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Direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation

BACKGROUND: 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. METHODS: Pair-matched data on 5856 culpable drivers (initiators)...

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Autores principales: Chihuri, Stanford, Li, Guohua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488993/
https://www.ncbi.nlm.nih.gov/pubmed/32921302
http://dx.doi.org/10.1186/s40621-020-00276-9
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author Chihuri, Stanford
Li, Guohua
author_facet Chihuri, Stanford
Li, Guohua
author_sort Chihuri, Stanford
collection PubMed
description BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: Our results indicate that the increased odds of fatal 2-vehicle crash initiation associated with marijuana use is due mainly to the direct effect.
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spelling pubmed-74889932020-09-16 Direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation Chihuri, Stanford Li, Guohua Inj Epidemiol Original Contribution BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: Our results indicate that the increased odds of fatal 2-vehicle crash initiation associated with marijuana use is due mainly to the direct effect. BioMed Central 2020-09-14 /pmc/articles/PMC7488993/ /pubmed/32921302 http://dx.doi.org/10.1186/s40621-020-00276-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Original Contribution
Chihuri, Stanford
Li, Guohua
Direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation
title Direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation
title_full Direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation
title_fullStr Direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation
title_full_unstemmed Direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation
title_short Direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation
title_sort direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation
topic Original Contribution
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488993/
https://www.ncbi.nlm.nih.gov/pubmed/32921302
http://dx.doi.org/10.1186/s40621-020-00276-9
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