title: Cannabis use in adolescence and risk of future disability pension: a 39-year longitudinal cohort study.
abstract: OBJECTIVE
  This study aimed at examining a possible association between cannabis use in adolescence and future disability pension (DP). DP can be granted to any person in Sweden aged 16-65 years if working capacity is judged to be permanently reduced due to long-standing illness or injury.
  
  
  METHODS
  Data were obtained from a longitudinal cohort study comprising 49,321 Swedish men born in 1949-1951 who were conscripted to compulsory military service aged 18-20 years. Data on DP was collected from national registers.
  
  
  RESULTS
  Results showed that individuals who used cannabis in adolescence had considerably higher rates of disability pension throughout the follow-up until 59 years of age. In Cox proportional-hazards regression analyses, adjustment for covariates (social background, mental health, physical fitness, risky alcohol use, tobacco smoking and illicit drug use) attenuated the associations. However, when all covariates where entered simultaneously, about a 30% increased hazard ratio of DP from 40 to 59 years of age still remained in the group reporting cannabis use more than 50 times.
  
  
  CONCLUSIONS
  This study shows that heavy cannabis use in late adolescence was associated with an increased relative risk of labor market exclusion through disability pension.
authors.affiliation: Karolinska Institute, Department of Public Health Sciences, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden. Electronic address: anna-karin.danielsson@ki.se.
authors.forename: Anna-Karin
authors.initials: AK
authors.lastname: Danielsson
authors.affiliation: Karolinska Institute, Department of Public Health Sciences, Stockholm, Sweden.
authors.forename: Emilie
authors.initials: E
authors.lastname: Agardh
authors.affiliation: Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Hemmingsson
authors.affiliation: Karolinska Institute, Department of Public Health Sciences, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Allebeck
authors.affiliation: Karolinska Institute, Department of Public Health Sciences, Stockholm, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Falkstedt
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D018868:Insurance, Disability / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D010415:Pensions / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012306:Risk; D012307:Risk Factors; D013548:Sweden; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Adolescence; Cannabis; Cohort study; Disability pension