|
r
<br /> a
<br /> Heavy Habitual Marijuana Smoking Does riot Cause
<br /> an Accelerated Decline in FE'V, With Age
<br /> DONALD P. TASHKIN, MICHAEL S. SIMMONS, DUANE L SHERRIII, and ANNE H. COULSON
<br /> Depsnments of Medicine and Epidemiology, UCLA Schools of'Medklne snd Public Health, Los Angeles;
<br /> and Division of Respiratory Sciences, University of Arizona College of Medicine, Tucson, Mitona
<br /> 7o assess the possibk rd~ of daily smoking of marijuana in the development of chronlc obst+uctlve
<br /> pulmonary disease (COPD), w• avakratad the cites ofhabitual use of marijuana with or witltout tobacro
<br /> on tM ageaelated change in lung function (meawrtd as fEVt) in comparison with the effect of non•
<br /> smoking and regular tobxco smoking. A convanknce sample of 394 healthy young Uucasian sdulp
<br /> {68%men; age: 33 t 6 yr; mean t SD) Including, at study entry,137 heavy, habitwl smokers of mariju•
<br /> ana aksrte,112 smokes of rrsarijwrta plus tobacco, 63 agular srrtoken of tobacco alone, and g6 non-
<br /> smoker of either substance wan rewind from the grease Los MgNae community. FEVt wa s mea•
<br /> sured in all 394 particlpaMS at study entryand In 2SS wbjacts (a5 on up to six additional occasbns
<br /> at Intervals of i 1 yr (1.7 s: 1.1 yr) over a period of g yr. Random<ffects models wen used to estimate
<br /> mean rtes f darJlne in FEVt and to compare these rase between smoking groups. Nlhough men
<br /> showed a sI~nlRUnt affect of tobacco on fEVt dadlne (p < O.OS), In Walther men nor women was
<br /> marijwea smoking assotlated with greater declines In FEVs than was nonsmoking, nor was an addl-
<br /> Uva effect of marljwna and tobacro noted, or a signifkant alattonshlp found between the number
<br /> of marijwna cigarettes smoked per day and the ran of decline in FEVt. Wa conclude that regular
<br /> lobpcco, but not maHjwna, smoking is assoriand with greats annual rtes o(decAna to lung function
<br /> than Is nonsmoking. 7lrasa Rndinys do not support an assoctadon between regular marijuana smakirtg
<br /> and chronk COPD but do not exclude the passibility of other adverse aspiratory effscts. Tashkln DP,
<br /> Slmmaats MS, flrarr111 DI, tou(wn AN. Haag hablWal tssarQwna smoking dose not cause an
<br /> accaleratad dadlne In t~1f1 svlth aye. ar r titarta can tar tats tarrsuna[•tw.
<br /> Marijuana remains [he moat commonly smokeddpdt subsnnce of marijuana smoker (goblet-cell roetaDlasis, reserve-eel! hyper-
<br /> in AmeriaD society (I, 2). After more titan a decade of declin- ptasla, squamous metaplasia) (I?, 18) that ue consistent with
<br /> ing prevalence of marijuans ux in she Uai[ed States, an upswing symptoms of mucus hypersecrtion.
<br /> in is ttsehas recently been demodstnted, espedally among ytwng In eoetnu m the concordance of fmdings in recent studies
<br /> individuals (1, 2). Because the COnalilarnia of marijuana smoke with respett to the Impact of regular marijuana smoking on
<br /> aresimilsrlnmatryrespectstolhoaeoPwbacro(3,4),i[upttssi• chrordctespfatorysymptoms,ctross•sectlonalstudiesofmariju•
<br /> ble that habitual smoking of marijuana may lead to some of the ana uses in I,oe Angeles (15) and of smoker of nontobacco (pre-
<br /> same respiratory effau that derive from regular tobacco use. sumably and hereafter referred to as roarljuana) in Tlraon (16)
<br /> ThbDOSSibilityissupportedbysevenltsnlmalandeellularuudles, have revealedconNctingeffeetsonlungfunttion.TheLosAn-
<br /> which have shown [hat chronlc exposure to marquess smoke geles study (t3) felled to demonstrate arty rclalionshio between
<br /> can Injure respiratory tissue (S-9). Ahhough earlier studies in marijuanA use and impairment in testa of lung tunctlon, includ-
<br /> humans yielded conlticUng data about the associa[lon ttetween ing xnsltive indlea of smelt airways dysfunction, whereas the
<br /> heavy marijuaru smoking snd tUnleal evidence of respiratory Tucson study (l6) demonstrated obstruttlve ven[lla[ory deftxu
<br /> illness pt)-r4), more resent eliaicat studies have demonsvatetl a additive to thox attribuuble to regular toboceo ux Recent anal-
<br /> relatlonshlp between habitual marijuana use and symptoms of ysis of longitudinal data from the lUcson study (19) estimated
<br /> chronic bronchitis(15,16). Moreover, histopatbobgic studieshave significant decrements In PE V, in continuing male (but na fe-
<br /> revealed epithelial al[entiona rn biopsinfrom proximal bronchi male) marijuana smokes ? I yr after marijuana smoking was
<br /> first reDOrted. hiorcove4 these decrements were twice as large
<br /> as the estimated decrements in continuing tobacco smokers, and
<br /> the effects of both habits were additive. The latter data suggest
<br /> (ascvired h afpinol ram Aorii 3, r996 std in mired roan rune 1d, try6) that marijWM smoking might be a significant rifle factor for
<br /> SuvP~d by Grant No. sot D,W)ote from the nstlonet insnorles or Progressive airflow olsatructlon.
<br /> MotthlN,uanN tmettuu an aua Muse. To further evaluate the possibility that continuing marijuana
<br /> eamspondena+na raquesn for reprwro shwid be addressed a twnad v. smoking might lead to progressive declines in lung tunctlon not
<br /> rashLtn, M.D., Dep.nmenl of MWklne, l1CU ktroot of Medsone, ten M- con3iStently apparent in C(09YSactiOnal tllldler, we invited non-
<br /> gets. sooss-taco. smoker and smokers of maryuana and/or tobacco who wire
<br />
<br /> ~I++~Ptr4tt6nMed VdtiS,ppsal-110.1997 partidpantsinarohOrtatudyofthapulmonaryeffecttofhabitual
<br />
<br />
|