Frequent Cannabis Use Increases Risk for Lung Diseases - Medscape

BOSTON — Daily cannabis use may raise the risk of developing chronic diseases such as asthma and chronic obstructive pulmonary disease (COPD), according to the research presented at the Society of General Internal Medicine (SGIM) 2024 Annual Meeting.

The abstract adds to a growing body of evidence suggesting that smoking cannabis, much like tobacco, poses significant risks to respiratory health, according to Alison Rustagi, MD, PhD, an assistant professor at the University of California, San Francisco, and a primary care physician in the Division of General Internal Medicine at the San Francisco VA Medical Center, who presented the research at SGIM.

"Our research indicates that cannabis use is not benign," Rustagi said. "It's crucial for both the public and healthcare providers to recognize cannabis use as a potential risk factor for chronic lung diseases."

Rustagi and her team analyzed cross-sectional data from over 434,000 adults who completed surveys on risk-taking behaviors from 2016 to 2020. They sought to investigate the relationship between cannabis use and the diagnosis of asthma and COPD.

The preliminary findings showed that people who smoke cannabis daily are at a higher risk of developing respiratory conditions than nonusers. Among adults between ages 18 and 34 years, daily cannabis use was associated with a 34% increased odds of developing asthma in their lifetime (adjusted odds ratio [aOR], 1.34; 95% CI, 1.15-1.55), a 39% increased odds of currently having asthma (aOR, 1.39; 95% CI, 1.14-1.69), and a 56% higher odds of developing COPD (aOR, 1.56; 95% CI, 1.13-2.14). Similar associations were observed in adults over the age of 35 years.

"People should be empowered to make informed decisions with relation to their health; they need to know that consumption of cannabis may carry risk," said Daniel Levey, PhD, an assistant professor of psychiatry at the Yale School of Medicine in New Haven, Connecticut, who was not involved in the current study.

Previous studies suggest that marijuana smoke contains toxins and carcinogens similar to those in tobacco smoke and has been linked to lung cancer in individuals independent of their tobacco use.

The study also highlighted a dose-response relationship, in which even people who smoked cannabis less frequently had an increased risk for respiratory issues, although lower than daily users. This pattern was consistent even among individuals who had never smoked cigarettes.

Cannabis is the second most commonly smoked substance after tobacco in the United States, according to the American Thoracic Society. Cannabis is smoked using pipes, bongs, paper-wrapped joints, blunts, and other devices including those that vaporize marijuana such as e-cigarettes.

Levy said the findings serve as a warning for clinicians and public health officials that cannabis consumption, especially as legalization and social acceptance spreads, comes with health risks.

"We exist in polarizing times, and people who seek data confirming their expectations will find plenty of evidence in support of possible positive effects of cannabis; potential for harm from use is very real and should be weighed against any perceived benefits," Levey said.

Levey, who studies cannabis use disorder, said while research is pointing toward marijuana smoking-related harms, more studies are needed on the health outcomes of ingesting cannabis via products like gummies.

Rustagi and Levey reported no relevant disclosures.

Lara Salahi is a health journalist based in Boston.

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