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Trends and age, period and cohort effects for marijuana use prevalence in the 1984-2015 US National Alcohol Surveys.

ABSTRACT: BACKGROUND AND AIMS:Epidemiological trends show marijuana use in the United States to have increased in recent years. Previous research has identified cohort effects as contributing to the rising prevalence, in particular birth cohorts born after 1945. However, given recent policy efforts to regulate marijuana use at the state level, period effects could also play a contributory role. This study aimed to examine whether cohort or period effects play a larger role in explaining trends in marijuana use. DESIGN:Using data from seven National Alcohol Surveys, we estimated age-period-cohort decomposition models for marijuana use, controlling for socio-demographic measures. SETTING:United States. PARTICIPANTS:US general population aged 18 and older from 1984 to 2015. MEASUREMENTS:Any past-year marijuana use. FINDINGS:Results indicated that period effects were the main driver of rising marijuana use prevalence. Models including indicators of medical and recreational marijuana policies did not find any significant positive impacts. CONCLUSIONS:The steep rise in marijuana use in the United States since 2005 occurred across the population and is attributable to general period effects not linked specifically to the liberalization of marijuana policies in some states.

SUBMITTER: Kerr WC

PROVIDER: S-EPMC5807111 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Trends and age, period and cohort effects for marijuana use prevalence in the 1984-2015 US National Alcohol Surveys.

Kerr William C WC Lui Camillia C Ye Yu Y

Addiction (Abingdon, England) 20171011 3

<h4>Background and aims</h4>Epidemiological trends show marijuana use in the United States to have increased in recent years. Previous research has identified cohort effects as contributing to the rising prevalence, in particular birth cohorts born after 1945. However, given recent policy efforts to regulate marijuana use at the state level, period effects could also play a contributory role. This study aimed to examine whether cohort or period effects play a larger role in explaining trends in ...[more]

PMID: 28895239

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Project description:Background and aimsUruguay and Chile have the highest levels of marijuana use in Latin America, and have experienced consistent increases during the last two decades. We aim to calculate separate age-period-cohort (APC) effects for past-year marijuana use in Uruguay and Chile, which have similar epidemiologica, and demographic profiles but diverging paths in cannabis regulation.DesignAPC study in which period and cohort effects were estimated as first derivative deviations from their linear age trend, separately by country and gender.SettingUruguay and Chile.ParticipantsGeneral population between 15 and 64 years.MeasurementsPast-year marijuana use from household surveys with five repeated cross-sections between 2001 and 2018 in Uruguay (median n = 4616) and 13 between 1994 and 2018 in Chile (median n = 15 895).FindingsMarijuana use prevalence in both countries peaked at 20-24 years of age and increased consistently across calendar years. Period effects were strong and positive, indicating that increases in use were evident across age groups. Relative to 2006 (reference year), Chilean period effects were approximately 48% lower in 1994 and approximately four times higher in 2018; in Uruguay, these effects were approximately 56% lower in 2001 and almost quadrupled in 2018. We observed non-linear cohort effects in Chile and similar patterns in Uruguay for the overall sample and women. In both countries, marijuana use increased for cohorts born between the mid-1970s and early 1990s, even in the context of rising period effects. Prevalence was consistently larger for men, but period increases were stronger in women.ConclusionsAge-period-cohort effects on past-year marijuana use appear to have been similar in Chile and Uruguay, decreasing with age and increasing over time at heterogeneous growth rates depending on gender and cohort. Current levels of marijuana use, including age and gender disparities, seem to be associated with recent common historical events in these two countries.

Project description:BackgroundIt has been suggested that an increasing number of Japanese adults remain sexually inexperienced; however, no study has assessed this issue using nationally representative data.MethodsWe used data from seven rounds of the National Fertility Survey of Japan, 1987-2015, and included adults aged 18-39 years (18-34 years in the 1987 survey) in the analyses (sample size 11,553-17,850 [1987-2010]; response rate 70.0-92.5%). For each survey year, sex and age group, we estimated the age-adjusted prevalence of heterosexual inexperience, defined as reporting no experience of sexual intercourse with someone of the opposite sex. We used logistic regression, adjusted for age, to identify factors associated with heterosexual inexperience in the 2010 survey. Information about same-sex sexual experience was not available.ResultsBetween 1992 and 2015, the age-standardized prevalence of heterosexual inexperience in adults aged 18-39 years increased from 21.7 to 24.6% for women (p-values for linear and quadratic trend < 0.05) and from 20.0 to 25.8% for men (p-values for trend < 0.05). Among those aged 30-34 years, the prevalence was 6.2% in 1987 and 11.9% in 2015 for women (p-values for trend ≥0.05) and 8.8% (1987) and 12.7% (2015) for men (p-values for trend ≥0.05). Among those aged 35-39 years, prevalence increased from 4.0% in 1992 to 8.9% in 2015 among women (p-values for trend < 0.05). The corresponding numbers for men in the same age group were 5.5 and 9.5%, respectively (p-values for trend ≥0.05). Among men aged 25-39 years, unemployment, temporary/part-time employment and lower income were associated with heterosexual inexperience.ConclusionsThe proportion of young Japanese adults with no experience of heterosexual intercourse had increased in the past two decades. Among adults in their thirties, around one in ten had no heterosexual experience. Unemployment, temporary/part-time employment and low income were associated with heterosexual inexperience among men. Further research is needed on the factors contributing to and the potential public health and demographic implications of the high proportion of the Japanese population that remains sexually inexperienced well into adult age.

Project description:BACKGROUND:The majority of U.S. older adults consume alcoholic beverages. The older population is projected to almost double by 2050. Substantially more drinkers are likely. PURPOSE:To describe gender-specific trends (1997 to 2014) in prevalence of drinking status (lifetime abstention, former drinking, current drinking [including average volume], and binge drinking) among U.S. adults ages 60+ by age group and birth cohort. METHODS:In the 1997 to 2014 National Health Interview Surveys, 65,303 respondents ages 60+ (31,803 men, 33,500 women) were current drinkers; 6,570 men and 1,737 women were binge drinkers. Prevalence estimates and standard errors were computed by age group (60+, 60 to 64, 65 to 69, 70 to 74, 75 to 79, 80+) and birth cohort (<1925, 1925 to 1935, 1936 to 1945, 1946 to 1954). Trends were examined using joinpoint regression and described as average annual percent change (AAPC; overall change 1997 to 2014) and annual percent change (APC; in-between infection points). Primary analyses were unadjusted. All analyses (unadjusted and adjusted for demographics/lifestyle) were weighted to produce nationally representative estimates. Statistical procedures accounted for the complex survey design. RESULTS:Among men ages 60+, unadjusted prevalence of current drinking trended upward, on average, 0.7% per year (AAPC, p = 0.02); average volume and prevalence of binge drinking remained stable. Adjusted results were similar. Among women age 60+, unadjusted prevalence of current drinking trended upward, on average, 1.6% per year (AAPC, p < 0.0001), but average volume remained stable; prevalence of binge drinking increased, on average, 3.7% per year (AAPC, p < 0.0001). Adjusted results were similar. Trends varied by age group and birth cohort. Among men born 1946 to 1954, unadjusted prevalence of current drinking trended upward, on average, 2.4% per year (AAPC, p = 0.02); adjusted results were nonsignificant. CONCLUSIONS:Our finding of upward trends in drinking among adults ages 60+, particularly women, suggests the importance of public health planning to meet future needs for alcohol-related programs.

Project description:BackgroundEpidemiological studies on cardiovascular diseases (CVD) among women of childbearing age (WCBA) remain scarce. Our research aims to delineate the prevalence trends of CVD within this population over the past three decades, considering age, period, and birth cohort dynamics.MethodsEstimates of CVD prevalence for WCBA, along with their 95% uncertainty intervals (UI), were extracted from the Global Burden of Diseases 2019 (GBD2019). An age-period-cohort (APC) model was utilized to assess the annual percentage change (net drifts) in overall prevalence, annual percentage changes in prevalence for individual age groups (local drifts), and fitted longitudinal age-specific rates adjusted for age effects and period/cohort relative risks (period/cohort effect).ResultsIn 2019, the global prevalence of CVD among WCBA was 53.42 million (95% UI: 47.77 to 60.18). Eight countries recorded a prevalence exceeding one million, accounting for 54.17% of the global CVD prevalence in WCBA. Over the past 30 years, the annual net drift in CVD prevalence among the global WCBA was 0.27% (95% CI: 0.25 to 0.29). This value was 0.01% (95% CI: 0.04 to 0.06) in regions with a high sociodemographic index (SDI) and 0.21% (95% CI: 0.19 to 0.22) in those with a low SDI. Seventy-seven countries demonstrated an increasing trend in CVD prevalence, while 53 showed a decrease, and 74 remained relatively stable. Notably, as shown in local drift, there was a rise in CVD prevalence among adolescents aged 15-19 and adults aged 40-49 in regions categorized by five distinct SDI levels. This drift varied by SDI regions. Regions with a high SDI consistently had elevated period risks throughout the study duration, while other regions had lower period risks until 2000-2004 and displayed increased adverse period risks. The prevalence in low-middle and low SDI regions manifested detrimental trends, whereas other regions demonstrated an initial decline followed by a surge in successive birth cohorts.ConclusionsResources dedicated to CVD care for WCBA are largely insufficient, especially in low SDI regions. Thus, there is an urgent need to allocate cardiovascular healthcare resources variably across different SDI regions, aiming to diminish risks among successively younger birth cohorts. Throughout this endeavor, the formulation of targeted policies and the judicious distribution of resources are essential to reduce risks for women across all age groups.

Project description:BackgroundGlobal, regional, and national estimates of prevalence of and tends in infertility are needed to target prevention and treatment efforts. By applying a consistent algorithm to demographic and reproductive surveys available from developed and developing countries, we estimate infertility prevalence and trends, 1990 to 2010, by country and region.Methods and findingsWe accessed and analyzed household survey data from 277 demographic and reproductive health surveys using a consistent algorithm to calculate infertility. We used a demographic infertility measure with live birth as the outcome and a 5-y exposure period based on union status, contraceptive use, and desire for a child. We corrected for biases arising from the use of incomplete information on past union status and contraceptive use. We used a Bayesian hierarchical model to estimate prevalence of and trends in infertility in 190 countries and territories. In 2010, among women 20-44 y of age who were exposed to the risk of pregnancy, 1.9% (95% uncertainty interval 1.7%, 2.2%) were unable to attain a live birth (primary infertility). Out of women who had had at least one live birth and were exposed to the risk of pregnancy, 10.5% (9.5%, 11.7%) were unable to have another child (secondary infertility). Infertility prevalence was highest in South Asia, Sub-Saharan Africa, North Africa/Middle East, and Central/Eastern Europe and Central Asia. Levels of infertility in 2010 were similar to those in 1990 in most world regions, apart from declines in primary and secondary infertility in Sub-Saharan Africa and primary infertility in South Asia (posterior probability [pp] ?0.99). Although there were no statistically significant changes in the prevalence of infertility in most regions amongst women who were exposed to the risk of pregnancy, reduced child-seeking behavior resulted in a reduction of primary infertility among all women from 1.6% to 1.5% (pp=0.90) and a reduction of secondary infertility among all women from 3.9% to 3.0% (pp>0.99) from 1990 to 2010. Due to population growth, however, the absolute number of couples affected by infertility increased from 42.0 million (39.6 million, 44.8 million) in 1990 to 48.5 million (45.0 million, 52.6 million) in 2010. Limitations of the study include gaps in survey data for some countries and the use of proxies to determine exposure to pregnancy.ConclusionsWe analyzed demographic and reproductive household survey data to reveal global patterns and trends in infertility. Independent from population growth and worldwide declines in the preferred number of children, we found little evidence of changes in infertility over two decades, apart from in the regions of Sub-Saharan Africa and South Asia. Further research is needed to identify the etiological causes of these patterns and trends.

Dataset Information

Trends and age, period and cohort effects for marijuana use prevalence in the 1984-2015 US National Alcohol Surveys.

Publications

Trends and age, period and cohort effects for marijuana use prevalence in the 1984-2015 US National Alcohol Surveys.

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