Smoke Study – Cannabis doesn’t damage your lungs like tobacco smoke, a new report says

A study recently published on JAMA NETWORK posed the age-old question; Is there a relationship between marijuana exposure and lung function over 20 years?

Now that enough data is available, researchers could finally address this problem. What they found was that “the occasional and low cumulative use of marijuana had NO adverse effects on lung function.”

In other words, unlike tobacco smoke, cannabis smoke does not have such a drastic effect on lung function, despite having some of the same chemical properties in smoke.

To arrive at the results, the researchers used data from a sample group first tracked in 1985, with subsequent follow-ups to ensure the longevity of the study.

Here is the method used, as reported in the study itself;

CARDIA is a longitudinal study measuring risk factors for coronary artery disease in a cohort of black and white women and men (n = 5115) ages 18 to 30 who were healthy when admitted in 1985.17,18 participants were selected from 4 US Communities with no choice for smoking habits and include a broad cross-section of typical tobacco and marijuana use patterns.

With the written consent of the participants and the approval of the institutional examination boards at each study center (Oakland, Chicago, Minneapolis and Birmingham), participants underwent a baseline exam and 6 follow-up exams, with 69% retained in year 20, functional tests were carried out in years 0, 2 , 5, 10 and 20 performed. For this investigation, we included all visits for which lung function, smoking behavior, secondhand smoke exposure, height and waist circumference were available. – SOURCE

The method

The researchers had to divide the groups into those who smoke tobacco, those who smoke cannabis, and those who smoked both. They found that the average daily tobacco smoker consumed around 7,300 cigarettes in any given year.

For cannabis smokers, they charged at least “1 joint a day,” which makes about 365 joints a year. Of course, these variables also fluctuated a bit, but this allowed the researchers to create a basis for their studies.

How they were tested

Again, instead of trying to explain how they did it;

The study results were the forced expiratory volume in the first second of expiration (FEV1) and the forced vital capacity (FVC) as measured by forced spirometry. These were with a. collected Collins Survey 8L Waterproof Spirometer and a Eagle II microprocessor (Years 0, 2, 5 and 10) and then an OMI Rolling Seal Spirometer (Year 20). A comparative study carried out on 25 participants showed an average difference of less than 1% for both measurements. Standard quality control and testing procedures were followed according to established guidelines

Essentially, they used these tools and ran tests on the participants at different stages.

The results

After the researchers made the right adjustments, a large sample pool of participants remained. They found that “smoking behavior varies by race and gender, with black women most likely to smoke only tobacco, white men most likely to smoke only marijuana, and black men most likely to smoke both. Tobacco smokers tended to have lower levels of education and income, and were slightly smaller and less active, while marijuana smokers tended to be taller and more active. “

Interesting to say the least. But what does this have to do with lung function?

Let’s take a look at what they had to say about tobacco use;

When we modeled current and lifelong tobacco and marijuana exposure as continuous exposure and allowed flexible nonlinear associations (via splines), we again found strong dose-dependent associations (P <0.001) between increasing tobacco exposure and lower FEV1 and FVC ( Illustration .). 2), without any indications of non-linearity (Table 3). The falling slopes ranged from −2.8 ml (95% CI, −4.8 to −0.7; P = 0.007) per additional cigarette smoked per day to −7.0 ml (95% CI, - 10 to −3.7; P <0.001.). ) per additional pack year for FEV1 and were of a similar order of magnitude for FVC (Table 3). After 50 pack years of exposure, FEV1 was a mean 332 ml lower (95% CI, -401 to -263; P <0.001) and FVC was 229 ml lower (95% CI, -310 to -147; P <.001 ) compared to no exposure.

What they found was basically what was expected. As people continued to smoke tobacco, their ability to wield oxygen decreased over time. However, this was different from smoking cannabis;

For marijuana, we found strong statistical evidence that the associations between marijuana use and lung function were non-linear (Figure 2, Table 3). With low lifetime exposure, increasing marijuana use was associated with a steep increase in FEV1 (13 ml / year together higher [95% CI, 6.4 to 20], P <0.001) and FVC (20 ml / common year higher.) [95% CI, 12 to 27], P < .001), but at higher levels of exposure (>7 years), the slope leveled or even turned down. With more than 10 joint years of lifelong exposure, we found a non-significant decrease in FEV1 (−2.2 ml / joint year [95% CI, −4.8 to 0.3], P = .08), but a significant decrease in FEV1 for more than 20 marijuana use episodes per month (−3.2 ml / episode [95% CI, −5.8 to −0.6], P = 0.02). Although the net associations with FEV1 became negative at very high exposure levels (> 40 years together or> 25 episodes / month), these negative deviations were not statistically significant (Table 3). The FVC remained significantly elevated even in heavy users (e.g. 76 ml [95% CI, 34 to 117; P < .001] for 20 years together).

Essentially, they found that moderate to low levels of cannabis use did not lead to any reduction in lung function. In people who only smoke occasionally, this has no real impact on lung function.

With lifelong exposure of up to 7 joint years (e.g. 1 joint / day for 7 years or 1 joint / week for 49 years), we found no evidence that increasing marijuana exposure impaired lung function. However, this relationship was non-linear: at higher exposure levels we found a flattening or even a reversal of this relationship, especially for FEV1. Although our sample did not include enough heavy users to confirm an adverse effect of very heavy marijuana use on lung function, our results suggest this possibility.

In other words, for those who smoke similarly to tobacco smokers (who by default cannabis users smoke far less than tobacco smokers) – heavy use suggests some adverse effects.

The good news is that when you smoke moderately, your lungs appear to be fine. Of course, smoke causes inflammation and can cause coughing, but unlike tobacco, cannabis smoke does not appear to negatively affect the lungs when consumed in moderation.

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