title: The burden of disease attributable to cannabis use in Canada in 2012.
abstract: OBJECTIVE
  Cannabis use is associated with several adverse health effects. However, little is known about the cannabis-attributable burden of disease. This study quantified the age-, sex- and adverse health effect-specific cannabis-attributable (1) mortality, (2) years of life lost due to premature mortality (YLLs), (3) years of life lost due to disability (YLDs) and (4) disability-adjusted life years (DALYs) in Canada in 2012.
  
  
  METHODS
  Epidemiological modeling.
  
  
  METHODS
  Canada.
  
  
  METHODS
  Canadians aged ≥ 15 years in 2012.
  
  
  METHODS
  Using comparative risk assessment methodology, cannabis-attributable fractions were computed using Canadian exposure data and risk relations from large studies or meta-analyses. Outcome data were obtained from Canadian databases and the World Health Organization. The 95% confidence intervals (CIs) were computed using Monte Carlo methodology.
  
  
  RESULTS
  Cannabis use was estimated to have caused 287 deaths (95% CI = 108, 609), 10,533 YLLs (95% CI = 4760, 20,833), 55,813 YLDs (95% CI = 38,175, 74,094) and 66,346 DALYs (95% CI = 47,785, 87,207), based on causal impacts on cannabis use disorders, schizophrenia, lung cancer and road traffic injuries. Cannabis-attributable burden of disease was highest among young people, and males accounted for twice the burden than females. Cannabis use disorders were the most important single cause of the cannabis-attributable burden of disease.
  
  
  CONCLUSIONS
  The cannabis-attributable burden of disease in Canada in 2012 included 55,813 years of life lost due to disability, caused mainly by cannabis use disorders. Although the cannabis-attributable burden of disease was substantial, it was much lower compared with other commonly used legal and illegal substances. Moreover, the evidence base for cannabis-attributable harms was smaller.
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|Institute of Medical Science, University of Toronto, Toronto, Canada.
authors.forename: Sameer
authors.initials: S
authors.lastname: Imtiaz
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|Institute of Medical Science, University of Toronto, Toronto, Canada.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Shield
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Roerecke
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|Institute for Clinical Evaluative Sciences, Toronto, Canada.
authors.forename: Joyce
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|Institute of Medical Science, University of Toronto, Toronto, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.|Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Popova
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|Institute for Clinical Evaluative Sciences, Toronto, Canada.|Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Kurdyak
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|Department of Psychiatry, University of Toronto, Toronto, Canada.|Centre for Applied Research in Mental Health and Addiction, Simon Fraser University, Vancouver, Canada.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Fischer
authors.affiliation: Centre for Addiction and Mental Health, Toronto, Canada.|Institute of Medical Science, University of Toronto, Toronto, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.|Department of Psychiatry, University of Toronto, Toronto, Canada.|Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D002188:Cannabis / Q000009:adverse effects*; D017281:Cost of Illness; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D055815:Young Adult
keywords: Burden of disease; Canada; cannabis; comparative risk assessment; disability-adjusted life years; marijuana; mortality; years of life lost due to disability; years of life lost due to premature mortality