Abstract 11890: Association Between State Marijuana Legalization Policies and Marijuana Use Reasoning Among Adults With Cardiovascular Disease, 2017-2020

Abstract

Introduction: The rapid adoption of marijuana legalization policies in states has forced clinicians to evaluate the health effects of marijuana due to increased availability; however, little is known about changes in marijuana use among adults with CVD after legalization (medical, recreational, dual) in the US. Methods: Using a sample of 298,651 adults from 2017-2020 survey data from the Behavioral Risk Factor and Surveillance System (BRFSS), we estimated the prevalence of recent (past-month) marijuana use in eleven states among adults with and without CVD by marijuana legalization (ML) status of a state. Multivariate logistic regression models were conducted to examine factors associated with marijuana use by self-reported CVD status. Results: Recent marijuana use was higher among adults with CVD in ML states compared to non-ML states (10.7% vs. 6.4%). The mean days of marijuana use in the CVD cohort in ML-states were 17.2±15.5, and 16.1±13.7 days in non-ML-states. Medical use among CVD adults decreased from 57.4% in 2017 to 47% in 2020. In contrast, dual-use increased from 14.4% in 2017 to 30.9% in 2020. However, trends were different in ML vs non-ML states(Figure). Adults with CVD in ML-states had higher (OR=1.75, p<.001), while in non-ML states had lower (OR=0.81, p<0.05), odds of marijuana use compared to those without CVD in non-ML states (reference group). Among CVD adults who used marijuana, odds of medical use were 85% higher in ML-states (OR=1.85, p<0.05), while more than two-fold for recreational (OR=2.10, p<0.05) and 2.5-fold for dual-use (OR=2.53, p<0.05), than non-ML states. Conclusions: We found a higher prevalence and likelihood of marijuana use in adults with CVD living in legalized vs. non-legalized states, which was not unexpected. However, marginal decline in use for medical reasons in ML states with the increasing prevalence of recreational and dual-use in the CVD population requires greater attention to the risk/benefits of individual preferences.