ArticleInjury epidemiology2020
Direct and indirect effects of marijuana use on the risk of fatal 2-vehicle crash initiation.
Article in Injury epidemiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed.
- Pediatric Trauma Trends Before and After Recreational Cannabis Legalization in Nevada: A Retrospective Repeated Cross-Sectional Study.Children (Basel, Switzerland) · 2026Article
- Risk of Motor Vehicle Collisions and Culpability among Older Drivers Using Cannabis: A Meta-Analysis.Brain sciences · 2023Review
- Understanding feeling "high" and its role in medical cannabis patient outcomes.Frontiers in pharmacology · 2023Article
- Can cannabis kill? Characteristics of deaths following cannabis use in England (1998-2020).Journal of psychopharmacology (Oxford, England) · 2022Article
- Use of Labor Neuraxial Analgesia for Vaginal Delivery and Severe Maternal Morbidity.JAMA network open · 2022Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
backgroundMarijuana 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.
methodsPair-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.
resultsCrash 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).
conclusionOur 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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