To compare the pulmonary hazards of smoking marijuana and tobacco, we quantified the relative burden to the lung of insoluble particulates (tar) and carbon monoxide from the smoke of similar quantities of marijuana and tobacco. The 15 subjects, all men, had smoked both marijuana and tobacco habitually for at least five years. We measured each subject's blood carboxyhemoglobin level before and after smoking and the amount of tar inhaled and deposited in the respiratory tract from the smoke of single filter-tipped tobacco cigarettes (900 to 1200 mg) and marijuana cigarettes (741 to 985 mg) containing 0.004 percent or 1.24 percent delta 9-tetrahydrocanabinol. As compared with smoking tobacco, smoking marijuana was associated with a nearly fivefold greater increment in the blood carboxyhemoglobin level, an approximately threefold increase in the amount of tar inhaled, and retention in the respiratory tract of one third more inhaled tar (P less than 0.001). Significant differences were also noted in the dynamics of smoking marijuana and tobacco, among them an approximately two-thirds larger puff volume, a one-third greater depth of inhalation, and a fourfold longer breath-holding time with marijuana than with tobacco (P less than 0.01). Smoking dynamics and the delivery of tar during marijuana smoking were only slightly influenced by the percentage of tetrahydrocanabinol. We conclude that smoking marijuana, regardless of tetrahydrocannabinol content, results in a substantially greater respiratory burden of carbon monoxide and tar than smoking a similar quantity of tobacco.
Source Information
Department of Medicine, University of California, Los Angeles School of Medicine 90024.
This article has been cited by other articles:
Berthiller, J., Lee, Y.-c. A., Boffetta, P., Wei, Q., Sturgis, E. M., Greenland, S., Morgenstern, H., Zhang, Z.-F., Lazarus, P., Muscat, J., Chen, C., Schwartz, S. M., Eluf Neto, J., Wunsch Filho, V., Koifman, S., Curado, M. P., Matos, E., Fernandez, L., Menezes, A., Daudt, A. W., Ferro, G., Brennan, P., Hashibe, M.
(2009). Marijuana Smoking and the Risk of Head and Neck Cancer: Pooled Analysis in the INHANCE Consortium. Cancer Epidemiol. Biomarkers Prev.
18: 1544-1551
[Abstract][Full Text]
Aldington, S., Harwood, M., Cox, B., Weatherall, M., Beckert, L., Hansell, A., Pritchard, A., Robinson, G., Beasley, R., on behalf of the Cannabis and Respiratory Disease,
(2008). Cannabis use and risk of lung cancer: a case-control study. Eur Respir J
31: 280-286
[Abstract][Full Text]
Lange, P.
(2007). Cannabis and the lung. Thorax
62: 1036-1037
[Full Text]
Aldington, S., Williams, M., Nowitz, M., Weatherall, M., Pritchard, A., McNaughton, A., Robinson, G., Beasley, R.
(2007). Effects of cannabis on pulmonary structure, function and symptoms. Thorax
62: 1058-1063
[Abstract][Full Text]
Mehra, R., Moore, B. A., Crothers, K., Tetrault, J., Fiellin, D. A.
(2006). The association between marijuana smoking and lung cancer: a systematic review.. Arch Intern Med
166: 1359-1367
[Abstract][Full Text]
Sarafian, T. A., Habib, N., Oldham, M., Seeram, N., Lee, R.-P., Lin, L., Tashkin, D. P., Roth, M. D.
(2006). Inhaled marijuana smoke disrupts mitochondrial energetics in pulmonary epithelial cells in vivo. Am. J. Physiol. Lung Cell. Mol. Physiol.
290: L1202-L1209
[Abstract][Full Text]
Chapman, K. R., Mannino, D. M., Soriano, J. B., Vermeire, P. A., Buist, A. S., Thun, M. J., Connell, C., Jemal, A., Lee, T. A., Miravitlles, M., Aldington, S., Beasley, R.
(2006). Epidemiology and costs of chronic obstructive pulmonary disease. Eur Respir J
27: 188-207
[Full Text]
Deusch, E., Kress, H. G., Kraft, B., Kozek-Langenecker, S. A.
(2004). The Procoagulatory Effects of Delta-9-Tetrahydrocannabinol in Human Platelets. Anesth. Analg.
99: 1127-1130
[Abstract][Full Text]
Gross, D. W., Hamm, J., Ashworth, N. L., Quigley, D.
(2004). Marijuana use and epilepsy: Prevalence in patients of a tertiary care epilepsy center. Neurology
62: 2095-2097
[Abstract][Full Text]
Rosenblatt, K. A., Daling, J. R., Chen, C., Sherman, K. J., Schwartz, S. M.
(2004). Marijuana Use and Risk of Oral Squamous Cell Carcinoma. Cancer Res.
64: 4049-4054
[Abstract][Full Text]
Sarafian, T. A., Kouyoumjian, S., Khoshaghideh, F., Tashkin, D. P., Roth, M. D.
(2003). Delta 9-Tetrahydrocannabinol disrupts mitochondrial function and cell energetics. Am. J. Physiol. Lung Cell. Mol. Physiol.
284: L298-L306
[Abstract][Full Text]
Roth, M. D., Marques-Magallanes, J. A., Yuan, M., Sun, W., Tashkin, D. P., Hankinson, O.
(2001). Induction and Regulation of the Carcinogen-Metabolizing Enzyme CYP1A1 by Marijuana Smoke and Delta 9-Tetrahydrocannabinol. Am. J. Respir. Cell Mol. Bio.
24: 339-344
[Abstract][Full Text]
ASHTON, C. H.
(2001). Pharmacology and effects of cannabis: a brief review. Br. J. Psychiatry
178: 101-106
[Abstract][Full Text]
Zhu, L. X., Sharma, S., Stolina, M., Gardner, B., Roth, M. D., Tashkin, D. P., Dubinett, S. M.
(2000). {Delta}-9-Tetrahydrocannabinol Inhibits Antitumor Immunity by a CB2 Receptor-Mediated, Cytokine-Dependent Pathway. J. Immunol.
165: 373-380
[Abstract][Full Text]
Cunnington, D., Teichtahl, H., Hunt, J. M., Dow, C., Valentine, R.
(2000). Necrotizing Pulmonary Granulomata in a Marijuana Smoker. Chest
117: 1511-1515
[Abstract][Full Text]
Johnson, M. K, Smith, R. P, Morrison, D., Laszlo, G., White, R. J
(2000). Large lung bullae in marijuana smokers. Thorax
55: 340-342
[Abstract][Full Text]
Zhang, Z.-F., Morgenstern, H., Spitz, M. R., Tashkin, D. P., Yu, G.-P., Marshall, J. R., Hsu, T. C., Schantz, S. P.
(1999). Marijuana Use and Increased Risk of Squamous Cell Carcinoma of the Head and Neck. Cancer Epidemiol. Biomarkers Prev.
8: 1071-1078
[Abstract][Full Text]
Committee on Substance Abuse,
(1999). Marijuana: A Continuing Concern for Pediatricians. Pediatrics
104: 982-985
[Abstract][Full Text]
Tashkin, D. P.
(1999). Effects of Marijuana on the Lung and its Defenses against Infection and Cancer. School Psychology International
20: 23-37
[Abstract]
Belcher, H. M. E., Shinitzky, H. E.
(1998). Substance Abuse in Children: Prediction, Protection, and Prevention. Arch Pediatr Adolesc Med
152: 952-960
[Abstract][Full Text]
ROTH, M. D., ARORA, A., BARSKY, S. H., KLEERUP, E. C., SIMMONS, M., TASHKIN, D. P.
(1998). Airway Inflammation in Young Marijuana and Tobacco Smokers. Am. J. Respir. Crit. Care Med.
157: 928-937
[Abstract][Full Text]
Ferguson, R. P., Hasson, J., Walker, S.
(1989). Metastatic Lung Cancer in a Young Marijuana Smoker. JAMA
261: 41-42
[Abstract]
(1988). PULMONARY CONSEQUENCES OF MARIJUANA SMOKING. JWatch General
1988: 3-3
[Full Text]