Association between cannabis use and myocardial infarction among young adults from the 2017 and 2018 Behavioral Risk Factor Surveillance System surveys
| Characteristic | Unadjusted OR for myocardial infarction (95% CI) | Adjusted OR for myocardial infarction* (95% CI) |
|---|---|---|
| Cannabis use | ||
| No | Reference | Reference |
| Yes | 1.92 (1.11–3.34) | 2.07 (1.12–3.82) |
| Frequency of use† | ||
| No use | Reference | Reference |
| Less frequent | 1.26 (0.46–3.45) | 1.48 (0.52–4.21) |
| More frequent | 2.20 (1.21–3.99) | 2.31 (1.18–4.50) |
| Primary method of consumption | ||
| No use | Reference | Reference |
| Smoke | 2.02 (1.10–3.70) | 2.01 (1.02–3.98) |
| Vapourize | 1.26 (0.33–4.92) | 2.26 (0.58–8.82) |
| Other | 1.91 (0.61–6.01) | 2.36 (0.81–6.88) |
| Sensitivity analyses‡ | ||
| Additionally adjusted model§ | 3.00 (1.19–7.56) | 3.54 (1.13–11.05) |
| Missing category cohort¶ | 1.60 (1.03–2.50) | 1.68 (1.01–2.79) |
| Inverse probability weighting for missing data | 1.88 (1.09–3.25) | 2.04 (1.11–3.76) |
| Negative control analyses | ||
| Skin cancer | 0.93 (0.58–1.48) | 1.02 (0.59–1.75) |
| Blindness | 1.15 (0.86–1.54) | 0.98 (0.71–1.35) |
| Posthoc analyses | ||
| Cannabis as a continuous variable** | 1.02 (1.00–1.04) | 1.02 (1.00–1.04) |
| Propensity-score matched analysis | – | 2.11 (1.12–3.97) |
Note: CI = confidence interval, OR = odds ratio.
↵* Model adjusted for sex, race, age, body mass index, education level, income level, marital status, health care coverage, combustible cigarette use, smokeless tobacco use, e-cigarette use, heavy drinking (> 14 drinks per week for males, and > 7 drinks per week for females), sedentary lifestyle (no reported physical activity or exercise during past 30 days other than regular job), chronic kidney disease, and diabetes.
↵† Less frequent defined as consumption of cannabis ≤ 4 times per month (≤ 1 time per week). More frequent defined as consumption of cannabis > 4 times per month (> 1 time per week).
↵‡ Sensitivity analyses assess cannabis use as a binary outcome (the reference group is nonusers).
↵§ Analysis of only 2017 data including adjustment for hypertension and high cholesterol.
↵¶ The missing category cohort includes a level for “missing data” for each covariate with > 5% missing data.
↵** The incremental amount for cannabis use as a continuous variable is per additional day of use within the last 30 days.