A rise in asthma cases has been observed in children from certain racial and ethnic minority groups in states where recreational use of marijuana has been legalized.
A recent study conducted by the Columbia University Mailman School of Public Health and The City University of New York has revealed that there has been a rise in the prevalence of asthma among teenagers in states where recreational use of cannabis has been legalized, as well as among children from certain racial and ethnic minority groups in states with recreational legalization, in comparison to states where it remains fully illegal.
The findings of the study offer initial indications that the legalization and commercialization of cannabis for adult use could be linked to an increase in asthma prevalence. This study is the first to investigate the connection between changes in cannabis policy for adult use and the incidence of asthma among children and teenagers. The findings have been published in the journal Preventive Medicine.
“Our findings suggest that state-level cannabis policy could have downstream impacts on children’s respiratory health,” said Renee D. Goodwin, Ph.D., adjunct associate professor in the Department of Epidemiology at Columbia Mailman School of Public Health and professor at The City University of New York. “Cannabis use is increasing among adults with children in the home, particularly in states which have legalized for medical or recreational use. Exposure to secondhand smoke is a key risk factor for asthma among children. This study offers a critical first step in identifying a key children’s health concern emerging in the context of rapid, ongoing changes in cannabis policy that are unaccompanied by clinical or public health guidelines for parents.”
Asthma affects approximately 5 million children and is the most common chronic condition affecting children in the nation. The researchers used data from the 2011-2019 National Survey on Children’s Health, a representative sample of the physical and mental health of non-institutionalized children in the U.S. ages 0-17 years old.
Nationally, a statistically significant decrease in the prevalence of pediatric asthma was reported from 2011-2012 to 2016-2017, with no decline thereafter. Relative to states where cannabis was fully illegal, the prevalence of asthma increased slightly among adolescents 12-17 years old and among children identifying with non-Hispanic minoritized race and ethnic groups in states where cannabis was legal for adult recreational use.
Cannabis use has been increasing among adults with minor children in the home and is more common among those who live in states where cannabis is legal for recreational use. An earlier study by Goodwin found that, among parents with minor children, cannabis use was observed in 12 percent of parents in states with legal cannabis for recreational purposes, followed by parents residing in states with legalized cannabis for medical purposes (9.5 percent), with the lowest prevalence seen in parents in states with no cannabis laws (6 percent).
“Increased adult cannabis use across the U.S. may inadvertently impact asthma among youth. In the context of the rapidly increasing legalization of adult (21 and older) use and commercialization in the U.S., an evidence base is urgently needed to inform legislators, policymakers, clinicians, and the public on the potential health impact of increasing secondhand cannabis smoke (SCS) exposure among children. Yet, no clinical nor public education regarding child exposure to SCS is available or routinely offered to parents,” noted Goodwin.
“While tremendous progress has been made in asthma management in concert with tobacco control over the past several decades, the possibility that increased adult cannabis use may pose new risks, requires more in-depth study and, in particular, to learn whether SCS is associated with increases in asthma morbidity, including symptom frequency, use of rescue medicines, impairment—including missed school days — and emergency medical services.
“We believe that more research is urgently needed to estimate the potential consequences of increased adult use of cannabis in the community for children’s respiratory health and that this work should come before, or at least be done contemporaneously with, the widespread commercialization of cannabis for adult use in U.S. states,” observed Goodwin.”
Reference: “Cannabis legalization and childhood asthma in the United States: An ecologic analysis” by Renee D. Goodwin, Katarzyna Wyka, Man Luo, Andrea H. Weinberger, and Meyer Kattan, 30 December 2022, Preventive Medicine.
The study was funded by the National Institutes of Health/National Heart, Lung, and Blood Institute.