The Danger of Cannabis Smoking on Respiratory Health: A Comprehensive Review

Introduction

Despite the growing popularity of cannabis (marijuana) and its legalization in some places, its consumption, particularly through smoking, is not free from health risks – notably to the respiratory system. A comprehensive review in the Respiratory Medicine journal has shed light on the gravity of the situation, emphasizing the need for public awareness and healthcare provider readiness to address cannabis smoking cessation.

The State of Cannabis Use

With estimates showing 120-250 million users globally, the liberal attitude toward cannabis has contributed to a notable rise in its use. Methods of consumption such as joints, blunts, bongs, and vaporisers deliver not only the psychoactive THCs but also a host of other chemicals – some with potentially harmful consequences when inhaled.

Bronchial and Lung Concerns

The review details that cannabis smoke can lead to chronic bronchitis, coughing, wheezing, and other respiratory symptoms. It causes airway inflammation and remodelling reminiscent of tobacco-related damage. Moreover, it is associated with bullous lung disease, spontaneous pneumothorax, and hypersensitivity pneumonitis.

Asthma and Respiratory Infections

Cannabis smokers with asthma are more likely to exhibit poor disease control. Additionally, smokers are at risk for various respiratory infections. Cases of invasive pulmonary aspergillosis have been particularly concerning, even in immunocompetent individuals, due to cannabis's immunosuppressive effects.

Lung Cancer Link

Another alarming finding is the apparent link between cannabis smoking and lung cancer. Studies suggest that substances found in cannabis smoke, akin to those in tobacco smoke, might play a role in carcinogenesis, with younger individuals at risk as well.

COPD and Other Lung Ailments

Contrastingly, no clear link between Cannabis Use Disorder and Chronic Obstructive Pulmonary Disease (COPD) has been established. However, the review hasn't ruled out the possibility of cannabis-related lung damage, considering patterns different from tobacco-induced effects.

EVALI: The Vaping Warning

Highlighting recent concerns, the epidemic of EVALI (e-cigarette or vaping product use-associated lung injury) has been associated with the inhalation of vaporized cannabis oil, underscoring the perils of unregulated vaping practices.

Conclusion

This review sends a clear message: cannabis smoking poses significant risks to respiratory health. The normalization of its use without comprehensive understanding of its long-term effects is a call for caution. Healthcare providers must be equipped to educate and assist with smoking cessation to mitigate these risks.

Further Research and Policies

Future studies should focus on understanding the full extent of respiratory health impacts, considering age, dosage, and methods of cannabis consumption. Policies legalizing recreational use require careful reassessment in light of these findings.

A Critical Note

The therapeutic benefits of orally consumed cannabis in treating various health conditions are acknowledged; however, the focus here is on the prevalent and much riskier practice of cannabis smoking.

For further reading, refer to the original article in Respiratory Medicine, vol. 221 (2024), 107494, available online at elsevier.com/locate/rmed.

Credit and Acknowledgments

The article was conceptualized and written by a multi-national team led by Lugain Khoj et al, thanking Manar Yousef for graphic assistance.

Article Written with the help of Buoy Health.