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Marijuana and chronic obstructive lung disease: a population-based study.
CMAJ. 2009 Apr 14; 180(8):814-20.CMAJ

Abstract

BACKGROUND

Our aim was to determine the combined and independent effects of tobacco and marijuana smoking on respiratory symptoms and chronic obstructive pulmonary disease (COPD) in the general population.

METHOD

We surveyed a random sample of 878 people aged 40 years or older living in Vancouver, Canada, about their respiratory history and their history of tobacco and marijuana smoking. We performed spirometric testing before and after administration of 200 microg of salbutamol. We examined the association between tobacco and marijuana smoking and COPD.

RESULTS

The prevalence of a history of smoking in this sample was 45.5% (95% confidence interval [CI] 42.2%-48.8%) for marijuana use and 53.1% (95% CI 49.8%-56.4%) for tobacco use. The prevalence of current smoking (in the past 12 months) was 14% for marijuana use and 14% for tobacco use. Compared with nonsmokers, participants who reported smoking only tobacco, but not those who reported smoking only marijuana, experienced more frequent respiratory symptoms (odds ratio [OR] 1.50, 95% CI 1.05-2.14) and were more likely to have COPD (OR 2.74, 95% CI 1.66-4.52). Concurrent use of marijuana and tobacco was associated with increased risk (adjusted for age, asthma and comorbidities) of respiratory symptoms (OR 2.39, 95% CI 1.58-3.62) and COPD (OR 2.90, 95% CI 1.53-5.51) if the lifetime dose of marijuana exceeded 50 marijuana cigarettes. The risks of respiratory symptoms and of COPD were related to a synergistic interaction between marijuana and tobacco.

INTERPRETATION

Smoking both tobacco and marijuana synergistically increased the risk of respiratory symptoms and COPD. Smoking only marijuana was not associated with an increased risk of respiratory symptoms or COPD.

Authors+Show Affiliations

iCapture Centre for Cardiovascular and Pulmonary Research, St. Paul's Hospital and the University of British Columbia, Vancouver, Canada. wtan@mrl.ubc.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19364790

Citation

Tan, Wan C., et al. "Marijuana and Chronic Obstructive Lung Disease: a Population-based Study." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 180, no. 8, 2009, pp. 814-20.
Tan WC, Lo C, Jong A, et al. Marijuana and chronic obstructive lung disease: a population-based study. CMAJ. 2009;180(8):814-20.
Tan, W. C., Lo, C., Jong, A., Xing, L., Fitzgerald, M. J., Vollmer, W. M., Buist, S. A., & Sin, D. D. (2009). Marijuana and chronic obstructive lung disease: a population-based study. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 180(8), 814-20. https://doi.org/10.1503/cmaj.081040
Tan WC, et al. Marijuana and Chronic Obstructive Lung Disease: a Population-based Study. CMAJ. 2009 Apr 14;180(8):814-20. PubMed PMID: 19364790.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Marijuana and chronic obstructive lung disease: a population-based study. AU - Tan,Wan C, AU - Lo,Christine, AU - Jong,Aimee, AU - Xing,Li, AU - Fitzgerald,Mark J, AU - Vollmer,William M, AU - Buist,Sonia A, AU - Sin,Don D, AU - ,, PY - 2009/4/15/entrez PY - 2009/4/15/pubmed PY - 2009/5/5/medline SP - 814 EP - 20 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 180 IS - 8 N2 - BACKGROUND: Our aim was to determine the combined and independent effects of tobacco and marijuana smoking on respiratory symptoms and chronic obstructive pulmonary disease (COPD) in the general population. METHOD: We surveyed a random sample of 878 people aged 40 years or older living in Vancouver, Canada, about their respiratory history and their history of tobacco and marijuana smoking. We performed spirometric testing before and after administration of 200 microg of salbutamol. We examined the association between tobacco and marijuana smoking and COPD. RESULTS: The prevalence of a history of smoking in this sample was 45.5% (95% confidence interval [CI] 42.2%-48.8%) for marijuana use and 53.1% (95% CI 49.8%-56.4%) for tobacco use. The prevalence of current smoking (in the past 12 months) was 14% for marijuana use and 14% for tobacco use. Compared with nonsmokers, participants who reported smoking only tobacco, but not those who reported smoking only marijuana, experienced more frequent respiratory symptoms (odds ratio [OR] 1.50, 95% CI 1.05-2.14) and were more likely to have COPD (OR 2.74, 95% CI 1.66-4.52). Concurrent use of marijuana and tobacco was associated with increased risk (adjusted for age, asthma and comorbidities) of respiratory symptoms (OR 2.39, 95% CI 1.58-3.62) and COPD (OR 2.90, 95% CI 1.53-5.51) if the lifetime dose of marijuana exceeded 50 marijuana cigarettes. The risks of respiratory symptoms and of COPD were related to a synergistic interaction between marijuana and tobacco. INTERPRETATION: Smoking both tobacco and marijuana synergistically increased the risk of respiratory symptoms and COPD. Smoking only marijuana was not associated with an increased risk of respiratory symptoms or COPD. SN - 1488-2329 UR - https://www.unboundmedicine.com/medline/citation/19364790/Marijuana_and_chronic_obstructive_lung_disease:_a_population_based_study_ L2 - http://www.cmaj.ca/cgi/pmidlookup?view=long&pmid=19364790 DB - PRIME DP - Unbound Medicine ER -