文章基本信息

标题：Direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation
其他标题：Direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation
本地全文：下载
作者：Stanford Chihuri ; Guohua Li
期刊名称：Injury Epidemiology
印刷版ISSN：2197-1714
出版年度：2020
卷号：7
期号：1
页码：1-10
DOI：10.1186/s40621-020-00276-9
出版社：BioMed Central
摘要：Marijuana and alcohol each play a significant role in fatal crash initiation. We decomposed the total effect of marijuana use in the presence or absence of alcohol on fatal crash initiation into direct and indirect effects. Pair-matched data on 5856 culpable drivers (initiators) and 5856 nonculpable drivers (noninitiators) involved in the same fatal 2-vehicle crashes recorded in the Fatality Analysis Reporting System between 2011 and 2016 were analyzed using the conditional logistic regression model and the unified mediation and interaction analysis framework. Crash initiators were more likely than noninitiators to test positive for marijuana (16.1% vs. 9.2%, P < 0.001), alcohol (28.6% vs. 9.7%, P < 0.001) and both substances (6.3% vs. 1.6%, P < .0001). Adjusted odds ratios of fatal 2-vehicle crash initiation revealed a positive interaction on the additive scale between marijuana and alcohol. Of the total effect of marijuana use on fatal 2-vehicle crash initiation, 68.8% was attributable to the direct effect (51.5% to controlled direct effect and 17.3% to reference interaction effect with alcohol) and 31.2% to the indirect effect (7.8% to mediated interaction effect and 23.4% to pure indirect effect through alcohol). Our results indicate that the increased odds of fatal 2-vehicle crash initiation associated with marijuana use is due mainly to the direct effect.
关键词：Alcohol ; Causal inference ; Driving safety ; Marijuana ; Motor vehicle crashes