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In general, additive models inclusion of ethnicity:cannabinoid and ethnicity:tobacco interactions were significant down to P=zero for cannabis, \u03949THC and cannabidiol. Sequentially doubly robust targeted multiple likelihood estimations confirmed epidemiologically causal relationships under standard assumptions. ASDR amongst Asians and Pacific Islanders in Nevada showed an exponential doubling time of 2.83 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cannabinoid and cannabinoid:ethnicity interactions drive ASDR and meet epidemiological causal criteria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41372-026-02717-7","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T11:37:01Z","timestamp":1779881821000},"page":"1323-1333","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cannabinoid impacts on ethnic modulation of atrial septal defect prevalence USA"],"prefix":"10.1038","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3256-720X","authenticated-orcid":false,"given":"Albert Stuart","family":"Reece","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary Kenneth","family":"Hulse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"2717_CR1","unstructured":"Centers for Disease Control (CDC), A, Geogia,. 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