea H; Kattan, Meyer. (2023). Cannabis legalization and childhood asthma in the United States: An ecologic analysis.. Preventive medicine, 170, 107414. https://doi.org/10.1016/j.ypmed.2022.107414