Broad Spectrum epidemiological contribution of cannabis and other substances to the teratological profile of northern New South Wales: geospatial and causal inference analysis

BACKGROUND: Whilst cannabis commercialization is occurring rapidly guided by highly individualistic public narratives, evidence that all congenital anomalies (CA) increase alongside cannabis use in Canada, a link with 21 CA's in Hawaii, and rising CA's in Colorado indicate that transgenerational effects can be significant and impact public health. It was therefore important to study Northern New South Wales (NNSW) where cannabis use is high. METHODS: Design: Cohort. 2008-2015. SETTING: NNSW and Queensland (QLD), Australia. PARTICIPANTS: Whole populations. Exposures. Tobacco, alcohol, cannabis. SOURCE: National Drug Strategy Household Surveys 2010, 2013. MAIN OUTCOMES: CA Rates. NNSW-QLD comparisons. Geospatial and causal regression. RESULTS: making uncontrolled confounding unlikely. CONCLUSIONS: These results suggest that population level CA's react more strongly to small rises in cannabis use than tobacco or alcohol; cardiovascular, chromosomal, body wall and gastrointestinal CA's rise significantly with small increases in cannabis use; that cannabis is a bivariate correlate of AVTPCDSGDH and ACT anomalies, is robust to adjustment for other substances; and is causal.