CMAJ • April 14, 2009; 180 (8). doi:10.1503/cmaj.081040.
© 2009 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Research

Marijuana and chronic obstructive lung disease: a population-based study

Wan C. Tan, MB, Christine Lo, BSc, Aimee Jong, BSc, Li Xing, MSc, Mark J. FitzGerald, MB, William M. Vollmer, PhD, Sonia A. Buist, MD PhD, Don D. Sin, MD MPH for the Vancouver Burden of Obstructive Lung Disease (BOLD) Research Group

From the iCapture Centre for Cardiovascular and Pulmonary Research (Tan, Lo, Jong, Xing, Sin), St. Paul’s Hospital and the University of British Columbia, and the Vancouver General Hospital (FitzGerald), Vancouver, BC; the Oregon Health and Sciences University (Vollmer) and the Kaiser Permanente Center for Health Research (Buist), Portland, USA

Correspondence to: Dr. Wan C. Tan, University of British Columbia, iCapture Centre for Cardiovascular and Pulmonary Research, St. Paul’s Hospital, 1081 Burrard St., Vancouver BC V6Z 1Y6; fax 604 806-8351; wtan{at}mrl.ubc.ca

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 µg 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.


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D. P. Tashkin
Does smoking marijuana increase the risk of chronic obstructive pulmonary disease?
Can. Med. Assoc. J., April 14, 2009; 180(8): 797 - 798.
[Full Text] [PDF]