Cannabis legalisation and cardiovascular hospitalisations in the United States: nationwide difference-in-differences analysis, 2012-2018

Abstract: To determine the association between legal recreational cannabis sales (hereafter ‘legalisation’) and cardiovascular hospitalisations. This study leverages a natural experiment wherein legalisation began earlier in the Western census region of the United States (January 2014) versus non-Western regions (November 2018).

Design

Using the National Inpatient Sample (NIS), we performed a difference-in-differences analysis of the association between legalisation and hospitalisation rates for six cardiovascular diagnoses, a positive control (cannabis-related diagnoses) and two negative control diagnoses (opioid-related and urinary stones).

Setting

US states before (2012–2013) and after (2014–2018) legalisation in the Western region