@article{ref1,
title="Association of vaping-related lung injuries with rates of e-cigarette and cannabis use across US states",
journal="Addiction",
year="2020",
author="Friedman, Abigail S.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND AND AIMS: Responses to the 2019 US outbreak of 'e-cigarette or vaping product use-associated lung injury' (EVALI) ranged from temporary restrictions on nicotine e-cigarette sales to critiques of state cannabis policies. Yet, if either mass-marketed nicotine e-cigarettes or cannabis use per se drove this outbreak, as opposed to an additive in regionally available black market e-liquids, states' rates of vaping and/or cannabis use should predict their EVALI prevalence. This study tests that relationship.   DESIGN: Observational study of EVALI data from US states' health departments SETTING: United States PARTICIPANTS: All US states (N=50) MEASUREMENTS: The outcome of interest was each state's total EVALI cases per 12-64-year-old resident-an age-group covering most EVALI patients-as reported in the second week of January 2020. Predictors are 2017-2018 rates of adult e-cigarette use and past-month cannabis use, by state.   FINDINGS: The average state EVALI prevalence was 1.4 cases per 100,000 12-64-year-olds. Maps suggest a high-prevalence cluster comprising seven contiguous states in the northern Midwest. EVALI cases per capita were negatively associated with rates of vaping and past-month cannabis use, with the preferred specification's coefficients at -0.239 (95% Confidence Interval [CI]: -0.441, -0.037; P=0.02) and -0.086 (95% CI: -0.141, -0.031; P=0.003), respectively. Robustness checks supported the finding.   CONCLUSIONS: In the US, states with higher rates of e-cigarette and cannabis use prior to the 2019 'e-cigarette or vaping product use-associated lung injury' (EVALI) outbreak had lower EVALI prevalence. These results suggest that EVALI cases did not arise from e-cigarette or cannabis use per se, but rather from locally distributed e-liquids or additives most prevalent in the affected areas.<p /> <p>Language: en</p>",
language="en",
issn="0965-2140",
doi="10.1111/add.15235",
url="http://dx.doi.org/10.1111/add.15235"
}