Marijuana Causes Lung Disease

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It is frequently claimed that marijuana smoke contains such high concentrations of irritants that marijuana users’ risk of developing lung disease is equal to or greater than that of tobacco users.

The Facts

Except for their psychoactive ingredients, marijuana and tobacco smoke are nearly identical. 21 Because most marijuana smokers inhale more deeply and hold the smoke in their lungs, more dangerous material may be consumed per cigarette. However, it is the total volume of irritant inhalation—not the amount in each cigarette—that matters.

Most tobacco smokers consume more than 10 cigarettes per day and some consume 40 or more. Regular marijuana smokers seldom consume more than three to five cigarettes per day and most consume far fewer. Thus, the amount of irritant material inhaled almost never approaches that of tobacco users.

Frequent marijuana smokers experience adverse respiratory symptoms from smoking, including chronic cough, chronic phlegm, and wheezing. However, the only prospective clinical study shows no increased risk of crippling pulmonary disease (chronic bronchitis and emphysema).

Since 1982, UCLA researchers have evaluated pulmonary function and bronchial cell characteristics in marijuana-only smokers, tobacco-only smokers, smokers of both, and non-smokers. Although they have found changes in marijuana-only smokers, the changes are much less pronounced than those found in tobacco smokers. The nature of the marijuana-induced changes were also different, occurring primarily in the lung’s large airways – not the small peripheral airways affected by tobacco smoke. Since it is small-airway inflammation that causes chronic bronchitis and emphysema, marijuana smokers may not develop these diseases. 22

In an epidemiological survey, approximately 1200 subjects gave information on smoking and pulmonary function at two-year intervals. A large percentage of the subjects underwent pulmonary function testing. Although a small group who reported previous marijuana smoking had significant pulmonary abnormalities, current marijuana smokers had no significant reduction in any pulmonary functions. 23

There are no epidemiological or aggregate clinical data suggesting that marijuana-only smokers develop lung cancer. However, since some bronchial cell changes appear to be pre-cancerous, an increased risk of cancer among frequent marijuana smokers is possible. 24

Since the pulmonary risks associated with marijuana are related to smoking, the danger is eliminated with other routes of administration. For committed smokers, pulmonary risk might be reduced with higher-potency products, which produce desired psychoactive effects with less inhalation of irritants. Smokers could also be encouraged to abandon deep inhalation and breath-holding, which increase drug delivery only slightly. Finally, pulmonary risk might be reduced if marijuana were smoked in water pipes rather than cigarettes. 25

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