JAMA: Long-Term Exposure To Cannabis Smoke Is Not Associated With Adverse Effects On Pulmonary FunctionJanuary 10, 2012
Exposure to cannabis smoke, even over the long-term, is not associated with adverse effects on pulmonary function. That’s the conclusion of a major clinical trial published today in the prestigious Journal of the American Medical Association (JAMA).
Investigators at the University of California, San Francisco analyzed the association between marijuana exposure and pulmonary function over a 20 year period in a cohort of 5,115 men and women in four US cities.
Predictably, researchers “confirmed the expected reductions in FEV1 (forced expiratory volume in the first second of expiration) and FVC (forced vital capacity)” in tobacco smokers. By contrast, “Marijuana use was associated with higher FEV1 and FVC at the low levels of exposure typical for most marijuana users. With up to 7 joint-years of lifetime exposure (eg, 1 joint/d for 7 years or 1 joint/wk for 49 years), we found no evidence that increasing exposure to marijuana adversely affects pulmonary function.”
The study concludes, “Our findings suggest that occasional use of marijuana … may not be associated with adverse consequences on pulmonary function.”
To those familiar with the science of cannabis, JAMA’s findings should come as no great surprise. They are consistent with previous findings reporting no significant decrease in pulmonary function associated with moderate cannabis smoke exposure. For instance, according to a 2007 literature review conducted by researchers at the Yale University School of Medicine and published in the Archives of Internal Medicine (and summarized by NORML here), cannabis smoke exposure is not associated airflow obstruction (emphysema), as measured by airway hyperreactivity, forced expiratory volume, or other measures.
Further, in 2006, the results of the largest case-controlled study ever to investigate the respiratory effects of marijuana smoking reported that cannabis use was not associated with lung-related cancers, even among subjects who reported smoking more than 22,000 joints over their lifetime. (Read NORML’s summary of this study here.)
“We hypothesized that there would be a positive association between marijuana use and lung cancer, and that the association would be more positive with heavier use,” the study’s lead researcher, Dr. Donald Tashkin of the University of California at Los Angeles stated. “What we found instead was no association at all, and even a suggestion of some protective effect” among marijuana smokers who had lower incidences of cancer compared to non-users.
A previous 1997 retrospective cohort study consisting of 64,855 examinees in the Kaiser Permanente multiphasic health checkup in San Francisco and Oakland also reported, “[E]ver- and current use of marijuana were not associated with increased risk of cancer … of the following sites: colorectal, lung, melanoma, prostate, breast, cervix.”
Separate studies of cannabis smoke and pulmonary function have indicated that chronic exposure may be associated with an increased risk of certain respiratory complications, including cough, bronchitis, phlegm. However, the ingestion of cannabis via alternative methods such as edibles, liquid tinctures, or via vaporization — a process whereby the plant’s cannabinoids are heated to the point of vaporization but below the point of combustion –- virtually eliminates consumers’ exposure to such unwanted risk factors and has been determined to be a ‘safe and effective’ method of ingestion in clinical trial settings.
Unlike Tennessee Congressman Steve Cohen (who favors America having a fair and constitutionally consistent cannabis policy…), the current Speaker of the House of Representatives, John Boehner, simply does not get how hypocritical he is by favoring another 74 years of the failed federal Cannabis Prohibition, while at the same time, being a frequent consumer (and longtime political ally) of far more dangerous and deadly drugs like alcohol and tobacco.
A NORML supporter from Ohio named Todd recently used NORML’s webpage to contact his elected representative in Congress, who just so happens to be the Speaker of the House John Boehner, to encourage him to become a co-sponsor of the Ron Paul/Barney Frank bill to allow states to legalize cannabis for responsible adult use.
What Todd did was exactly what tens of thousands of other like-minded NORML supporters have done since late June, when H.R. 2306 was introduced: they contacted their member of Congress and asked them to support the passage of H.R. 2306.
What cannabis reformers and consumers really need to do now is to send hundreds of thousands of letters and emails to their members of Congress, and to, like Todd, not take ‘no’ for an answer, especially from hypocrites like Speaker Boehner, who maybe one of the capital’s most notorious tobacco addicts and consumer of hard liquor.
Last October at a fancy Washington restaurant in a section of town called ‘Barracks Row’, a week or so before his ascendency to the Speakership of the House, High Times’ associate publisher Rick Cusick and I watched Mr. Boehner (and five or six of his fellow Republican colleagues from the House, and one from the Senate) continuously leave their table–after rounds of shot glasses of hard liquor were consumed–to stand out in front of the establishment in a circle to smoke cigarettes. We witnessed this kind of excessive ‘drug’ consumption from Congressional leaders for over two hours.
Mr. Boehner, the son of a bar owner in Ohio, needs to get real and quick regarding losing his Reefer Madness about cannabis and to start treating cannabis consumers with the same respect and dignity that he wants afforded to him as a tobacco and alcohol consumer.
If not, then, based on his unscientific and non-sensible reply to his constituent in Ohio found below, the man should 1.) stop buying and consuming clearly deadly and dangerous drugs like hard booze and cigarettes and 2.) pass federal laws banning these unhealthy and unsafe products from people who’d be foolish enough to consume them.
NORML thanks ‘Todd’ from Ohio for being a stand up cannabis law reformer who is not keen to be governed by a hypocrite (who would have him consume drugs much, much less safe—and toxic—than cannabis. Just like him….).
Boehner writes below: “I am unalterably opposed to the legalization of marijuana or any other FDA Schedule I drug. I remain concerned that legalization will result in increased abuse of all varieties of drugs, including alcohol.”
Maybe the Speaker of the House is speaking for himself here as both the science and my own personal experience is crystal clear here: When adults consume cannabis products they consume less—or no—alcohol products.
I, for one, have always publicly acknowledged that I consume far less alcohol (and don’t binge drink at all) if I have access to cannabis products.
Further, in the twenty years I’ve worked at NORML and convening dozens of major pro-reform conferences, fundraising parties and events I’ve watched bar managers, restaurant owners and hotel catering managers from coast-to-coast do major double and triple takes on our alcohol consumption bills, insisting that there must be some kind of billing error. When, in fact, if 500 cannabis consumers are attending a NORML soiree, we as a group consume 50%-75% less alcohol than similar size events.
At a large and famous San Francisco waterfront restaurant that hosted a NORML event a few years back, when I went into the manager’s office at the end of the night to settle the final bill and remit payment, he too was flabbergasted at the dearth of our large group’s alcohol consumption tab and wryly remarked to me: “No wonder ya’ll can’t get pot legalized, because, you’ll cut too deeply into the alcohol industry’s bottom line.”
The process to lobby your member of Congress is easy, free and necessary to finally—and once and for all—end Cannabis Prohibition in America.
Wed, Aug 24, 2011 at 1:19 PM, Congressman John Boehner wrote:
Thank you for contacting me regarding the legalization of marijuana. I appreciate hearing from you.
On June 23, 2011, Representative Barney Frank (D-MA) introduced H.R. 2306, the Ending Federal Marijuana Prohibition Act of 2011. H.R. 2306 would remove marijuana from Schedule I of the Controlled Substances Act to provide states with jurisdiction in the regulation of marijuana. H.R. 2306 has been referred to the House Committees on the Judiciary and Energy and Commerce for consideration.
According to the Office of National Drug Control Policy (ONDCP), “research shows that marijuana use in its raw form is harmful and its average potency has tripled in the past 20 years.” ONDCP goes on to say that “studies also show teens are using the drug at earlier ages and the earlier a person begins to use drugs, the more likely they are to progress to more serious abuse and addiction.” In addition, the Department of Health and Human Services stated that “marijuana dependence in the U.S. population is higher than that for any other illicit drug and over 150,000 people who showed up voluntarily at treatment facilities in 2009 reported marijuana as their primary substance of abuse.”
As you know, the Food and Drug Administration (FDA) has classified marijuana, together with heroin, LSD, methamphetamines, hashish, and a number of other drugs as Schedule I drugs. According to the FDA, these drugs carry a high potential for dangerous abuse. To date, no clinical study of marijuana has progressed to the level required for approval by the FDA. Even more, the Department of Justice has reiterated its intent to enforce the Controlled Substances Act in states who have legalized marijuana for medicinal purposes.
I am unalterably opposed to the legalization of marijuana or any other FDA Schedule I drug. I remain concerned that legalization will result in increased abuse of all varieties of drugs, including alcohol.
Thank you again for contacting me with your thoughts. Please don’t hesitate to inform me of your concerns in the future. To sign up for email updates, I invite you to visit my website at http://johnboehner.house.gov.
John A. Boehner
* * * * * * * * *
Dear John Boehner,
Wow thats a mouthful did someone write that for you. Your seriously trying to tell me that marijuana is as harmful as lsd, crack, methamphetamines, cocaine,legal sildenafil,merinol and other “chemicals” when marijuana is a plant which is nearly impossible to overdose. You sir are uninformed as are most of our “representatives”, who, are supposed to represent the interest of the people, but end up representing their own interests entirely. I would think that given our current economic crisis, it would be ideal to look objectively at every opportunity to decrease frivolous spending, and increase revenue. By legalizing and taxing marijuana on a federal level, the taxes alone are estimated at billions of dollars annually. Given the annual cost of the failed war on drugs and incarcerated nonviolent marijuana users, the annual savings plus revenue could reach in the hundreds of billions of dollarsNot to mention the tens of thousands of jobs legalizing marijuana would create. This is common sense knowledge and neither you nor the “F.D.A.” can tell me otherwise.
As for your statement ” I remain concerned that legalization will result in increased abuse of all varieties of drugs, including alcohol.” Please elaborate as I do not understand how the legalization and regulation of marijuana on a federal level, will result in increased abuse of other drugs and alcohol. Regulating marijuana will not only decrease it’s availability on the black market, but will also decrease its value, therefore being less available, and of less interest, to teens and other underage people.
On the subject of the Department of Health and Human Services statement that “marijuana dependence in the U.S. population is higher than that for any other illicit drug and over 150,000 people who showed up voluntarily at treatment facilities in 2009 reported marijuana as their primary substance of abuse.” What this statement does not tell you is that roughly 97% of these 150,000 people “voluntarily” showed up because they were given an ultimatum by the courts when found in possesion of marijuana, rather than face probation, or even worse, jail time.
How about the statement made by Francis Young, the D.E.A.s’ own judge, ”Marijuana in it’s natural form, is one of the safest therapeutically active substances known to man.” If marijuana is considered a schedule I narcotic with no medicinal benefits, why do we have Marinol, the synthetic form of T.H.C. (tetrahydrocannabinol), the main psycoactive substance found in marijuana?. And why is the “chemical” Marinol a schedule III drug, meaning it is considered to be non-narcotic and to have a low risk of physical or mental dependence, when it is another form of T.H.C.?. There has never been a documented human fatality from overdosing on tetrahydrocannabinol or cannabis in its natural form. However, the synthetic T.H.C. pill Marinol was cited by the FDA as being responsible for 4 of the 11,687 deaths from 17 different FDA approved drugs between January 1, 1997 to June 30, 2005.
I would appreciate a personal response from you, rather than one of your pre-writen responses. Thank you for your time.
Drug Czar Blames Rising Teen Pot Use On Medical Cannabis Laws Rather Than On His Own Failed PoliciesDecember 14, 2010
[UPDATE! I have a revised version of this blog post online now on The Hill.com's Congress blog. This is the website where Washington DC insiders go to blog. Click here to read my op/ed, and when you are done please leave a polite comment for the Drug Czar.]
Since 1975 the University of Michigan at Ann Arbor has been tracking students self-reported use of cannabis and other intoxicants, and every year their use of these substances trends either up or down from the prior survey. Predictably, when self-reported use goes down, drug war lackeys like Drug Czar Gil Kerlikowske claim that drug prohibition is working. Conversely, when use trends upward — as it did this past year — drug warriors respond by pointing the blame at everyone else.
Teenagers are beginning to think of marijuana as medicine, and more and more young people are toking up as a result, White House drug czar Gil Kerlikowske argues upon the release of a major survey on teenage drug use.
The 2010 Monitoring the Future Survey queried 50,000 eighth, 10th and 12th graders about their use of, and attitudes toward, illicit drugs.
The Office of National Drug Control Policy survey found that daily pot use among high school seniors is at 6.1 percent, its highest point since the early 1980s. In the past month, 21.4 percent of 12th graders said they had used marijuana, continuing an upward tick that began in the middle of the decade. Monthly, more seniors now smoke pot than cigarettes, a phenomenon not seen in nearly three decades.
It’s the decreasing perception of the harm of marijuana that is leading to increased pot use, according to the drug czar.
“If young people don’t really perceive that [marijuana] is dangerous or of any concern, it usually means there’ll be an uptick in the number of kids who are using. And sure enough, in 2009, that’s exactly what we did see,” Kerlikowske told ABC News Radio.
“We have been telling young people, particularly for the past couple years, that marijuana is medicine,” the former Seattle police chief argued. “So it shouldn’t be a great surprise to us that young people are now misperceiving the dangers or the risks around marijuana.”
On the other hand, he said, a broad understanding of the harms of tobacco and alcohol has led to lower cigarette smoking and binge drinking in teens. Regular cigarette smoking continues its decline, and binge drinking (five or more drinks at one sitting) among high school seniors is down from 25.2 percent to 23.2 percent. Tougher enforcement has also contributed to these declines, Kerlikowske said.
“We know that through education and enforcement, something can be done. But I think we should also be very concerned about these marijuana numbers, particularly among these very young people,” Kerlikowske said.
Okay, let me get this straight: California enacted legislation legalizing the physician-supervised use of medical marijuana in 1996 — some fourteen years ago — thus kicking off the national debate that is still taking place today. Between 1996 and 2005, nine additional states enacted similar laws (Alaska, 1999; Colorado, 2000; Hawaii, 2000; Maine, 1999; Montana, 2004; Nevada, 2000; Oregon, 1998; Vermont, 2004; Washington, 1998). Yet, the Drug Czar claims to the national media that this discussion has only been taking place in earnest for “the past couple years”?! Does he really think the public is that stupid?!
Further, the Czar is well aware that throughout this period of time, youth-reported use of marijuana declined across the nation — including in the very same states that enacted medical cannabis access. NORML Advisory Board member Mitch Earleywine co-authored a comprehensive review of this data here, concluding: “More than a decade after the passage of the nation’s first state medical marijuana law, California’s Prop. 215, a considerable body of data shows that no state with a medical marijuana law has experienced an increase in youth marijuana use since its law’s enactment. All states have reported overall decreases – exceeding 50% in some age groups – strongly suggesting that the enactment of state medical marijuana laws does not increase marijuana use.”
Investigators at the Texas A&M Health Science Center also assessed whether the passage of medical cannabis laws encourages greater recreational use. They too found, definitively, that it does not. “Our results indicate that the introduction of medical cannabis laws was not associated with an increase in cannabis use among either arrestees or emergency department patients in cities and metropolitan areas located in four states in the USA (California, Colorado, Oregon, and Washington). … Consistent with other studies of the liberalization of cannabis laws, medical cannabis laws do not appear to increase use of the drug.”
As this government map (Marijuana Use in Past Year among Persons Age 12 or Older) so keenly illustrates, marijuana use rates as a percentage of the overall population vary only slightly among states, despite states having remarkably varying degrees of marijuana enforcement and punishments. In fact, several states with the most lenient laws regarding marijuana possession — such as Nebraska (possession of up to one ounce is a civil citation) and Mississippi (possession of up to 30 grams is a summons) — report having some of the lowest rates of marijuana use, while several states that maintain strict penalties for personal users (e.g., Rhode Island) report comparatively high levels of use. The Drug Czar is aware of this of course, yet he is forbidden by his office from ever acknowledging it publicly.
But wait, it gets even sillier. One statistic gleaned from the Monitoring the Future study that was not emphasized by the Drug Czar (for obvious reasons) was that more than eight out of ten 12th graders report that marijuana is “fairly easy” or “very easy” to get — a percentage that has remained constant for three and a half decades! So much for the notion that criminal prohibition is limiting youth marijuana access. It never has and it never will. On the other hand, Kerlikwoske concedes that the legalization, regulation, and the imposition of age restrictions on alcohol and cigarettes is associated with a reduction in teens use of those drugs. Nevertheless, the Czar irrationally brags that, when it comes to cannabis, those words are not even in his vocabulary. Seriously.
Finally, as to the Czar’s notion that teens are ‘misperceiving’ (a term that was apparently made up by Kerlikowske) the harms of marijuana compared to cigarettes and alcohol, let’s get real. Cigarette smoke is far more dangerous to humans than cannabis smoke, the latter of which has been shown to have an inverse relationship with incidences of certain types of cancer, even when consumed long-term. Further, unlike alcohol, marijuana is incapable of causing lethal overdose, is relatively nontoxic to healthy cells and organs, and its use is not typically associated with violent, aggressive, or reckless behavior. That’s why, according to the latest Rasmussen poll, fewer than one in five Americans nationwide now believe that consuming marijuana is more dangerous than drinking alcohol, and by a nearly two-to-one majority, respondents agree that marijuana is far less dangerous than smoking cigarettes. In short, the public has gotten it right even though their government keeps getting it wrong.
As for the Drug Czar and his mindless rhetoric, never forget the words of novelist Upton Sinclair, “It is difficult to get a man to understand something, when his salary depends upon his not understanding it.” In reality, Kerlikowske is not nearly as stupid as his sound bytes imply; he just assumes that you are.
Because The Hill is widely read by lawmakers and by the national media, it is vital that we demonstrate the popularity of the marijuana legalization issue by commenting prolifically. Please post your feedback to The Hill and make a point of disseminating this essay to your friends and colleagues.
According to a report released today by the Centers for Disease Control, fewer Americans are smoking cigarettes than at any time in modern history.
“The number of U.S. adults who smoke has dropped below 20 percent for the first time on record,” Reuters reported. This is less than half the percentage (42 percent) of Americans who smoked cigarettes during the 1960s.
Imagine that; in the past 40 years tens of millions of Americans have voluntarily quit smoking a legal, yet highly addictive intoxicant. Many others have refused to initiate the habit. And they’ve all made this decision without ever once being threatened with criminal prosecution and arrest, imprisonment, probation, and drug testing.
By contrast, during this same period of time, state and local police have arrested some 20 million Americans for pot law violations — primarily for violations no greater than simple possession. And yet marijuana use among the public has skyrocketed.
There’s a lesson to be learned here — if only our lawmakers were willing to listen.